Body, Mind & Spirit Articles and Latest News

Although the herb Ginkgo biloba is widely marketed and used to improve cognitive health in aging, adequate scientific evidence of its effect on long-term cognitive functioning has been lacking. In a recent study, NCCAM-funded researchers analyzed data from the Ginkgo Evaluation of Memory (GEM) study to determine ginkgo’s effect on cognitive health in older adults.

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The Texas Department of State Health Services is warning consumers, especially pregnant or breastfeeding women, to avoid consuming a traditional product called Nzu because of the potential health risks from high levels of lead and arsenic.

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Randomized trial of brief motivational treatments for pathological gamblers: More is not necessarily better.

J Consult Clin Psychol. 2009 Oct;77(5):950-60

Authors: Hodgins DC, Currie SR, Currie G, Fick GH

The efficacy of brief treatments for media-recruited pathological gamblers was tested in a randomized clinical trial design (N = 314). Two self-directed motivational interventions were compared with a 6-week waiting list control and a workbook only control. Brief motivational treatment involved a telephone motivational interview and a mailed self-help workbook. Brief motivational booster treatment involved a telephone motivational interview, a workbook, and 6 booster telephone calls over a 9-month period. Primary outcomes were gambling frequency and dollar losses. As hypothesized, brief and brief booster treatment participants reported less gambling at 6 weeks than those assigned to the control groups. Brief and brief booster treatment participants gambled significantly less often over the first 6 months of the follow-up than workbook only participants. However, the workbook only participants were as likely to have significantly reduced their losses over the year and to have not met criteria for pathological gambling. Contrary to the hypothesis, participants in the brief booster treatment group showed no greater improvement than brief treatment participants. These results provide further support for the value of brief motivational treatments for pathological gambling.

PMID: 19803574 [PubMed - indexed for MEDLINE]

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Attention training in individuals with generalized social phobia: A randomized controlled trial.

J Consult Clin Psychol. 2009 Oct;77(5):961-73

Authors: Amir N, Beard C, Taylor CT, Klumpp H, Elias J, Burns M, Chen X

The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the attention modification program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the attention control condition (ACC), the probe appeared with equal frequency in the position of the threatening and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to postassessment and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. The percentage of participants no longer meeting Diagnostic and Statistical Manual (4th ed.) criteria for GSP at postassessment was 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during 4-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia.

PMID: 19803575 [PubMed - indexed for MEDLINE]

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Competitive memory training (COMET) for treating low self-esteem in patients with eating disorders: A randomized clinical trial.

J Consult Clin Psychol. 2009 Oct;77(5):974-80

Authors: Korrelboom K, de Jong M, Huijbrechts I, Daansen P

This study evaluates a short stepwise cognitive-behavioral intervention for the treatment of low self-esteem in patients with eating disorders. Competitive memory training (COMET) for low self-esteem is based on insights and findings from experimental psychology. A total of 52 patients with eating disorders and low self-esteem were treated with COMET in a routine mental health center in addition to their regular treatment. These patients were randomized to receive 8 weeks of COMET + therapy as usual (TAU) or to receive TAU only. Differential effects in favor of COMET + TAU were found for 2 indexes of self-esteem and for 1 index of depressive mood. Shortcomings of this study and possible clinical implications are discussed.

PMID: 19803576 [PubMed - indexed for MEDLINE]

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Exploring the role of parent training in the treatment of childhood anxiety.

J Consult Clin Psychol. 2009 Oct;77(5):981-6

Authors: Khanna MS, Kendall PC

Data from a randomized clinical trial comparing the relative efficacy of individual cognitive-behavioral therapy (ICBT), family CBT (FCBT), and a family-based education/support/attention control (FESA) condition were used to examine associations between in-session therapeutic techniques related to parent training (PT) and treatment outcomes. This study explored the extent to which therapists’ use of PT techniques, specifically (a) parental anxiety management, (b) transfer of control from therapist to parent to child over child’s coping, (c) communication skills training, and (d) contingency management training, contributed to treatment outcome in family-based CBT. Children (N = 53; 31 males; 7.8-13.8 years of age; M = 10.1 years, SD = 2.3; 85% Caucasian, 9% African American, 4% Asian, 2% “other” background) with a principal anxiety disorder completed 16 sessions of CBT with their parents. The relative contributions of PT components on treatment outcome were evaluated. As hypothesized, both transfer-of-control and parental anxiety management techniques significantly contributed to improvement on clinician and parent ratings of child global functioning within FCBT. PT did not significantly contribute to improvement on measures of child anxiety. These preliminary findings suggest that when FCBT is conducted for child anxiety, PT (i.e., transfer-of-control and parental anxiety management techniques) may contribute to improvements in the child’s global functioning.

PMID: 19803577 [PubMed - indexed for MEDLINE]

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A multisite randomized effectiveness trial of motivational enhancement therapy for Spanish-speaking substance users.

J Consult Clin Psychol. 2009 Oct;77(5):993-9

Authors: Carroll KM, Martino S, Ball SA, Nich C, Frankforter T, Anez LM, Paris M, Suarez-Morales L, Szapocznik J, Miller WR, Rosa C, Matthews J, Farentinos C

Hispanic individuals are underrepresented in clinical and research populations and are often excluded from clinical trials in the United States. Hence, there are few data on the effectiveness of most empirically validated therapies for Hispanic substance users. The authors conducted a multisite randomized trial comparing the effectiveness of 3 individual sessions of motivational enhancement therapy with that of 3 individual sessions of counseling as usual on treatment retention and frequency of substance use; all assessment and treatment sessions were conducted in Spanish among 405 individuals seeking treatment for any type of current substance use. Treatment exposure was good, with 66% of participants completing all 3 protocol sessions. Although both interventions resulted in reductions in substance use during the 4-week therapy phase, there were no significant Treatment Condition x Time interactions nor Site x Treatment Condition interactions. Results suggest that the individual treatments delivered in Spanish were both attractive to and effective with this heterogeneous group of Hispanic adults, but the differential effectiveness of motivational enhancement therapy may be limited to those whose primary substance use problem is alcohol and may be fairly modest in magnitude.

PMID: 19803579 [PubMed - indexed for MEDLINE]

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Integration of social and utilitarian factors in decision making.

Emotion. 2009 Oct;9(5):599-608

Authors: Averbeck BB, Duchaine B

Decision making is influenced by social cues, but there is little understanding of how social information interacts with other cues that determine decisions. To address this quantitatively, participants were asked to learn which of two faces was associated with a higher probability of reward. They were repeatedly presented with two faces, each with a different, unknown probability of reward, and participants attempted to maximize gains by selecting the face that was most often rewarded. Both faces had the same identity, but one face had a happy expression and the other had either an angry or a sad expression. Ideal observer models predict that the facial expressions should not affect the decision-making process. Our results however showed that participants had a prior disposition to select the happy face when it was paired with the angry but not the sad face and overweighted the positive outcomes associated with happy faces and underweighted positive outcomes associated with either angry or sad faces. Nevertheless, participants also integrated the feedback information. As such, their decisions were a composite of social and utilitarian factors.

PMID: 19803582 [PubMed - indexed for MEDLINE]

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Psychological interventions for reducing pain and distress during routine childhood immunizations: a systematic review.

Clin Ther. 2009;31 Suppl 2:S77-S103

Authors: Chambers CT, Taddio A, Uman LS, McMurtry CM,

BACKGROUND: Immunizations are a common source of pain and distress for children. Psychological interventions consist of a variety of techniques for relaxing and distracting children during immunization with the goal of reducing pain and distress. OBJECTIVE: We conducted a systematic review to determine the efficacy of various psychological strategies for reducing pain and distress in children during routine immunizations. METHODS: MEDLINE, PsycINFO, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials databases were searched to identify randomized controlled trials (RCTs) and quasi-RCTs that determined the effect of psychological interventions on pain and distress during injection of vaccines in children 0 to 18 years of age, using validated child self-reported pain or observer-reported assessments of child distress or pain. We examined the efficacy of 7 psychological interventions: (1) breathing exercises; (2) suggestion; (3) child-directed distraction; (4) parent-led distraction; (5) nurse-led distraction; (6) parent coaching; and (7) combined cognitive-behavioral interventions. All meta-analyses were performed using a fixed-effects model. RESULTS: Twenty RCTs involving 1380 infants and children (1 month to 11 years of age) were included in the systematic review. Breathing exercises were effective in reducing children’s self-reported pain (standardized mean difference [SMD], -0.43; 95% CI, -0.76 to -0.09; P = 0.01), observer-rated distress (SMD, -0.40; 95% CI, -0.68 to -0.11; P = 0.007), and nurse-reported distress (SMD, -0.57; 95% CI, -0.98 to -0.17; P = 0.005). Self-reported distress ratings appeared to be lower with breathing exercises, but the difference was not statistically significant. No evidence was found to support suggestion as a psychological intervention for reducing pain associated with pediatric immunization. Child-directed distraction was effective in reducing self-reported pain (SMD, -0.28; 95% CI, -0.54 to -0.03; P = 0.03). Parent-led distraction was effective in reducing observer-rated distress (SMD, -0.50; 95% CI, -0.82 to -0.19; P = 0.002), but not other measures of pain or distress. Nurse-led distraction was effective in reducing distress ratings as assessed by the observer (SMD, -0.40; 95% CI, -0.68 to -0.12; P = 0.005), the parent (SMD, -0.37; 95% CI, -0.66 to -0.07; P = 0.01), and the nurse (SMD, -0.42; 95% CI, -0.70 to -0.14; P = 0.004). Parent coaching was effective in reducing observer-rated distress (SMD, -0.71; 95% CI, -1.02 to -0.39; P < 0.001), but not other measures of pain or distress. Combined cognitive-behavioral interventions were effective in reducing children’s self-reported pain (SMD, -0.75; 95% CI, -1.03 to -0.48; P < 0.001), observer-rated distress (SMD, -0.53; 95% CI, -0.83 to -0.23; P < 0.001), and parent-rated distress (SMD, -0.97; 95% CI, -1.37 to -0.57; P < 0.001). The methodologic quality of the included trials was generally poor, with 18 (90%) of the 20 studies rated as having a high risk of bias. CONCLUSIONS: Evidence suggests that breathing exercises, child-directed distraction, nurse-led distraction, and combined cognitive-behavioral interventions are effective in reducing the pain and distress associated with routine childhood immunizations. Although additional well-designed trials examining psychological interventions are needed, parents and health care professionals should be advised to incorporate psychological interventions to reduce the pain and distress experienced by children during immunization.

PMID: 19781437 [PubMed - indexed for MEDLINE]

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Psychiatrists’ perceptions and practices in treating patients’ obesity.

Acad Psychiatry. 2009 Sep-Oct;33(5):370-6

Authors: Lichwala-Zyla C, Price JH, Dake JA, Jordan T, Price JA

OBJECTIVE: This study identified psychiatrists’ perceptions and practices regarding advising and treating obese patients. METHODS: Questionnaires were mailed to a national random sample of 500 members of APA. A three-wave mailing was used to maximize the return rate. The questionnaire contained items on weight control based on the Stages of Change and Health Belief models, Self-Efficacy theory, and the 5As strategy. RESULTS: A total of 236 psychiatrists responded to the survey. Most did not have any formal training during medical school on treating obese patients and three-quarters evaluated their training in psychiatric residency programs on weight loss/control issues as “not adequate at all” or “not very adequate.” The majority regularly assisted their obese patients with weight management. Most psychiatrists felt confident to ask, advise, assess, assist, and arrange (5As) regarding weight loss issues and believed that doing so would result in significant weight loss. The majority were more likely to advise obese patients to lose weight when comorbid conditions were present. The most common barriers to aiding obese patients were time constraints, poor patient compliance, lack of clear guidelines and practice tools, limited medical training on the issue, and fear of offending patients. CONCLUSION: Patients can no longer afford to have their psychiatrists provide cursory assistance with obesity. Weight management training should be incorporated into psychiatric residency training and continuing education programs.

PMID: 19828848 [PubMed - indexed for MEDLINE]

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