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Ethnic group differences in substance use, depression, peer relationships, and parenting among adolescents receiving brief alcohol counseling.

J Ethn Subst Abuse. 2010 Jan;9(1):14-27

Authors: Hernandez L, Eaton CA, Fairlie AM, Chun TH, Spirito A

This study examined differences in substance use and related risk factors in a matched sample of Hispanic and White non-Hispanic adolescents receiving brief alcohol counseling. Findings revealed that the White non-Hispanic adolescents reported smoking a higher number of cigarettes per day. The Hispanic adolescents reported perceiving less acceptance from the neighborhood environment in which they live, whereas their parents reported monitoring their teens less than the parents’ of White non-Hispanic adolescents. Consistent with the findings found in community samples, the overall findings of this study suggest that Hispanic and White non-Hispanic adolescents enrolled in this alcohol intervention have similar baseline characteristics.

PMID: 20390970 [PubMed - indexed for MEDLINE]

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Critical appraisal of methods used in randomized controlled trials of treatments for temporomandibular disorders.

J Orofac Pain. 2010;24(2):139-51

Authors: Fricton JR, Ouyang W, Nixdorf DR, Schiffman EL, Velly AM, Look JO

AIMS: To evaluate the quality of methods used in randomized controlled trials (RCTs) of treatments for management of pain and dysfunction associated with temporomandibular muscle and joint disorders (TMJD) and to discuss the implications for future RCTs. METHODS: A systematic review was made of RCTs that were implemented from 1966 through March 2006, to evaluate six types of treatments for TMJD: orthopedic appliances, occlusal therapy, physical medicine modalities, pharmacologic therapy, cognitive-behavioral and psychological therapy, and temporomandibular joint surgery. A quality assessment of 210 published RCTs assessing the internal and external validity of these RCTs was conducted using the Consolidated Standards of Reporting Trials (CONSORT) criteria adapted to the methods of the studies. RESULTS: Independent assessments by raters demonstrated consistency with a mean intraclass correlation coefficient of 0.63 (95% confidence interval). The mean percent of criteria met was 58%, with only 10% of the RCTs meeting the four most important criteria. CONCLUSIONS: Much of the evidence base for TMJD treatments may be susceptible to systematic bias and most past studies should be interpreted with caution. However, a scatter plot of RCT quality versus year of publication shows improvement in RCT quality over time, suggesting that future studies may continue to improve methods that minimize bias.

PMID: 20401352 [PubMed - indexed for MEDLINE]

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Reviewing the evidence: can cognitive behavioral therapy improve outcomes for patients with chronic orofacial pain?

J Orofac Pain. 2010;24(2):163-71

Authors: Aggarwal VR, Tickle M, Javidi H, Peters S

AIMS: To review evidence for chronic orofacial pain management using cognitive behavioral therapy (CBT). METHODS: Electronic databases were searched for randomized controlled trials in which CBT was compared either alone or in combination with other forms of therapy for management of chronic orofacial pain. The quality of trials was assessed blind by three authors using a validated scale that had been specifically designed to score the quality of randomized controlled trials for psychological interventions. Author agreement was assessed using interclass correlation co_efficients. RESULTS: Fourteen potentially relevant randomized controlled trials were identified. Seven trials were excluded, leaving seven for analysis; two studies were merged as they included the same trial and therefore six trials were used in the final analysis. All but one of the randomized controlled trials identified were based on temporomandibular disorders (TMD). Scoring of the trials showed that the three raters were in close agreement, with four trials performing well (scores of 22-35) whilst the remaining two trials were poor (scores < 18). Of the four trials, one did not show any improvement with CBT prior to conservative treatment whilst the other three showed that CBT alone or in conjunction with conservative treatment improved both short-term and long-term outcomes in functional, dysfunctional, and chronic TMD patients. CONCLUSIONS: CBT, either alone or in combination with biofeedback, conservative treatment and/or self-care, can improve outcomes for patients with TMD in secondary care. However, further research is needed to assess its effectiveness in primary care and in management of other chronic orofacial pain conditions. Further, the number of sessions needed, mode of delivery, and cost-effectiveness also remain unclear.

PMID: 20401354 [PubMed - indexed for MEDLINE]

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Towards positive diagnostic criteria: a systematic review of somatoform disorder diagnoses and suggestions for future classification.

J Psychosom Res. 2010 May;68(5):403-14

Authors: Voigt K, Nagel A, Meyer B, Langs G, Braukhaus C, Löwe B

OBJECTIVES: The classification of somatoform disorders is currently being revised in order to improve its validity for the DSM-V and ICD-11. In this article, we compare the validity and clinical utility of current and several new diagnostic proposals of those somatoform disorders that focus on medically unexplained somatic symptoms. METHODS: We searched the Medline, PsycInfo, and Cochrane databases, as well as relevant reference lists. We included review papers and original articles on the subject of somatoform classification in general, subtypes of validity of the diagnoses, or single diagnostic criteria. RESULTS: Of all diagnostic proposals, only complex somatic symptom disorder and the Conceptual Issues in Somatoform and Similar Disorders (CISSD) example criteria reflect all dimensions of current biopsychosocial models of somatization (construct validity) and go beyond somatic symptom counts by including psychological and behavioral symptoms that are specific to somatization (descriptive validity). Predictive validity of most of the diagnostic proposals has not yet been investigated. However, the number of somatic symptoms has been found to be a strong predictor of disability. Some evidence indicates that psychological symptoms can predict disease course and treatment outcome (e.g., therapeutic modification of catastrophizing is associated with positive outcome). Lengthy symptom lists, the requirement of lifetime symptom report (as in abridged somatization), complicated symptom patterns (as in current somatization disorder), and imprecise definitions of diagnostic procedures (e.g., missing symptom threshold in complex somatic symptom disorder) reduce clinical utility. CONCLUSION: Results from the reviewed studies suggest that, of all current and new diagnostic suggestions, complex somatic symptom disorder and the CISSD definition appear to have advantages regarding validity and clinical utility. The integration of psychological and behavioral criteria could enhance construct and descriptive validity, and confers prospectively relevant treatment implications. The incorporation of a dimensional approach that reflects both somatic and psychological symptom severity also has the potential to improve predictive validity and clinical utility.

PMID: 20403499 [PubMed - indexed for MEDLINE]

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The central role of cognitive processes in the perpetuation of chronic fatigue syndrome.

J Psychosom Res. 2010 May;68(5):489-94

Authors: Knoop H, Prins JB, Moss-Morris R, Bleijenberg G

OBJECTIVE: Chronic fatigue syndrome (CFS) is considered to be one of the functional somatic syndromes (FSS). Cognitions and behavior are thought to perpetuate the symptoms of CFS. Behavioral interventions based on the existing models of perpetuating factors are quite successful in reducing fatigue and disabilities. The evidence is reviewed that cognitive processes, particularly those that determine the perception of fatigue and its effect on behavior, play a central role in the maintenance of symptoms. METHOD: Narrative review. RESULTS: Findings from treatment studies suggest that cognitive factors mediate the positive effect of behavioral interventions on fatigue. Increased fitness or increased physical activity does not seem to mediate the treatment response. Additional evidence for the role of cognitive processes is found in studies comparing the subjective beliefs patients have of their functioning with their actual performance and in neurobiological research. CONCLUSION: Three different cognitive processes may play a role in the perpetuation of CFS symptoms. The first is a general cognitive representation in which fatigue is perceived as something negative and aversive and CFS is seen as an illness that is difficult to influence. The second process involved is the focusing on fatigue. The third element is formed by specific dysfunctional beliefs about activity and fatigue.

PMID: 20403509 [PubMed - indexed for MEDLINE]

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Related Articles

Psychobiological differences between depression and somatization.

J Psychosom Res. 2010 May;68(5):495-502

Authors: Rief W, Hennings A, Riemer S, Euteneuer F

BACKGROUND: Comorbidity studies have shown that depression and somatization (multiple somatoform symptoms) often overlap. Therefore it has been suggested to classify at least some patients with somatization syndromes under the category of depressive disorders. We wanted to investigate whether psychobiological investigations confirm the lumping of somatization and depression, or whether psychobiological pathways favor distinguishing these disorders. METHOD: An overview is presented summarizing psychobiological studies including patients with depression and/or somatization-associated syndromes. We focus on the following topics: heritability, polymorphisms in special candidate genes, immune activation, hypothalamic-pituitary-adrenal (HPA) axis reactivity, serotonergic pathways, monoamino acids, and fatty acid concentrations. RESULTS: Immunological activation seems to be associated with specific features of somatoform disorders, namely, sickness behavior and pain thresholds. Genetic factors can also contribute to somatic complaints, e.g., via serotonergic pathways, HPA-axis response, immune activation, and other biological systems that contribute to the self-description of not being healthy. Some results indicate that psychobiological aspects of depression and somatization overlap in part (e.g., the relevance of serotonergic pathways), but there is clearly more evidence for discrepancies of psychobiological pathways in depression and somatization (e.g., the relevance of proinflammatory immune processes; HPA-axis activity; monoamino acid availability; omega-3-concentration; the role of triallelic subtypes of 5-HTTLPR). CONCLUSION: Many psychobiological pathways act differently in depression and somatization. These differences in psychobiology favor the distinction of these syndromes in classification approaches.

PMID: 20403510 [PubMed - indexed for MEDLINE]

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Reflections on paranoia.

Psychoanal Rev. 2010 Apr;97(2):231-7

Authors: Stein R

PMID: 20406054 [PubMed - indexed for MEDLINE]

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Screening for hypochondriasis with the Illness Attitude Scales.

J Pers Assess. 2010 May;92(3):260-8

Authors: Weck F, Bleichhardt G, Hiller W

The Illness Attitude Scales (IAS; Kellner, 1986, 1987) may prove highly useful for the screening of hypochondriasis. We expected the IAS subscales to be equally as effective as the 7-item short version of the Whiteley Index (Whiteley-7; Fink et al., 1999), which has previously been shown to be useful in screening for somatoform disorders. We investigated participants of a German population (n = 1,575) and 61 patients with the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnosis of hypochondriasis. The Bodily Preoccupations (BP) subscale showed high sensitivity (.92) and specificity (.90) as well as demonstrating convergent and discriminant validity. We found evidence for the superiority of the BP subscale over the Whiteley-7 in the screening of hypochondriasis.

PMID: 20408026 [PubMed - indexed for MEDLINE]

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Aggression, grief, and conflict in a patient with psychosis: an integration of psychodynamic and cognitive-behavioral perspectives.

Harv Rev Psychiatry. 2010 Jun;18(3):195-205

Authors: Shea M, Goisman RM, Greenberg R

PMID: 20415635 [PubMed - indexed for MEDLINE]

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Treatment of psychopathy: a review and brief introduction to the mental model approach for psychopathy.

Behav Sci Law. 2010 Mar;28(2):235-66

Authors: Salekin RT, Worley C, Grimes RD

Psychopathy is thought by many to be an untreatable disorder. This article puts the treatment of psychopathy into historical context and reviews research on the treatment of the disorder with adults (K = and youth (K = 5). Findings indicate that treatment for adults shows low to moderate success with three of eight studies demonstrating treatment gains. Treatment of youth appears to be more promising with six of eight studies showing treatment benefits. Although less than optimal success rates with adults, we suggest that bright line distinctions regarding the treatability of those with psychopathic characteristics from non-psychopathic individuals are inappropriate at this time. We conclude with directions for future research and briefly introduce the mental models approach for the treatment of psychopathy in youths.

PMID: 20422648 [PubMed - indexed for MEDLINE]

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