Body, Mind & Spirit Articles and Latest News

Attention training for school-aged children with ADHD: results of an open trial.

J Atten Disord. 2010 Jul;14(1):86-94

Authors: Tamm L, Hughes C, Ames L, Pickering J, Silver CH, Stavinoha P, Castillo CL, Rintelmann J, Moore J, Foxwell A, Bolanos SG, Hines T, Nakonezny PA, Emslie G

OBJECTIVE: The article discusses a feasibility study conducted to examine whether Pay Attention!, an intervention training sustained, selective, alternating, and divided attention, could be utilized in a clinical setting with children diagnosed with ADHD, and whether children who received the intervention made attention and executive functioning gains. METHOD: After a diagnostic and baseline evaluation, 23 school-aged children with ADHD participate in up to 16 sessions of Pay Attention! and the outcomes are evaluated. RESULTS: Results show the intervention is feasible to administer and acceptable to participants. Parents and clinicians rate fewer ADHD symptoms following the intervention and report improvements in executive function. Child performance on neuropsychological tests showed improvements in fluid reasoning and cognitive flexibility and working memory. CONCLUSION: The findings suggest that a randomized clinical trial of Pay Attention! is warranted to investigate its viability as a treatment for attention and executive functioning deficits in ADHD.

PMID: 19805621 [PubMed - indexed for MEDLINE]

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Decisions under distress: stress profiles influence anchoring and adjustment.

Psychol Sci. 2009 Nov;20(11):1394-9

Authors: Kassam KS, Koslov K, Mendes WB

People frequently make decisions under stress. Understanding how stress affects decision making is complicated by the fact that not all stress responses are created equal. Challenge states, for example, occur when individuals appraise a stressful situation as demanding, but believe they have the personal resources to cope, and are characterized by efficient cardiovascular reactivity and approach motivation. Threat states, in contrast, occur when situational demands are perceived to outweigh resources and are characterized by less efficient cardiovascular reactivity and withdrawal motivation. We randomly assigned participants to social-feedback conditions (i.e., positive or negative feedback) designed to engender challenge or threat, or a no-stress condition. Participants then completed an anchoring-and-adjustment questionnaire. Those assigned to the challenge condition adjusted more from self-generated anchors than those assigned to the threat condition. Cardiovascular responses mediated the relationship between condition and adjustment. This study demonstrates the importance of considering profiles of cardiovascular reactivity when examining the influence of stress on decision making.

PMID: 19843261 [PubMed - indexed for MEDLINE]

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A randomized controlled trial of a web-based early intervention for children and their parents following unintentional injury.

J Pediatr Psychol. 2010 Jul;35(6):581-92

Authors: Cox CM, Kenardy JA, Hendrikz JK

OBJECTIVE: The aim of this article was to evaluate the effectiveness of an information provision web-based early intervention via a randomized controlled trial for children and their parents following pediatric unintentional injury. METHOD: Participants were randomly assigned to an intervention (n = 29) or a control group (n = 27) following baseline measurements. Further assessment was taken at 4-6 weeks and 6 months post-trauma event. RESULTS: Analyses revealed that children within the intervention group reported improved anxiety, in comparison to a worsening of symptoms for children in the control group. Furthermore, children who had higher baseline trauma scores reported the intervention to be helpful. CONCLUSIONS: The intervention showed promising results in its ability to aid child recovery.

PMID: 19906829 [PubMed - indexed for MEDLINE]

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A randomized controlled study of parent-assisted Children’s Friendship Training with children having autism spectrum disorders.

J Autism Dev Disord. 2010 Jul;40(7):827-42

Authors: Frankel F, Myatt R, Sugar C, Whitham C, Gorospe CM, Laugeson E

This study evaluated Children’s Friendship Training (CFT), a manualized parent-assisted intervention to improve social skills among second to fifth grade children with autism spectrum disorders. Comparison was made with a delayed treatment control group (DTC). Targeted skills included conversational skills, peer entry skills, developing friendship networks, good sportsmanship, good host behavior during play dates, and handling teasing. At post-testing, the CFT group was superior to the DTC group on parent measures of social skill and play date behavior, and child measures of popularity and loneliness, At 3-month follow-up, parent measures showed significant improvement from baseline. Post-hoc analysis indicated more than 87% of children receiving CFT showed reliable change on at least one measure at post-test and 66.7% after 3 months follow-up.

PMID: 20058059 [PubMed - indexed for MEDLINE]

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Moderators of continuation phase cognitive therapy’s effects on relapse, recurrence, remission, and recovery from depression.

Behav Res Ther. 2010 Jun;48(6):449-58

Authors: Vittengl JR, Clark LA, Jarrett RB

About half of patients who respond to acute-phase cognitive therapy (CT) for major depressive disorder (MDD) will relapse/recur within 2 years; continuation-phase CT lowers this risk. We analyzed demographic, clinical, cognitive, social-interpersonal, and personality variables to clarify which patients continuation-phase CT helps to avoid relapse and recurrence and achieve remission and recovery. Participants had recurrent MDD, responded to acute-phase CT, were randomized to 8 months of continuation-phase CT (n = 41) or assessment control (n = 43), and were assessed 16 additional months (Jarrett et al., 2001). Consistent with an underlying risk-reduction model, continuation-phase CT was helpful for responders to acute-phase CT with greater risk and/or dysfunction as follows: Younger patients with earlier MDD onset who displayed greater dysfunctional attitudes and lower self-efficacy; personality traits suggesting low positive activation (e.g., reduced energy, enthusiasm, gregariousness); and transiently elevated depressive symptoms late in acute-phase CT and residual symptoms after acute-phase CT response. We emphasize the need for replication of these results before clinical application.

PMID: 20163785 [PubMed - indexed for MEDLINE]

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Visual cues as a surrogate for tactile feedback during robotic-assisted laparoscopic prostatectomy: posterolateral margin rates in 1340 consecutive patients.

BJU Int. 2010 Aug;106(4):528-36

Authors: Tewari AK, Patel ND, Leung RA, Yadav R, Vaughan ED, El-Douaihy Y, Tu JJ, Amin MB, Akhtar M, Burns M, Kreaden U, Rubin MA, Takenaka A, Shevchuk MM

OBJECTIVE: To analyse consecutive cases of robotic-assisted laparoscopic prostatectomy (RALP), present the incidence of nerve-sparing-related positive surgical margins (SM+), include visual cues that might assist in smoothly changing to the robotic platform, and discuss the scientific rationale for ‘intersensory integration’ which might explain the ‘reverse Braille’ phenomenon, i.e. the ability to feel when vision is greatly enhanced, as the lack of tactile feedback during RALP is often cited as a disadvantage of robotic surgery, interfering with a surgeon’s ability to make intraoperative oncological decisions. PATIENTS AND METHODS: Data from 1340 consecutive patients undergoing RALP from one institution were analysed and trends for positive posterolateral SM+ (PLSM+) were correlated with oncological variables before and after RALP. A sample of patient slides were reviewed by a extramural pathologist. Multivariate regression modelling was used to compare the projected rates of PLSM+ vs the actual rate, given the effect of a conscious effort to use visual cues. Finally, video recordings of the procedure were systematically reviewed and correlated with anatomical and histopathological images in an integrated session involving the surgeon and the pathology team. RESULTS: The incidence of PLSM+ was 2.1%, which gradually declined to 1.0% in the last 100 patients. The reduction in PLSM+ occurred despite an increased rate of high-risk tumours operated on during this period. Forecasting analysis showed that the actual PLSM+ rate declined by half in the most recent 1000 patients, due to an integrated effort involving the use of visual cues during surgery. The following visual cues were considered important; appreciation of periprostatic (lateral prostatic) fascial compartments; colour and texture of the tissue; periprostatic veins as a landmark for athermal dissection; signs of inflammation; and a freely separating bloodless plane showing loose shiny areolar tissue. CONCLUSION: Adapting to the robotic platform is easy and there is no compromise of the oncological safety of this procedure. Experienced surgeons can use visual cues to assist during nerve-sparing RALP and achieve low PLSM+ rates.

PMID: 20192955 [PubMed - indexed for MEDLINE]

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Laboratory stressors in clinically anxious and non-anxious individuals: the moderating role of mindfulness.

Behav Res Ther. 2010 Jun;48(6):495-505

Authors: Arch JJ, Craske MG

OBJECTIVE: Mindfulness forms the basis for multiple clinical interventions and has been induced in laboratory settings. However, few studies have examined the effects of dispositional or trait mindfulness. The purpose of this study was to investigate the relationship of trait mindfulness to laboratory stressor responding across fear-based anxiety disorder and non-anxious samples. We hypothesized that trait mindfulness would be associated with diminished stressor responding above and beyond the contribution of anxiety and depression-related variables, and to a greater extent in high anxiety than low anxiety individuals. METHODS: 90 participants, including 46 with anxiety disorders and 44 non-anxious controls, were assessed on hyperventilation and relaxation stressors. The relationship of trait mindfulness to stressor-related anxiety, negative affect, and duration was investigated in a hierarchical multiple regression model. RESULTS: Trait mindfulness predicted stressor responding in over 80% of measured outcomes, and predicted to a greater extent among high anxiety individuals in 50% of outcomes. CONCLUSIONS: Trait mindfulness was associated with diminished responses to laboratory stressors in clinically anxious and non-anxious samples. Implications for emotion regulation and clinical interventions are discussed.

PMID: 20303471 [PubMed - indexed for MEDLINE]

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Are obsessive-compulsive tendencies related to reliance on external proxies for internal states? Evidence from biofeedback-aided relaxation studies.

Behav Res Ther. 2010 Jun;48(6):516-23

Authors: Lazarov A, Dar R, Oded Y, Liberman N

This article presents two studies that examine the hypothesis that obsessive-compulsive (OC) tendencies are associated with a general deficiency in subjective conviction, which leads to seeking and reliance on external proxies to compensate for that deficiency. We examined this hypothesis using a biofeedback-aided relaxation procedure. In Study 1 low OC participants performed better on a relaxation task than high OC participants. More importantly, viewing the biofeedback monitor (an external proxy for the internal state of relaxation) had a different effect on the two groups: Whereas high OC participants performed better, low OC participants did not. In addition, when given the opportunity, high OC participants requested the biofeedback monitor more than did the low OC participants. In Study 2 high OC participants were more affected by false biofeedback when judging their level of relaxation compared to low OC participants. Real relaxation level differences between the two false biofeedback phases among the two groups were not found. These results provide preliminary support for the hypothesis that obsessive-compulsive disorder is associated with deficient subjective conviction in internal states and increased reliance on external proxies. Implications for the understanding of OCD-related rules and rituals as well as for cognitive therapy for OCD are discussed.

PMID: 20303473 [PubMed - indexed for MEDLINE]

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A preliminary investigation of sudden gains in exposure therapy for PTSD.

Behav Res Ther. 2010 Jun;48(6):555-60

Authors: Doane LS, Feeny NC, Zoellner LA

The purpose of the current study was to examine sudden gains in those receiving treatment for PTSD and whether these rapid changes were related to overall symptom reduction in a small sample of female assault survivors with PTSD undergoing prolonged exposure (PE) therapy. Sudden gains were found to occur in 52% of the sample. Among those who experienced a sudden gain, the average magnitude (12.4 points) accounted for 61% of overall symptom reduction. Importantly, treatment outcome was better for those who experienced sudden gains than those who did not. The experience of a sudden gain may result in patients becoming more fully engaged with treatment, and recognition of them may result in identifying potential process-related predictors of treatment response.

PMID: 20304385 [PubMed - indexed for MEDLINE]

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Behavioural group therapy for obsessive-compulsive disorder in Norway. An open community-based trial.

Behav Res Ther. 2010 Jun;48(6):547-54

Authors: HÃ¥land AT, Vogel PA, Lie B, Launes G, Pripp AH, Himle JA

The aim of the current study was to test the effectiveness of ERP-based 12 weeks group therapy for OCD patients in a community-based, general Norwegian outpatient clinic. The sample consisted of 54 patients diagnosed with OCD. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI) and the Spielberger State Anxiety Inventory (STAI-S) were administered before treatment, after treatment and at 3- and 12-month follow-ups. Analyses with mixed models for repeated measurements showed that group behavioural therapy offered to OCD patients significantly improved ratings of obsessive-compulsive symptoms, depression and anxiety. These improvements were maintained at 3- and 12-month follow-ups and an additional reduction in obsessive-compulsive symptoms was observed from post-treatment to 3-month follow-up. However, the delayed effect of therapy was no longer present at 12-month follow-up. The results also revealed that the patients had a lower chance for an increased outcome category (e.g. from unchanged to improved or recovered) with high scores on STAI-S at the given observation times (post-treatment, 3- and 12-months follow-ups). Depressive symptoms (BDI) at post-treatment and follow-ups had no significant influences on the three categories of outcome for OCD. In conclusion, the results indicate that behavioural group therapy can successfully be delivered to patients with considerable comorbidity in a real world setting conducted by therapists with limited training in the CBT.

PMID: 20359692 [PubMed - indexed for MEDLINE]

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