Body, Mind & Spirit Articles and Latest News

Patient perspectives on the integration of an intensive online behavioral weight loss intervention into primary care.

Patient Educ Couns. 2011 May;83(2):261-4

Authors: McTigue KM, Bhargava T, Bryce CL, Conroy M, Fischer GS, Hess R, Simkin-Silverman LR, Zickmund S

Abstract
OBJECTIVE: To examine patients’ perception of how a referral-based online lifestyle intervention contributed to primary care medicine.
METHODS: We invited 50 adults to complete a semi-structured interview after a 1-year online behavioral weight loss intervention (average weight change: -4.79 kg). We developed an iterative codebook using content analysis. Two coders independently coded all transcripts (kappa=0.895). We analyzed responses regarding the integration of the program with primary care.
RESULTS: Among the 35 participants who completed the interview, 46% described a positive experience between the program and their routine medical care; 14% noted it was fine/OK; 9% reported no effect, 3% were negative, 11% said that the program was unrelated to their medical care, and 14% that the only connection was the referral. Factors such as physician feedback and support, coordination with routine health care, and improved cardiovascular risk factors were cited in support of a positive experience. Physician feedback was reported by 89%, and 80% stated that the program helped them to follow their physician’s advice.
CONCLUSION: Physician referral to online education and counseling may facilitate the integration of evidence-based behavioral counseling with primary care.
PRACTICE IMPLICATIONS: Internet technology may enable improved access to evidence-based counseling for chronic health problems.

PMID: 21459256 [PubMed - indexed for MEDLINE]

[Read more →]

[Web of Science production quality indicators of ten professors’ at the area of personality, assessment and psychological treatment: additional contributions to Olivas-Ávila y Musi-Lechuga study].

Psicothema. 2011 Apr;23(2):267-73

Authors: Aluja A, Becoña E, Botella C, Colom R, Echeburúa E, Forns M, Pérez M, Vila J

Abstract
Rankings of scientific productivity are increasingly relevant both from an individual and a collective perspective. Therefore, making sure they are based on reliable and exhaustive information is really important. This study clearly shows that available rankings change dramatically when internationally acknowledged bibliometric indices are considered. Data from the 10 Professors belonging to the ‘Personality, Assessment, and Psychological Treatment’ Department considered in the recent analysis by Olivas-Ávila y Musi-Lechuga ( Psicothema 2010. Vol. 22, nº 4, pp. 909-916) are revisited here for illustrative purposes.

PMID: 21504680 [PubMed - indexed for MEDLINE]

[Read more →]

Civilizing the ‘Barbarian’: a critical analysis of behaviour modification programmes in forensic psychiatry settings.

J Nurs Manag. 2011 Apr;19(3):293-301

Authors: Holmes D, Murray SJ

Abstract
AIM: Drawing on the works of Erving Goffman and Michel Foucault, this article presents part of the results of a qualitative study conducted in a forensic psychiatry setting.
BACKGROUND: For many years, behaviour modification programmes (BMPs) have been subjected to scrutiny and harsh criticism on the part of researchers, clinicians and professional organizations. Nevertheless, BMPs continue to be in vogue in some ‘total’ institutions, such as psychiatric hospitals and prisons.
METHOD: Discourse analysis of mute evidence available in situ was used to critically look at behaviour modification programmes.
RESULTS: Compelling examples of behaviour modification care plans are used to illustrate our critical analysis and to support our claim that BMPs violate both scientific and ethical norms in the name of doing ‘what is best’ for the patients.
CONCLUSION: We argue that the continued use of BMPs is not only flawed from a scientific perspective, but constitutes an unethical approach to the management of nursing care for mentally ill offenders.
IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers need to be aware that BMPs violate ethical standards in nursing. As a consequence, they should overtly question the use of these approaches in psychiatric nursing.

PMID: 21507099 [PubMed - indexed for MEDLINE]

[Read more →]

[Evaluation of the Relapse Prevention Guidance for drug-dependent inmates: the intervention using self-teach workbook and group therapy in a “Private Finance Initiative” prison –the second report].

Nihon Arukoru Yakubutsu Igakkai Zasshi. 2011 Jun;46(3):368-80

Authors: Kobayashi O, Matsumoto T, Imamura F, Wada K, Ozaki S, Takeuchi Y, Hasegawa M, Imamura Y, Tania Y, Adachi Y

Abstract
BACKGROUND: There has been no relapse prevention program for drug dependent inmates in Japanese prisons. Recently, “Relapse Prevention Guidance” program is provided to the adult male inmates in Harima Rehabilitation Program Center (HRPC), one of the newly founded “Private Finance Initiative” prisons.
AIMS: To evaluate the effectiveness of the program by comparing the outcomes between groups of inmates with different severity level of dependence.
METHODS: The program was provided to 89 subjects in HRPC. Inmates were classified into 4 groups according to the severity measured by the Drug Abuse Screening Test (DAST). After a month of waiting period, self-teaching workbook was provided to each inmate for 4 weeks. The educational program consisting of 8 weekly psychoeducational group therapies was then provided to each group of 10 inmates. The evaluation was conducted both at the beginning and at the end of the workbook and the educational program intervention by administering 2 self-reporting questionnaires; the Self-efficacy Scale for drug dependence (SES), and the 8th version of the Stages of Change Readiness and Treatment Eagerness Scale for drug dependence (SOCRATES-8D).
RESULTS: Only the “mild” group showed significant increase in SES during waiting period. After the workbook intervention, “moderate” group showed significant decrease in SES, and increase in the recognition and the ambivalence subscale of the SOCRATES-8D. The same increase in the subscales of SOCRATES-8D was noted in “Severe” group. Educational program produced increase in the recognition and the taking steps subscales of SOCRATES-8D in “mild” group, increase in SES score and the taking steps subscale in “moderate”, increase in SES score and total score of SOCRATES-8D in “severe” group. No significant change was noted in “very severe” group in any of the interventions.
CONCLUSION: The “Relapse Prevention Guidance” is sufficiently effective, improving self-efficacy and motivation for change in drug dependent adult male inmates.

PMID: 21861334 [PubMed - indexed for MEDLINE]

[Read more →]

Preference of lethal methods is not the only cause for higher suicide rates in males.

J Affect Disord. 2011 Sep 19;

Authors: Cibis A, Mergl R, Bramesfeld A, Althaus D, Niklewski G, Schmidtke A, Hegerl U

Abstract
BACKGROUND: In most countries worldwide suicide rates are higher for males whereas attempted suicide rates are higher for females. The aim is to investigate if the choice of more lethal methods by males explains gender differences in suicide rates. METHODS: Data on completed and attempted suicides were collected (n=3235, Nuremberg and Wuerzburg, years 2000-2004). The research question was analyzed by comparing the method-specific case fatality (= completed suicides/completed+attempted suicides) for males and females. RESULTS: Among the events captured, men chose high-risk methods like hanging significantly more often than women (φ=-0.27; p<0.001). However, except for drowning, case fatalities were higher for males than for females within each method. This was most apparent in “hanging” (men 83.5%, women 55.3%; φ=-0.28; p<0.001) and “poisoning by drugs” (men 7.2%, women 3.4%; φ=-0.09; p<0.001). LIMITATIONS: The sample size (n=3235) was not enough for comparing method and gender specific case fatalities with a fine-meshed stratification regarding age. CONCLUSIONS: Higher suicide rates in males not only result from the choice of more lethal methods. Other factors have to be considered.

PMID: 21937122 [PubMed - as supplied by publisher]

[Read more →]

Impulsive personality and the ability to resist immediate reward: An fMRI study examining interindividual differences in the neural mechanisms underlying self-control.

Hum Brain Mapp. 2011 Sep 21;

Authors: Diekhof EK, Nerenberg L, Falkai P, Dechent P, Baudewig J, Gruber O

Abstract
The ability to resist immediate rewards is crucial for lifetime success and individual well-being. Using functional magnetic resonance imaging, we assessed the association between trait impulsivity and the neural underpinnings of the ability to control immediate reward desiring. Low and high extreme impulsivity groups were compared with regard to their behavioral performance and brain activation in situations, in which they had to forego immediate rewards with varying value to achieve a superordinate long-term goal. We found that highly impulsive (HI) individuals, who successfully compensated for their lack in behavioral self-control, engaged two complementary brain mechanisms when choosing actions in favor of a long-term goal, but at the expense of an immediate reward. First, self-controlled decisions led to a general attenuation of reward-related activation in the nucleus accumbens, which was accompanied by an increased inverse connectivity with the anteroventral prefrontal cortex. Second, HI subjects controlled their desire for increasingly valuable, but suboptimal rewards through a linear reduction of activation in the ventromedial prefrontal cortex (VMPFC). This was achieved by an increased inverse coupling between the VMPFC and the ventral striatum. Importantly, the neural mechanisms observed in the HI group differed from those in extremely controlled individuals, despite similar behavioral performance. Collectively, these results suggest trait-specific neural mechanisms that allow HI individuals to control their desire for immediate reward. Hum Brain Mapp, 2011. © 2011 Wiley-Liss, Inc.

PMID: 21938756 [PubMed - as supplied by publisher]

[Read more →]

[Novel psychotherapeutic methods and the role of mental health centers in their implementation].

Harefuah. 2011 Aug;150(8):659, 687

Authors: Knobler HY, Abramowitz MZ

Abstract
In this issue of Harefuah, Arbel et at. describe the implementation of mindfulness-based psychotherapy IMBP) in the Beer Sheba Mental HeaLth Center. MBP is an example of a form of complementary and alternative medical treatment, which became widespread and is now considered both safe and efficient. It includes mindful sitting practice, developing awareness, mindful movement, psycho-education, and often a cognitive component. MBP has a role in the treatment of minor and major mental disorders, and’may also alleviate stress and improve weLtl-being among therapists. In the Beer Sheba Center, MBP courses were offered to all staff members, and MBP group treatment was started in one of the wards. The promising results of MBP’s implementation will be evaluated. This project emphasizes the pivotal role of mental health centers in the teaching of students and residents in mental health. This role must be considered while planning the future of these centers in the current reform of Israel’s psychiatric services.

PMID: 21939119 [PubMed - in process]

[Read more →]

Treatment manuals: Use in the treatment of bulimia nervosa.

Behav Res Ther. 2011 Sep 14;

Authors: Wallace LM, von Ranson KM

Abstract
As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians’ most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and “eclecticism” is at odds with efforts to disseminate manuals into clinical practice.

PMID: 21939960 [PubMed - as supplied by publisher]

[Read more →]

The impact of COMT gene polymorphisms on suicidality in treatment resistant major depressive disorder - A European Multicenter Study.

Eur Neuropsychopharmacol. 2011 Sep 20;

Authors: Schosser A, Calati R, Serretti A, Massat I, A Kocabas N, Papageorgiou K, Linotte S, Mendlewicz J, Souery D, Zohar J, Juven-Wetzler A, Montgomery S, Kasper S

Abstract
Many association studies have reported associations between the catechol-O-methyltransferase (COMT) gene and psychiatric disorders including major depression (MDD). The COMT gene has further been associated with suicidal behaviour, as well as with treatment response, although with conflicting results. In the present study, we further elucidate the impact of COMT in treatment response in MDD patients with suicide risk and/or a personal history of suicide attempts. Two hundred fifty MDD patients were collected in the context of a European multicentre resistant depression study and treated with antidepressants at adequate doses for at least 4weeks. Suicidality was assessed using Mini International Neuropsychiatric Interview (MINI) and the Hamilton Rating Scale for Depression (HAM-D). Treatment response was defined as HAM-D≤17 and remission as HAM-D≤7 after 4weeks of treatment with antidepressants at adequate dose. Genotyping was performed for seven SNPs (rs4680, rs2075507, rs737865, rs6269, rs4633, rs4818 and rs165599) within the COMT gene. With regard to suicide risk and personal history of suicide attempts, neither single marker nor haplotypic association was found with any SNP after multiple testing correction. In non-responders, we found significant single marker and haplotypic association with suicide risk, but not in responders. The same holds true for both remitters and non-remitters, and when testing for association with a personal history of suicide attempts and treatment response phenotypes. In conclusion, we found significant association of COMT SNPs with suicide risk in MDD patients not responding to antidepressant treatment. Larger well-defined cohorts will be required to dissect this further.

PMID: 21940152 [PubMed - as supplied by publisher]

[Read more →]

Revisiting Shimoda’s “Shuuchaku-Kishitsu” (Statothymia): A Japanese View of Manic-Depressive Patients.

Depress Res Treat. 2011;2011:193742

Authors: Tsuda H

Abstract
Although the empiric paradigm is now dominant in academic research, in Japan quite a few psychiatric clinicians still take phenomenological-anthropological approaches into consideration, especially when they address manic-depressive illness with typical endogenous features. This is because Shimoda’s concept of “shuuchaku-kishitsu” (statothymia) has been widely accepted, together with other phenomenological views of continental origin. In the present paper the author first delineates Shimoda’s concept which is based on observations of patients’ personality features and the characteristics of their emotionality. He then attempts to refine this concept in spatiotemporal terms, presenting the view that in patients the past self tends to adhere to the present self (the term “shuuchaku” means “adhering to” or “preoccupied with”). He also considers that patients tend to incorporate “soto” (outer space) into “uchi” (inner space), where they believe that symbiotic relations are preserved. Finally, he argues the clinical significance of the presented views in the cultural milieu in which Japanese psychiatric practices are situated.

PMID: 21941642 [PubMed - as supplied by publisher]

[Read more →]