Body, Mind & Spirit Articles and Latest News

[Evaluation of the “Schema-focused Emotive Behavioural Therapy” (SET) for patients with personality disorders: results of a randomised controlled trial].

Psychother Psychosom Med Psychol. 2008 Sep-Oct;58(9-10):371-8

Authors: Zorn P, Roder V, Soravia L, Tschacher W

Abstract
The “Schema-focussed Emotive Behavioral Therapy” (SET) was developed by our research group as a new group therapy approach for patients with personality disorders from all clusters (A to C; DSM-IV). It was evaluated in a randomised controlled study (n = 93). Data were collected before and after treatment as well as one year after study entry. A completer analysis was conducted with matched subgroups (n = 60). After therapy, SET patients improved in the outcome domains interactional behavior, strain, and symptomatic complaints (IIP-D, GAF, VEV-VW, BSI-P). Furthermore, they showed a significant lower dropout rate. At the follow-up assessment, Cluster C patients of the experimental group deteriorated with regard to symptomatic complaints (BSI-P). In contrast, cluster B patients improved more over time compared to control subjects. SET seems to be an adequate and effective group therapy with effects that seem to be stable over time, especially for patients with Cluster B diagnosis.

PMID: 18240113 [PubMed - indexed for MEDLINE]

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[From chaos to insight–the character of the dynamics of therapeutic changes with a linguistic analysis of verbatim transcripts].

Psychother Psychosom Med Psychol. 2008 Sep-Oct;58(9-10):379-86

Authors: Bergmann B, Villmann T, Gumz A

Abstract
The objective of this study is to determine and to analyze so-called key sessions in the frameworks of Therapeutic Cycles Model introduced by Mergenthaler and the Energy Model proposed by Caspar. For this purpose, different measures for key session identification are used based on linguistic text variables. The investigation is done for 10 high-frequency, psychodynamic, inpatient, individual therapies consisting of overall 206 therapeutic sessions, all of which were completely videotaped and transcribed. The text analysis was performed using the automated text analysis tool provided by Mergenthaler, which measures the construct of Emotional Tone as a linguistic manifestation of the emotional event and the construct of Abstraction as a linguistic manifestation of cognitive-reflective processes in speech and texts. Feeding these variables into both models, results reveal their coherence: Therapeutic change may occur, whenever an emotional and cognitive-reflective processing of the internal conflicts begins after destabilisation of coherent patterns of behaviour and experiencing. The discussion suggests a more detailed specification of the definition of key sessions in the Therapeutic Cycles Model by Mergenthaler.

PMID: 21918951 [PubMed - indexed for MEDLINE]

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A (fictional) interview with Lester Luborsky by Horst Kächele.

Psychother Psychosom Med Psychol. 2008 Sep-Oct;58(9-10):403-4

Authors: Luborsky L

PMID: 21918952 [PubMed - indexed for MEDLINE]

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Psychological care for maxillofacial trauma patients: a preliminary survey of oral and maxillofacial surgeons.

J Craniomaxillofac Surg. 2011 Oct;39(7):515-8

Authors: Pitak-Arnnop P, Hervé C, Coffin JC, Dhanuthai K, Bertrand JC, Meningaud JP

Abstract
INTRODUCTION: Psychological morbidities are major complications following maxillofacial injuries. The aim of this study was to assess self-evaluation of oral and maxillofacial surgeons on posttraumatic psychological care.
METHODS: Using a cross-sectional study design, we enrolled a sample of surgeons in 261 oral and maxillofacial surgery (OMFS) departments in the United States, United Kingdom and France. A self-administered e-mail questionnaire was used to evaluate knowledge, attitude and practice of the surgeons regarding psychological problems in maxillofacial injury patients, and their collaboration with psychological personnel. Appropriate descriptive and univariate statistics were computed, and P<0.05 was considered statistically significant.
RESULTS: The response rate was 28.1% (112 of 398), but we included only 100 respondents from 107 OMS units. 60% of the surgeons disclosed a moderate or high level of relevant knowledge. Only 28 OMS departments (26.2%) had intra-service psychological staff (commonly in France [P<0.05]), and five surgeons revealed considerable deficits in access to psychological care. Frequent reasons for patient referral to psychological staff were depression, body dysmorphic disorder, posttraumatic stress disorder, suicidal idea, anxiety and behavioural changes. Eighty-eight surgeons linked patient’s non-compliance with changes or difficulties in practice, and 58 surgeons experienced it already.
CONCLUSIONS: Despite several limitations, the results of this study suggest that oral and maxillofacial surgeons have a great interest and experience in posttraumatic psychological problems. Psychological professionals in charge will improve surgical care quality. Well-designed studies with larger sample size are desirable to confirm our results. Ethical issues of maxillofacial trauma care are also discussed.

PMID: 21195626 [PubMed - indexed for MEDLINE]

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The diet quality of adult women participating in a behavioural weight-loss programme.

J Hum Nutr Diet. 2011 Aug;24(4):360-9

Authors: Webber KH, Lee E

Abstract
BACKGROUND: Diet quality plays an important role in health and has been shown to impact the risk of heart disease and certain cancers. The present study aimed to examine baseline and 16-week follow-up levels of energy intake, energy density and diet quality, as measured by the Healthy Eating Index 2005 (HEI-2005), in overweight and obese women participating in a behavioural weight-loss programme.
METHODS: Sixty-six women [mean (SD) age 48.6 (10.8) years; body mass index 31.8 (3.7) kg m(-2) ; 92% Caucasian] completed dietary measures at baseline and follow-up. All participants received a 16-week Internet Behavioural weight-loss programme based on the core of the Diabetes Prevention Program. Dietary intake was measured using the 2005 Block food frequency questionnaire. Diet quality was calculated using the HEI-2005. Paired t-tests were used to determine changes over time.
RESULTS: There was a reduction in reported energy intake [7.867 (3.232) MJ versus 5.748 (1.775) MJ, P < 0.001] over the 16 weeks. Participants had an increase in diet quality [HEI score = 53.9 (9.9) versus 57.4 (10.6), P = 0.002] as well as a reduction in energy density [0.0088 (0.0021) MJ g(-1) to 0.0080 (0.0021) MJ g(-1) (P = 0.002)]. All micronutrient intakes decreased over the 16 weeks.
CONCLUSIONS:   Participation in a 16-week behavioural weight-loss programme significantly improved diet quality and reduced dietary energy density and energy intake in adult women. However, despite the overall increase in diet quality score, there were deficiencies in key micronutrients in the diets of most women at the conclusion of the 16-week study.

PMID: 21414046 [PubMed - indexed for MEDLINE]

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The current state of intervention research for posttraumatic stress disorder within the primary care setting.

J Clin Psychol Med Settings. 2011 Sep;18(3):268-80

Authors: Possemato K

Abstract
Posttraumatic Stress Disorder (PTSD) is common among primary care patients and is associated with significant functional impairment, physical health concerns, and mental health comorbidities. Significant barriers to receiving adequate treatment often exist for primary care patients with PTSD. Mental health professionals operating as part of the primary care team have the potential to provide effective brief intervention services. While good PTSD screening and assessment measures are available for the primary care setting, there are currently no empirically supported primary care-based brief interventions for PTSD. This article reviews early research on the development and testing of primary care-based PTSD treatments and also reviews other brief PTSD interventions (i.e., telehealth and early intervention) that could be adapted to the primary care setting. Cognitive and behavioral therapies currently have the strongest evidence base for establishing an empirically supported brief intervention for PTSD in primary care. Recommendations are made for future research and clinical practice.

PMID: 21512750 [PubMed - indexed for MEDLINE]

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Anesthesia awareness: narrative review of psychological sequelae, treatment, and incidence.

J Clin Psychol Med Settings. 2011 Sep;18(3):257-67

Authors: Bruchas RR, Kent CD, Wilson HD, Domino KB

Abstract
Awareness during general anesthesia occurs when patients recall events or sensations during their surgeries, although the patients should have been unconscious at the time. Anesthesiologists are cognizant of this phenomenon, but few discussions occur outside the discipline. This narrative review summarizes the patient recollections, psychological sequelae, treatment and follow-up of psychological consequences, as well as incidence and etiology of awareness during general anesthesia. Recalled memories include noises, conversations, images, mental processes, feelings of pain and/or paralysis. Psychological consequences include anxiety, flashbacks, and posttraumatic stress disorder diagnosis. Limited discussion for therapeutic treatment after an anesthesia awareness experience exists. The incidence of anesthesia awareness ranges from 0.1 to 0.2% (e.g., 1-2/1000 patients). Increased recognition of awareness during general anesthesia within the psychological/counseling community, with additional research focusing on optimal therapeutic treatment, will improve the care of these patients.

PMID: 21512752 [PubMed - indexed for MEDLINE]

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Effectiveness of different music-playing devices for reducing preoperative anxiety: a clinical control study.

Int J Nurs Stud. 2011 Oct;48(10):1180-7

Authors: Lee KC, Chao YH, Yiin JJ, Chiang PY, Chao YF

Abstract
BACKGROUND: While waiting for surgery, patients often exhibit fear and anxiety. Music is thought to be an alternative to medication to relieve anxiety. However, due to concerns about infection control, devices other than headphones may be considered for this purpose.
OBJECTIVES: The purpose of this study was to determine the anxiety-relieving effect of broadcast versus headphone music playing for patients awaiting surgery.
DESIGN: A randomized controlled clinical study.
SETTING: The waiting area of an operating theater of a metropolitan teach hospital in Taiwan.
PARTICIPANTS: Alert adult with age between 20 and 65 years old waiting for surgery without premedications.
METHODS: A total of 167 patients were randomly assigned to the headphone, broadcast and control groups. Both the headphone and the broadcast groups were provided with the same instrumental music, while the control group did not listen to any music. The tools for measuring anxiety were visual analogue scale (VAS) ranging from “not anxious at all” to “extremely anxious” and heart rate variability (HRV).
RESULTS: The VAS score exhibited a significant decrease for both the headphone and broadcast groups. The low frequency and low-to-high frequency LF/HF ratio of the broadcast and headphone groups were significantly lower than those of the control group. None of the heart rate variables showed significant differences between the broadcast group and the headphone group.
CONCLUSION: Both headphone and broadcast music are effective for reducing the preoperative patient’s anxiety in the waiting room.
RELEVANCE TO CLINICAL PRACTICE: In order to take infection control into account, broadcast speakers can substitute for headphones for playing music to lower the anxiety level of patients waiting for surgery.

PMID: 21565344 [PubMed - indexed for MEDLINE]

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Evaluation of an adjustment group for people with multiple sclerosis and low mood: a randomized controlled trial.

Mult Scler. 2011 Oct;17(10):1250-7

Authors: Lincoln NB, Yuill F, Holmes J, Drummond AE, Constantinescu CS, Armstrong S, Phillips C

Abstract
BACKGROUND: Mood problems affect many people with multiple sclerosis (MS). The aim was to evaluate the effectiveness of a group treatment based on cognitive behavioural principles.
METHODS: People with MS were screened on the General Health Questionnaire 12 (GHQ-12) and Hospital Anxiety and Depression Scale (HAD). Those identified with low mood were invited to take part in a randomized trial comparing the effect of attending an adjustment group with a waiting list control. Patients allocated to the adjustment group received six 2 h group treatment sessions. Outcomes were assessed 4 and 8 months after randomization, blind to group allocation.
RESULTS: Of the 311 patients identified, 221 (71%) met the criteria for low mood and 151 (68%) agreed to take part. Hierarchical regression analyses were conducted to compare the two groups, correcting for baseline mood and disability. At 4 months, group allocation alone was a significant predictor of the primary outcome measure, the GHQ-12. At 8 months, group allocation alone was no longer a significant predictor for GHQ-12 scores, but it was when baseline GHQ-12 and Guy’s Neurological Disability Scale scores were controlled for. Comparison of the area under the curve revealed significant differences between the groups for GHQ-12 (p = 0.003), HAD Anxiety (p = 0.013), HAD Depression (p = 0.004), Beck Depression Inventory (p = 0.001), MS Self-efficacy (p = 0.037) and MS Impact Scale Psychological (p = 0.012).
CONCLUSION: Patients receiving treatment were less distressed and had less depression and anxiety. There was some evidence of improved self-efficacy and a reduction of the impact of MS on people’s lives.

PMID: 21613332 [PubMed - indexed for MEDLINE]

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Treating primary insomnia: clinical effectiveness and predictors of outcomes on sleep, daytime function and health-related quality of life.

J Clin Psychol Med Settings. 2011 Sep;18(3):312-21

Authors: Van Houdenhove L, Buyse B, Gabriëls L, Van den Bergh O

Abstract
Primary insomnia, as defined by DSM-IV-TR, refers to a persistent sleep disturbance which is not connected to a current psychiatric or physical condition, but significantly impairs social and occupational functioning. This study explored the impact of Cognitive Behavioral Therapy for Insomnia (CBT-i) on sleep, daytime functioning and health-related quality of life (HRQoL). Next, we investigated which factors predicted positive treatment outcome by examining demographics, insomnia characteristics, baseline levels of daytime function, HRQoL, sleep-disruptive beliefs and psychological health on post-treatment sleep quality, daytime function and HRQoL. 138 consecutive primary insomnia patients completed questionnaires pre- and post-treatment and at 6 months follow-up. After CBT-i, robust clinical improvements were observed in sleep, daytime function and HRQoL, regardless of age, gender, type or duration of the complaint. Patients with pre-treatment severe insomnia, pronounced daytime impairment and low psychological well-being benefited most.

PMID: 21629999 [PubMed - indexed for MEDLINE]

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