Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Intern...Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.展开更多
Objectives:The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide.Since April 2016,Japanese national health insurance has covered nurseadministered cogniti...Objectives:The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide.Since April 2016,Japanese national health insurance has covered nurseadministered cognitive behavioral therapy(CBT)for mood disorders.However,empirical support for nurse-led CBT for depression in Asian countries,especially in Japan,is still lacking.This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression.Methods:In this single-arm study,we evaluated the effects of a 6-week group CBT,led by trained nurses,on patients with major depression.The primary outcome was the Beck Depression Inventory-Ⅱ(BDI-Ⅱ).Assessments were conducted at the beginning and end of the intervention.Results:Of 25 participants screened,23 were eligible for the study(of these,three dropped out during the trial but were included in the analysis).Nurse-led group CBT led to significant improvements in the severity of depression(BDI-Ⅱ,P<0.001).The mean total BDI-Ⅱscore improved from 23.1(SD=7.56)to 12.4(SD=8.57),and the pre-to post-effect size was large(Cohen's d=1.33).After CBT,45%of the participants were judged to be treatment responders,and 34%met the remission criteria.Conclusions:Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting.The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice.Further controlled trials that address the limitations of this study are required.展开更多
Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition without a conclusivesubtype dimension. This study will focus on the meta-analysis of the clinical responses of OCD subtypes to co...Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition without a conclusivesubtype dimension. This study will focus on the meta-analysis of the clinical responses of OCD subtypes to cognitivebehavioral therapy (CBT), which might clarify this issue. Methods: We performed a systematic search and ameta-analysis for the studies of OCD subtypes and the response to CBT in PubMed, ScienceDirect, Embase, Webof Science, and Scopus databases. The selective criteria were the OCD without significant medical or psychiatricco-morbidities and pre-and post-treatment changes in scores of OCD dimension. In addition, different subtypesof OCD in symptom dimensions, such as symmetry, contamination, unacceptable thoughts, and hoarding, werecompared to find the most significant subtype using the treatment response parameters by CBT. After limitedselection, four studies and 479 OCD subjects were enrolled. The meta-analysis was performed by Review Manager5.4, and only significant results were reported. Results: Among the OCD subtypes, the meta-analysis favors thehoarding subtype with poorer responses to CBT than symmetry, contamination, and unacceptable thoughts.The meta-analysis results were negative mean differences, significant tests for overall effect, and limited heterogeneitiesin the random effects model. In addition, the results were more significant when the hoarding subtypewas compared with non-hoarding subtypes. Conclusion: The hoarding subtype might be the most significantrepresentative subtype of OCD symptom dimension under the impression of unfavorable clinical response toCBT. However, future studies with more treatment parameters will be warranted to confirm this finding.展开更多
Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed...Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.展开更多
Obsessive-compulsive disorder is a disorder which is resistant to the existing treatments and to compensate this defect, it is necessary to design and search for the new treatments. This study aims to develop and eval...Obsessive-compulsive disorder is a disorder which is resistant to the existing treatments and to compensate this defect, it is necessary to design and search for the new treatments. This study aims to develop and evaluate the effectiveness of the behavioral-cognitive-metacognitive intervention on the symptoms of obsessive-compulsive disorder. In order to achieve objectives of the study, after developing the behavioral-cognitive-metacognitive intervention, it was evaluated in a single-subject procedure. OCI-R scores at baseline were obtained by following the treatment on 3 individuals. The study was a single-subject research and the data were analyzed by drawing the graph. Graph drawing results showed that the behavioral-cognitive-metacognitive intervention reduced the symptoms of obsessive-compulsive disorder (OCD), and reduction of OCD symptoms was also clinically significant. As the intervention of the present study is multi-dimensional and takes into account all the three behavioral, cognitive and metacognitive aspects and considers them interdependent and not apart or contradictory, it is considered as a new intervention.展开更多
In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention...In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.展开更多
The objective of this systematic review is to examine the effectiveness of psychotherapy in treating Post-Traumatic Stress Disorder(PTSD)in military personnel.PubMed,Web of Science,The Cochrane Library,EBSCO and CNKI ...The objective of this systematic review is to examine the effectiveness of psychotherapy in treating Post-Traumatic Stress Disorder(PTSD)in military personnel.PubMed,Web of Science,The Cochrane Library,EBSCO and CNKI databases were searched from 1 January,2000 to November 2022 for Randomized Controlled Trials(RCTs)on psychotherapeutic interventions for military PTSD.The physical Therapy Evidence Database(PEDro)scale was used to evaluate the quality of the literature.Two researchers conducted literature screening,data extraction,and risk bias assessment in accordance with inclusion and exclusion criteria.Ultimately,49 RCTs were included,involving a total of 5073 veterans,retired and active military from four countries.The average score on the PEDro scale was 7.60.The primary psychotherapeutic modalities for military PTSD intervention include Cognitive-Behavioral Therapy,Exposure Therapy,Mindfulness interventions,psychotherapy based on new technological tools,and other emerging psychotherapeutic tools.The review highlights that Cognitive Processing Therapy(CPT)and Prolonged Exposure Therapy(PET)stand out as the primary psychotherapeutic modalities for treating PTSD in military personnel.In cases where CPT and PET yield limited benefits,Mindfulness interventions emerge as effective alternatives.Moreover,considering the diverse needs and high dropout rates in the military,population,the review suggests using web-based,computer,and virtual reality technology tools as supplements to first-line treatments(CPT/PET)to enhance overall intervention effectiveness.For the advancement of future psychotherapeutic initiatives,there is a pronounced emphasis on prioritizing proven first-line interventions,CPT and PET while also recognizing the potential of mindfulness-based interventions as credible alternatives.In tandem with this,the active integration of technological tools is advocated to amplify the therapeutic impact of conventional psychological treatment modalities.展开更多
Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children an...Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children and adults with this disorder as, thanks to advances in both pharmacological and psychological therapies, prognosis for those afflicted with OCD is quite good in the long term, even though most have comorbid disorders that are also problematic. We still have far to go, however, until OCD can be described as either easily treatable or the effective treatments are widely known about among clinicians. This review focuses on the current state of the art in treatment for OCD and where we still are coming up short in our work as a scientific community. For example, while the impact of medications is quite strong for adults in reducing OCD symptoms, current drugs are only somewhat effective for children. In addition, there are unacceptably high relapse rates across both populations when treated with pharmacological alone. Even in the cognitive-behavioral treatments, which show higher effect sizes and lower relapse rates than drug therapies, drop-out rates are at a quarter of those who begin treatment. This means a sizable portion of the OCD population who do obtain effective treatments(which appears to be only a portion of the overall population) are not effectively treated.Suggestions for future avenues of research are also presented. These are primarily focused on(1) increased dissemination of effective therapies;(2) augmentation of treatments for those with residual symptoms, both for psychotherapy and pharmacotherapy; and(3) the impact of comorbid disorders on treatment outcome.展开更多
Objective: Anxiety disorders of childhood are prevalent, debilitating conditions that do not always respond to existing treatments. Attentional biases towards threatening stimuli have been reported in anxious children...Objective: Anxiety disorders of childhood are prevalent, debilitating conditions that do not always respond to existing treatments. Attentional biases towards threatening stimuli have been reported in anxious children and hypothesized to interfere with treatment response. Therefore, we examined such biases in children with anxiety disorders in relation to cognitive behavioral therapy (CBT) outcomes. Method: Thirty-eight children diagnosed with anxiety disorders in a specialized clinic (21 girls and 17 boys;age = 10.50 ± 1.11 years) and 36 unaffected community controls (19 girls and 17 boys;age = 10.20 ± 1.07 years) participated. Participants completed standardized questionnaire measures of anxiety and a probe position task (PPT) with facial cues. This task often reveals a response slowing effect related to threatening faces in vulnerable individuals. Children with anxiety disorders repeated these measures after completing CBT. Results: Groups did not differ in performance on the PPT, but angry/calm incongruent difference scores were significantly associated with self-reports of social anxiety and state anxiety. When controlling for pre-CBT anxiety levels, incongruent difference scores involving angry faces predicted post-CBT anxiety disorders index scores on the Multidimensional Anxiety Scale for Children. PPT scores did not change significantly with CBT. Conclusions: Attentional bias towards threat on the PPT task may predict response to CBT and appears linked to social anxiety. Interventions to ameliorate this bias merit further study, as they might improve treatment outcomes for anxious, especially socially anxious, children.展开更多
AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied...AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied Health Literature,PsycI NFO,Clinical Trial.gov searches were performed using the keywords "hallucinations","behavioural therapy" and " cognitive therapy" in order to identify relevant articles published during the years of 2011 to 2016.No language limits were used.Studies conducted within control group,reviews,editorials,were excluded.Data on efficacy,acceptability and tolerability were extracted by three authors independently.Disagreements were resolved in a consensus meeting or by another reviewer.RESULTS A total of eight articles were eligible for inclusion.Two are randomized clinical trials(RCTs) and six are observational studies.The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations(AHs).Nevertheless,they considered different CBT models,particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations.As regards non RCT-studies,all papers included showed reduction on frequency and severity of AHs and distress related to them.However,the lack of content details within non-RCTs studies decreased their comparability.In terms of predictive variables,our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy.Indeed,negative symptoms showed a significant negative correlation on outcome.CONCLUSION Although more conclusive studies are still needed,we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.展开更多
This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at...This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at all stages of their life.We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population,along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems.We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID.The review is structured around the three generations of therapies:Applied behavior analysis(e.g.,positive behavior support),cognitive behavioral therapies(e.g.,mindfulness-based cognitive therapy),and contextual therapies(e.g.,dialectical behavior therapy).We conclude with some recommendations for professional practice in the fields of ID and psychiatry.展开更多
This essay explores the connections between Hoarding Disorder and Substance Use Disorder,two distinct mental health conditions with clear diagnostic criteria in the DSM-5.Hoarding Disorder,marked by excessive possessi...This essay explores the connections between Hoarding Disorder and Substance Use Disorder,two distinct mental health conditions with clear diagnostic criteria in the DSM-5.Hoarding Disorder,marked by excessive possession accumulation and difficulties in letting go,affects 2-6%of the global population,leading to severe consequences.Potential causes include genetic predisposition,neural issues,and traumatic experience.Substance Use Disorder is influenced by more societal factors.Both disorders share a comorbidity in Attention-Deficit/Hyperactivity Disorder(ADHD).Network analysis shows a strong direct relationship between Hoarding Disorder and ADHD,while social influences increase ADHD prevalence in Substance Use Disorder individuals.Moreover,both disorders benefit from Cognitive Behavioral Therapy(CBT).Exposure and Ritual Prevention effectively address hoarding symptoms,while CBT for Substance Use Disorder focuses on the interplay between thoughts,emotions,and actions.Despite being classified as a mental illness in DSM-5,Hoarding Disorder receives less attention than Substance Use Disorder.This essay aims to raise awareness of Hoarding Disorder by highlighting its commonalities with Substance Use Disorder in terms of causes,comorbidities,and treatment approaches.展开更多
基金the Shanxi Soft Science Research Program, No. 2008041061-03
文摘Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.
基金This work was financially supported by the Grants-in-Aid for Scientific Research(KAKENHI)from the Japan Society for the Promotion of Science(JSPS),Grant Number 25463556 to YS.
文摘Objectives:The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide.Since April 2016,Japanese national health insurance has covered nurseadministered cognitive behavioral therapy(CBT)for mood disorders.However,empirical support for nurse-led CBT for depression in Asian countries,especially in Japan,is still lacking.This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression.Methods:In this single-arm study,we evaluated the effects of a 6-week group CBT,led by trained nurses,on patients with major depression.The primary outcome was the Beck Depression Inventory-Ⅱ(BDI-Ⅱ).Assessments were conducted at the beginning and end of the intervention.Results:Of 25 participants screened,23 were eligible for the study(of these,three dropped out during the trial but were included in the analysis).Nurse-led group CBT led to significant improvements in the severity of depression(BDI-Ⅱ,P<0.001).The mean total BDI-Ⅱscore improved from 23.1(SD=7.56)to 12.4(SD=8.57),and the pre-to post-effect size was large(Cohen's d=1.33).After CBT,45%of the participants were judged to be treatment responders,and 34%met the remission criteria.Conclusions:Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting.The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice.Further controlled trials that address the limitations of this study are required.
基金National Natural Science Foundation of China(No.82171542)Beijing Municipal Administration of Hospitals Incubating Program(code:PX2020075)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(code:XMLX202129).
文摘Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition without a conclusivesubtype dimension. This study will focus on the meta-analysis of the clinical responses of OCD subtypes to cognitivebehavioral therapy (CBT), which might clarify this issue. Methods: We performed a systematic search and ameta-analysis for the studies of OCD subtypes and the response to CBT in PubMed, ScienceDirect, Embase, Webof Science, and Scopus databases. The selective criteria were the OCD without significant medical or psychiatricco-morbidities and pre-and post-treatment changes in scores of OCD dimension. In addition, different subtypesof OCD in symptom dimensions, such as symmetry, contamination, unacceptable thoughts, and hoarding, werecompared to find the most significant subtype using the treatment response parameters by CBT. After limitedselection, four studies and 479 OCD subjects were enrolled. The meta-analysis was performed by Review Manager5.4, and only significant results were reported. Results: Among the OCD subtypes, the meta-analysis favors thehoarding subtype with poorer responses to CBT than symmetry, contamination, and unacceptable thoughts.The meta-analysis results were negative mean differences, significant tests for overall effect, and limited heterogeneitiesin the random effects model. In addition, the results were more significant when the hoarding subtypewas compared with non-hoarding subtypes. Conclusion: The hoarding subtype might be the most significantrepresentative subtype of OCD symptom dimension under the impression of unfavorable clinical response toCBT. However, future studies with more treatment parameters will be warranted to confirm this finding.
文摘Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.
文摘Obsessive-compulsive disorder is a disorder which is resistant to the existing treatments and to compensate this defect, it is necessary to design and search for the new treatments. This study aims to develop and evaluate the effectiveness of the behavioral-cognitive-metacognitive intervention on the symptoms of obsessive-compulsive disorder. In order to achieve objectives of the study, after developing the behavioral-cognitive-metacognitive intervention, it was evaluated in a single-subject procedure. OCI-R scores at baseline were obtained by following the treatment on 3 individuals. The study was a single-subject research and the data were analyzed by drawing the graph. Graph drawing results showed that the behavioral-cognitive-metacognitive intervention reduced the symptoms of obsessive-compulsive disorder (OCD), and reduction of OCD symptoms was also clinically significant. As the intervention of the present study is multi-dimensional and takes into account all the three behavioral, cognitive and metacognitive aspects and considers them interdependent and not apart or contradictory, it is considered as a new intervention.
文摘In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.
基金funded by a research Grant CCNU22JC004 from Department of Science and Technology,Central China Normal Universitythe Fundamental Research Funds for the Central Universities(CCNU23CS035).
文摘The objective of this systematic review is to examine the effectiveness of psychotherapy in treating Post-Traumatic Stress Disorder(PTSD)in military personnel.PubMed,Web of Science,The Cochrane Library,EBSCO and CNKI databases were searched from 1 January,2000 to November 2022 for Randomized Controlled Trials(RCTs)on psychotherapeutic interventions for military PTSD.The physical Therapy Evidence Database(PEDro)scale was used to evaluate the quality of the literature.Two researchers conducted literature screening,data extraction,and risk bias assessment in accordance with inclusion and exclusion criteria.Ultimately,49 RCTs were included,involving a total of 5073 veterans,retired and active military from four countries.The average score on the PEDro scale was 7.60.The primary psychotherapeutic modalities for military PTSD intervention include Cognitive-Behavioral Therapy,Exposure Therapy,Mindfulness interventions,psychotherapy based on new technological tools,and other emerging psychotherapeutic tools.The review highlights that Cognitive Processing Therapy(CPT)and Prolonged Exposure Therapy(PET)stand out as the primary psychotherapeutic modalities for treating PTSD in military personnel.In cases where CPT and PET yield limited benefits,Mindfulness interventions emerge as effective alternatives.Moreover,considering the diverse needs and high dropout rates in the military,population,the review suggests using web-based,computer,and virtual reality technology tools as supplements to first-line treatments(CPT/PET)to enhance overall intervention effectiveness.For the advancement of future psychotherapeutic initiatives,there is a pronounced emphasis on prioritizing proven first-line interventions,CPT and PET while also recognizing the potential of mindfulness-based interventions as credible alternatives.In tandem with this,the active integration of technological tools is advocated to amplify the therapeutic impact of conventional psychological treatment modalities.
基金National Science and Technology Support Plan[Key Technique of Major Mental Illness Prevention Study](2012BAI01B04)Shanghai "Science and Technology Innovation Action Plan"Science and Technology Support Project in Medicine and Agriculture in 2015(Code:15411950201)Shanghai Construction Plan of Key Medical Specialty(ZK2015A06)
文摘Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children and adults with this disorder as, thanks to advances in both pharmacological and psychological therapies, prognosis for those afflicted with OCD is quite good in the long term, even though most have comorbid disorders that are also problematic. We still have far to go, however, until OCD can be described as either easily treatable or the effective treatments are widely known about among clinicians. This review focuses on the current state of the art in treatment for OCD and where we still are coming up short in our work as a scientific community. For example, while the impact of medications is quite strong for adults in reducing OCD symptoms, current drugs are only somewhat effective for children. In addition, there are unacceptably high relapse rates across both populations when treated with pharmacological alone. Even in the cognitive-behavioral treatments, which show higher effect sizes and lower relapse rates than drug therapies, drop-out rates are at a quarter of those who begin treatment. This means a sizable portion of the OCD population who do obtain effective treatments(which appears to be only a portion of the overall population) are not effectively treated.Suggestions for future avenues of research are also presented. These are primarily focused on(1) increased dissemination of effective therapies;(2) augmentation of treatments for those with residual symptoms, both for psychotherapy and pharmacotherapy; and(3) the impact of comorbid disorders on treatment outcome.
文摘Objective: Anxiety disorders of childhood are prevalent, debilitating conditions that do not always respond to existing treatments. Attentional biases towards threatening stimuli have been reported in anxious children and hypothesized to interfere with treatment response. Therefore, we examined such biases in children with anxiety disorders in relation to cognitive behavioral therapy (CBT) outcomes. Method: Thirty-eight children diagnosed with anxiety disorders in a specialized clinic (21 girls and 17 boys;age = 10.50 ± 1.11 years) and 36 unaffected community controls (19 girls and 17 boys;age = 10.20 ± 1.07 years) participated. Participants completed standardized questionnaire measures of anxiety and a probe position task (PPT) with facial cues. This task often reveals a response slowing effect related to threatening faces in vulnerable individuals. Children with anxiety disorders repeated these measures after completing CBT. Results: Groups did not differ in performance on the PPT, but angry/calm incongruent difference scores were significantly associated with self-reports of social anxiety and state anxiety. When controlling for pre-CBT anxiety levels, incongruent difference scores involving angry faces predicted post-CBT anxiety disorders index scores on the Multidimensional Anxiety Scale for Children. PPT scores did not change significantly with CBT. Conclusions: Attentional bias towards threat on the PPT task may predict response to CBT and appears linked to social anxiety. Interventions to ameliorate this bias merit further study, as they might improve treatment outcomes for anxious, especially socially anxious, children.
文摘AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied Health Literature,PsycI NFO,Clinical Trial.gov searches were performed using the keywords "hallucinations","behavioural therapy" and " cognitive therapy" in order to identify relevant articles published during the years of 2011 to 2016.No language limits were used.Studies conducted within control group,reviews,editorials,were excluded.Data on efficacy,acceptability and tolerability were extracted by three authors independently.Disagreements were resolved in a consensus meeting or by another reviewer.RESULTS A total of eight articles were eligible for inclusion.Two are randomized clinical trials(RCTs) and six are observational studies.The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations(AHs).Nevertheless,they considered different CBT models,particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations.As regards non RCT-studies,all papers included showed reduction on frequency and severity of AHs and distress related to them.However,the lack of content details within non-RCTs studies decreased their comparability.In terms of predictive variables,our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy.Indeed,negative symptoms showed a significant negative correlation on outcome.CONCLUSION Although more conclusive studies are still needed,we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.
基金Supported by Ministry of Science,Innovation and Universities,and the State Research Agency,No.PID2019-105737RBI00/AEI/10.13039/501100011033。
文摘This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at all stages of their life.We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population,along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems.We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID.The review is structured around the three generations of therapies:Applied behavior analysis(e.g.,positive behavior support),cognitive behavioral therapies(e.g.,mindfulness-based cognitive therapy),and contextual therapies(e.g.,dialectical behavior therapy).We conclude with some recommendations for professional practice in the fields of ID and psychiatry.
文摘This essay explores the connections between Hoarding Disorder and Substance Use Disorder,two distinct mental health conditions with clear diagnostic criteria in the DSM-5.Hoarding Disorder,marked by excessive possession accumulation and difficulties in letting go,affects 2-6%of the global population,leading to severe consequences.Potential causes include genetic predisposition,neural issues,and traumatic experience.Substance Use Disorder is influenced by more societal factors.Both disorders share a comorbidity in Attention-Deficit/Hyperactivity Disorder(ADHD).Network analysis shows a strong direct relationship between Hoarding Disorder and ADHD,while social influences increase ADHD prevalence in Substance Use Disorder individuals.Moreover,both disorders benefit from Cognitive Behavioral Therapy(CBT).Exposure and Ritual Prevention effectively address hoarding symptoms,while CBT for Substance Use Disorder focuses on the interplay between thoughts,emotions,and actions.Despite being classified as a mental illness in DSM-5,Hoarding Disorder receives less attention than Substance Use Disorder.This essay aims to raise awareness of Hoarding Disorder by highlighting its commonalities with Substance Use Disorder in terms of causes,comorbidities,and treatment approaches.
