The Effectiveness of Psychotherapy on Posttraumatic Stress Disorder in Soldier:A Systematic Review

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.

Nutritional management and autism spectrum disorder:A systematic review

BACKGROUND Autism spectrum disorder(ASD)presents unique challenges related to feeding and nutritional management.Children with ASD often experience feeding difficulties,including food selectivity,refusal,and gastrointestinal issues.Various interventions have been explored to address these challenges,including dietary modifications,vitamin supplementation,feeding therapy,and behavioral interventions.AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD.We examine the effectiveness of dietary interventions,vitamin supplements,feeding therapy,behavioral interventions,and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.METHODS We systematically searched relevant literature up to June 2024,using databases such as PubMed,PsycINFO,and Scopus.Studies were included if they investigated dietary interventions,nutritional supplements,or behavioral strategies to improve feeding behaviors in children with ASD.We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes.Data extraction focused on intervention types,study designs,participant characteristics,outcomes measured,and intervention effectiveness.RESULTS The review identified 316 studies that met the inclusion criteria.The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies,the effectiveness of these approaches varies.Feeding therapy and behavioral interventions,including gradual exposure and positive reinforcement,promise to improve food acceptance and mealtime behaviors.The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications,supplementation,feeding therapy,and behavioral strategies.The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes.Collaborative efforts among healthcare providers,educators,and families are essential to optimize this population's nutritional health and feeding practices.Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.

Multimodal integrated intervention for children with attentiondeficit/hyperactivity disorder

BACKGROUND Attention-deficit/hyperactivity disorder(ADHD)is one of the most common disorders in child and adolescent psychiatry,with a prevalence of more than 5%.Despite extensive research on ADHD in the last 10 to 20 years,effective treatments are still lacking.Instead,the concept of ADHD seems to have become broader and more heterogeneous.Therefore,the diagnosis and treatment of ADHD remains challenging for clinicians.AIM To investigate the effects of a multimodal integrated intervention for children with ADHD.METHODS Between March 2019 and September 2020,a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility,two of whom revoked their consent.A case-control study was conducted in which the children were equally assigned,using a randomized number table,to either a medication group(methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets)or a multimodal integrated intervention group(medication+parent training+behavior modification+sensory integration therapy+sand tray therapy),with 49 patients in each group.The clinical endpoint was the efficacy of the different intervention modalities.RESULTS The two groups of children with ADHD had comparable patient characteristics(P>0.05).Multimodal integrated intervention resulted in a significantly higher treatment efficacy(91.84%)than medication alone(75.51%)(P<0.05).Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone(P<0.05).The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group(P<0.05).Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone(P<0.05).CONCLUSION Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children.It enhanced their memory and attention with high safety and parental satisfaction,demonstrating good potential for clinical promotion.

The incorporation of emotion-regulation skills into couple-and family-based treatments for post-traumatic stress disorder

Post-traumatic stress disorder(PTSD) is a disabling, potentially chronic disorder that is characterized by re-experience and hyperarousal symptoms as well as the avoidance of trauma-related stimuli. The distress experienced by many veterans of the Vietnam War and their partners prompted a strong interest in developing conjoint interventions that could both alleviate the core symptoms of PTSD and strengthen family bonds. We review the evolution of and evidence base for conjoint PTSD treatments from the Vietnam era through the post-911 era. Our review is particularly focused on the use of treatment strategies that are designed to address the emotions that are generated by the core symptoms of the disorder to reduce their adverse impact on veterans, their partners and the relationship. We present a rationale and evidence to support the direct incorporation of emotion-regulation skills training into conjoint interventions for PTSD. We begin by reviewing emerging evidence suggesting that high levels of emotion dysregulation are characteristic of and predict the severity of both PTSD symptoms and the level of interpersonal/marital difficulties reported by veterans with PTSD and their family members. In doing so, we present a compelling rationale for the inclusion of formal skills training in emotional regulation in couple–/family-based PTSD treatments. We further argue that increased exposure to trauma-related memories and emotions in treatments based on learning theory requires veterans and their partners to learn to manage the uncomfortable emotions that they previously avoided. Conjoint treatments that were developed in the last 30 years all acknowledge the importance of emotions in PTSD but vary widely in their relative emphasis on helping participants to acquire strategies to modulate them compared to other therapeutic tasks such as learning about the disorder or disclosing the trauma to a loved one. We conclude our review by describing two recent innovative treatments for PTSD that incorporate a special emphasis on emotion-regulation skills training in the dyadic context: structured approach therapy(SAT) and multi-family group for military couples(MFG-MC). Although the incorporation of emotion-regulation skills into conjoint PTSD therapies appears promising, replication and comparison to cognitive-behavioral approaches is needed to refine our understanding of which symptoms and veterans might be more responsive to one approach versus others.

Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans

Background:Large numbers of post-deployment U.S.veterans are diagnosed with post-traumatic stress disorder(PTSD)and/or traumatic brain injury(TBI),leading to an urgent need for effective interventions to reduce symptoms and increase veterans’coping.PTSD includes anxiety,flashbacks,and emotional numbing.The symptoms increase health care costs for stress-related illnesses and can make veterans’civilian life difficult.Methods:We used a randomized wait-list controlled design with repeated measures of U.S.military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding(THR)program for decreasing PTSD symptoms and increasing coping self-efficacy,emotion regulation,social and emotional loneliness.Fiftyseven participants were recruited and 29 enrolled in the randomized trial.They were randomly assigned to either the horse riding group(n=15)or a wait-list control group(n=14).The wait-list control group experienced a 6-week waiting period,while the horse riding group began THR.The wait-list control group began riding after 6 weeks of participating in the control group.Demographic and health history information was obtained from all the participants.PTSD symptoms were measured using the standardized PTSD Checklist-Military Version(PCL-M).The PCL-M as well as other instruments including,The Coping Self Efficacy Scale(CSES),The Difficulties in Emotion Regulation Scale(DERS)and The Social and Emotional Loneliness Scale for Adults-short version(SELSA)were used to access different aspects of individual well-being and the PTSD symptoms.Results:Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR(P≤0.01)as well as a statistically and clinically significant decrease after 6 weeks of THR(P≤0.01).Logistic regression showed that participants had a 66.7%likelihood of having lower PTSD scores at 3 weeks and 87.5%likelihood at 6 weeks.Under the generalized linear model(GLM),our ANOVA findings for the coping self-efficacy,emotion regulation,and social and emotional loneliness did not reach statistical significance.The results for coping self-efficacy and emotion regulation trended in the predicted direction.Results for emotional loneliness were opposite the predicted direction.Logistic regression provided validation that outcome effects were caused by riding longer.Conclusion:The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.

Recent advancements in noninvasive brain modulation for individuals with autism spectrum disorder

Autism spectrum disorder is classified as a spectrum of neurodevelopmental disorders with an unknown definitive etiology.Individuals with autism spectrum disorder show deficits in a variety of areas including cognition,memory,attention,emotion recognition,and social skills.With no definitive treatment or cure,the main interventions for individuals with autism spectrum disorder are based on behavioral modulations.Recently,noninvasive brain modulation techniques including repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,continuous theta burst stimulation,and transcranial direct current stimulation have been studied for their therapeutic properties of modifying neuroplasticity,particularly in individuals with autism spectrum disorder.Preliminary evidence from small cohort studies,pilot studies,and clinical trials suggests that the various noninvasive brain stimulation techniques have therapeutic benefits for treating both behavioral and cognitive manifestations of autism spectrum disorder.However,little data is available for quantifying the clinical significance of these findings as well as the long-term outcomes of individuals with autism spectrum disorder who underwent transcranial stimulation.The objective of this review is to highlight the most recent advancements in the application of noninvasive brain modulation technology in individuals with autism spectrum disorder.

Ultrasonic vocalizations in mice: relevance for ethologic and neurodevelopmental disorders studies

Mice use ultrasonic vocalizations(USVs)to communicate each other and to convey their emotional state.USVs have been greatly characterized in specific life phases and contexts,such as mother isolation-induced USVs for pups or female-induced USVs for male mice during courtship.USVs can be acquired by means of specific tools and later analyzed on the base of both quantitative and qualitative parameters.Indeed,different ultrasonic call categories exist and have already been defined.The understanding of different calls meaning is still missing,and it will represent an essential step forward in the field of USVs.They have long been studied in the ethological context,but recently they emerged as a precious instrument to study pathologies characterized by deficits in communication,in particular neurodevelopmental disorders(NDDs),such as autism spectrum disorders.This review covers the topics of USVs characteristics in mice,contexts for USVs emission and factors that modulate their expression.A particular focus will be devoted to mouse USVs in the context of NDDs.Indeed,several NDDs murine models exist and an intense study of USVs is currently in progress,with the aim of both performing an early diagnosis and to find a pharmacological/behavioral intervention to improve patients’quality of life.

Non-pharmacological management of pediatric functional abdominal pain disorders:Current evidence and future perspectives

Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome Ⅲ, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.

Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians

There is a complex relationship between sleep disorders and childhood neurodevelopmental,emotional,behavioral and intellectual disorders(NDEBID).NDEBID include several conditions such as attention deficit/hyperactivity disorder,autism spectrum disorder,cerebral palsy,epilepsy and learning(intellectual)disorders.Up to 75%of children and young people(CYP)with NDEBID are known to experience different types of insomnia,compared to 3%to 36%in normally developing population.Sleep disorders affect 15%to 19%of adolescents with no disability,in comparison with 26%to 36%among CYP with moderate learning disability(LD)and 44%among those with severe LD.Chronic sleep deprivation is associated with significant risks of behavioural problems,impaired cognitive development and learning abilities,poor memory,mood disorders and school problems.It also increases the risk of other health outcomes,such as obesity and metabolic consequences,significantly impacting on the wellbeing of other family members.This narrative review of the extant literature provides a brief overview of sleep physiology,aetiology,classification and prevalence of sleep disorders among CYP with NDEBIDs.It outlines various strategies for the management,including parenting training/psychoeducation,use of cognitive-behavioral strategies and pharmacotherapy.Practical management including assessment,investigations,care plan formulation and follow-up are outlined in a flow chart.

Bipolar I disorder and expressed emotion of families: A cohort study in Japan

The relationships between expressed emotion (EE) of the families and the course of bipolar disorder have been examined only in a limited number of cohort studies. No study has yet been reported from Asia. The subjects were 12 patients that had been diagnosed with bipolar I disorder according to DSM-IV and their 12 key family members. The families of the patients were interviewed using the Camberwell Family Interview (CFI) within 2 weeks of the admission of the patients, and their EE were evaluated. The patients were then followed up for 9 months after their discharge from the hospital. The patients were divided into a high-EE group and a low-EE group using the cut-off based on the number of critical comments (CC) and emotional overinvolvement (EOI), and the 9-month relapse risk was compared. When the subjects with 3 or more CC or an EOI score of 3 or more were regarded as the high-EE group, and the others as the low-EE group, the 9-month relapse risk was 100% (3/3) for the high EE group and 0% (0/9) for the low EE group. (Fisher’s exact test p = 0.005) EE based on the CFI appear to be correlated with relapse in bipolar I disorder in Japan.

共情理论的个性化干预措施对双相情感障碍患者情绪调节和康复的影响

目的:探讨基于共情理论的个性化干预措施对双相情感障碍(BD)患者情绪调节和康复的影响。方法:选取某院2022年3月—2024年3月收治的BD患者84例,根据随机数字表法将其分成对照组和观察组(各42例)。对照组给予常规干预措施,观察组在对照组基础上实施基于共情理论的个性化干预措施。比较两组应对方式[简易应对方式问卷(SCSQ)评分]、情绪状况[贝克-拉范森躁狂量表(BRMS)和抑郁自评量表(SDS)评分]、社会功能[社会功能缺陷筛选量表(SDSS)评分]、认知功能[蒙特利尔认知评估量表(MoCA)评分]、康复效果及睡眠质量[匹兹堡睡眠质量指数(PSQI)评分]。结果:干预后,观察组SCSQ中的积极应对评分高于对照组,消极应对评分低于对照组(t=4.910,8.327;P<0.05);观察组BRMS、SDS评分均低于对照组(t=8.365,2.949;P<0.05);观察组SDSS评分低于对照组,MoCA评分高于对照组(t=11.194,3.008;P<0.05);观察组总有效率高于对照组(χ^(2)=5.126;P<0.05);观察组PSQI各维度及总分均低于对照组(t=2.625,4.646,3.202,5.195,4.955,3.814,2.436,6.040;P<0.05)。结论:基于共情理论的个性化干预措施可改善BD患者应对方式和情绪状况,提高其社会功能、认知功能和睡眠质量,康复效果确切。

The Mechanism of Cortico-Striato-Thalamo-Cortical Neurocircuitry in Response Inhibition and Emotional Responding in Attention Deficit Hyperactivity Disorder with Comorbid Disruptive Behavior Disorder

The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.

An Exploratory Investigation of Difficulties in Applying Functional Behavior Assessment and Implementing Behavioral Intervention Plans in ADHD Programs in Saudi Arabia

Functional behavior assessment(FBA)and behavioral intervention plans(BIPs)can be effective for students with attention deficit hyperactivity disorder(ADHD);however,teachers may face difficulties when implementing FBA procedures and,in turn,BIPs because of lack of time,insufficient training,and multiplicity of beliefs.Thus,it is important to identify the difficulties teachers may face and the obstacles that can deter them from implementing intervention plans.This is a worthwhile endeavor because nearly all classrooms will have students with behavioral problems who will benefit from specifically designed educational interventions.This study aimed to identify the difficulties in applying FBA and the barriers in implementing BIPs among Saudi teachers in specialized ADHD programs.Using the descriptive-analytical approach,a questionnaire targeting difficulties and barriers was admi-nistered to 209 public school teachers from specialized ADHD programs in Saudi Arabia.The results revealed that the difficulty level of applying FBA in ADHD programs was high.The level of barriers in implementing BIPs was moderate.Finally,the study indicated that barriers in implementing BIPs could be predicted by the difficulties of applying FBA.The results suggest the importance offinding better practices,restructuring the provision of ADHD programs,training teachers,improving assessment tool availability,and ensuring cooperation between school administrators and teachers.

From Eating to Emotional Eating

Feeding and eating disorders are common in children, and may begin in infancy, in infants who nurse or are bottle-fed. The challenges and difficulties involved in feeding and eating are diverse and characterized differently at each developmental stage. There may be a continuum between the lack of parental sensitivity in feeding infants and children and eating disorders in adolescence. In other cases, eating disorders, such as emotional eating in adolescence, are a response to environmental-familial complexity and may have genetic components without a primary source in the early stages of development. In the case described in this article, Dalia was treated for about a year for emotional eating, which resulted in excess weight. Other aspects of emotional, social, and interpersonal issues were discussed. Treatment of the symptom was not achieved but due to the therapeutic flexibility and willingness to switch between therapeutic approaches, other important goals were achieved. Treatment using positive psychology with emphasis on empowerment may be beneficial to adolescents while personality is shaped as compared with cognitive-behavioral therapy that requires a long-term commitment.

Threat perception predicts cognitive behavioral therapy outcomes 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.

Sleep Disturbance in Parkinson’s Disease Varies with Age of Onset and Family History

Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disease more common in those over the age of 60. PD is classically characterized by motor features, although patients may also experience non-motor symptoms. Sleep disturbances, such as rapid eye movement (REM) behavior disorder (RBD), are common in patients with PD and may precede onset of PD. Methods: Data was collected on patients with PD (358 subjects)in a movement disorders clinic at a safety net hospital. In this retrospective database analysis, the association of PD complications with age of onset was evaluated using chi-square tests and logistic regression. Results: Of the PD complications analyzed, there was a significant difference in sleep disturbances by age. Among the 358 PD patients, 120 individuals (33.5%) had information regarding the presence or absence of sleep disturbances. There was a significant difference between the early (onset < 50) and later onset (≥50) groups (p = 0.03) with the odds of having a sleep disorder for the early group 1.6 times that of the late group. Those subjects with siblings who also had PD had 2.0 times the odds of having a sleep disorder compared those without (p = 0.02). Conclusion: Non-motor symptoms such as sleep disorders are a useful predictor of early onset PD. Genetic components of PD impact both motor and non-motor aspects of the disease.

沙盘游戏联合药物干预对学龄期ADHD患儿负性情绪及行为管理能力的影响

目的研究沙盘游戏疗法联合药物干预对学龄期注意缺陷多动障碍(ADHD)患儿负性情绪及行为管理能力的影响。方法选取2019年6月至2022年1月于本院治疗的120例ADHD患儿为研究对象,将其随机分为观察组和对照组,每组60例。对照组给予药物治疗,观察组在对照组的基础上进行沙盘游戏干预。分别于干预前后比较2组患儿症状积分[中文版注意缺陷多动障碍筛查量表(SNAP-IV)父母版]、情绪状态[儿童焦虑性情绪障碍筛查表(SCARED)和儿童抑郁障碍自评量表(DSRSC)]和行为管理能力。结果干预后,观察组对抗性行为、多动-冲动、注意力不集中症状积分和SCARED得分、DSRSC得分均明显低于对照组(P<0.05),注意力商数、控制力商数、综合控制力商数和综合注意力商数明显高于对照组(P<0.05)。结论沙盘游戏疗法联合药物干预可有效改善学龄期ADHD患儿各项临床症状,缓解患儿焦虑、抑郁等不良情绪,提高患儿行为管理能力。

中医情志护理结合早期康复干预在胫骨骨折患者中的效果及对应激障碍的影响

目的探析胫骨骨折患者采用中医情志护理配合早期康复干预的效果及对应激障碍的影响。方法选取2021年5月至2022年5月江西中医药大学附属医院收治的58例胫骨骨折患者作为研究对象,采用随机数字表法将其分为对照组(29例)和观察组(29例)。对照组采用早期康复护理,观察组结合中医情志护理。比较两组的应激障碍评分、康复指标、并发症发生率。结果观察组治疗后应激障碍评分低于对照组,差异有统计学意义(P<0.05);观察组骨折愈合时间、住院时间低于对照组,膝关节功能(Rasmussen)评分高于对照组,差异有统计学意义(P<0.05);两组干预前屈曲度、伸展度比较,差异无统计学意义(P>0.05),观察组干预后膝关节屈曲度大于对照组、伸展度小于对照组,差异有统计学意义(P<0.05)。观察组关节僵硬、切口感染、深静脉血栓总发生率低于对照组,差异有统计学意义(P<0.05)。结论中医情志护理配合早期康复干预应用在胫骨骨折护理干预中效果明显,可有效减轻患者应激障碍,促使患者病情康复,有效防止并发症发生,临床上可借鉴及推广。

认知行为治疗联合积极心理干预对酒精使用障碍伴抑郁患者的效果

目的探究认知行为治疗(CBT)联合积极心理干预对酒精使用障碍(AUD)伴抑郁患者酒精戒断反应、负性情绪以及复饮情况的影响。方法将184例AUD伴抑郁患者按照随机数字表法分为对照组和研究组,各92例。对照组患者给予常规药物治疗,研究组患者在对照组基础上给予CBT联合积极心理干预。比较治疗前后两组患者修订版临床酒精戒断症状评定量表(CIWAAr)、宾夕法尼亚酒精渴求量表(PACS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、药物成瘾者生存质量测定量表(QOL-DA)评分,并随访半年统计两组患者的复饮情况。结果对照组脱落2例,研究组脱落0例,最终对照组纳入90例,研究组纳入92例。治疗后,两组患者CIWA-Ar、PACS、HAMA、HAMD评分均低于治疗前,且研究组低于对照组(P<0.01)。治疗后,两组患者QOL-DA各维度评分均高于治疗前,且研究组高于对照组(P<0.01)。随访8周、16周、24周,研究组患者复饮率均低于对照组(P<0.05)。结论对AUD伴抑郁患者在常规药物治疗的基础上给予CBT联合积极心理干预,可有效帮助患者戒断酒精依赖,减轻其负性情绪,降低复饮率,改善生存质量。

孤独症谱系障碍RUBI-PT方案的改编及适应性调查

目的·探究“行为干预研究单位孤独症网络家长培训”[the Research Units in Behavioral Intervention(RUBI)Autism Network Parent Training,RUBI-PT]方案的中国本土化改编并对其适应性进行调查。方法·按照文化改编的4个步骤对RUBI-PT方案进行改编,包括信息收集、初步改编设计、初步改编测试、进一步调整。信息收集阶段邀请了6位儿科专家和2位心理治疗师进行6次焦点小组访谈,并根据专家意见从语言、治疗形式、治疗设置等方面对RUBI-PT方案进行初步改编;初步改编测试阶段招募了16位孤独症谱系障碍(autism spectrum disorder,ASD)患儿的家长,分2批参加线上RUBI-PT,结束后收集项目反馈问卷并行适应性调查分析,最后根据测试结果进行方案的进一步调整。结果·RUBI-PT的初步改编方案由个体培训调整为团体培训,包含8次核心技能课程,采用线上会议形式实施。初步测试结果显示,家长对于上课进度、上课过程、课后作业完成情况、作业点评情况的满意度分别为90%、80%、100%和100%;课程难度方面,第7次课(功能性沟通训练)和第8次课(教授技能)的难度最大。依据上述调查结果和专家小组意见完成进一步调整,最终形成本土化RUBI-PT的改编方案。结论·经过改编和适应性调查,形成了适用于中国ASD儿童家庭的家长行为训练策略即RUBI-PT。