Sessions Of Behavioral Therapy Research Articles

THE IMPACT OF PERSONALITY TRAITS ON COGNITIVE BEHAVIORAL THERAPY EFFECTIVENESS IN ADULTS WITH MAJOR DEPRESSIVE DISORDER: A PRE-POST EXPERIMENTAL STUDY

Objective: This study examined the Impact of Personality Traits on Cognitive Behavioral Therapy Effectiveness in Adults with Major Depressive Disorder. Design: Pre-Post Experimental Design Place and duration of study: Lahore, Pakistan, June 2024- September 2024. Subject and method: The participants were adults ranging in age between 18-65 years diagnosed with Major Depressive Disorder. The sample was selected through purposive sampling from different psychiatric hospitals of Lahore, Pakistan. The sample size was 40 (20 male & 20 female), equally divided and randomly assigned to a control group and an experimental group. In the pre assessment phase, Big Five inventory and Hamilton Depression Scales were employed to assess the participants’ personality traits and severity of their depression. In the intervention phase 16 group sessions of Cognitive Behavioral Therapy were carried out followed by re-assessment in the post assessment phase. Result and conclusion: The results confirmed that there is a significant difference in pre and post assessment score of Major Depressive Disorder in experimental group (t=9, p<.00). Results also showed that Personality traits are likely to impact the effectiveness of Cognitive behavioral therapy where Conscientiousness (M=18.25, SD=4.99) showed the highest significant difference with depression (p<.005). Moreover, Agreeableness also showed significant difference (p<.005) with depression (M=18.30), (SD=5.19). The findings indicated that clients with these two personality traits benefit the most from Cognitive Behavioral Therapy as compared to participants with other personality traits.

The potential effect of d-cycloserine on the development of anxiety during exposure sessions in patients with agoraphobia

IntroductionCombination of exposure therapy with d-cycloserine (DCS) in patients suffering from anxiety disorders yielded promising results regarding treatment outcomes. However, less is known about short-term effects of DCS during the treatment process, e. g. its potential influence on anxiety during exposure sessions. In this exploratory secondary analysis using data from a randomized, double-blind, placebo-controlled trial, we investigated longitudinal changes in anxiety during exposure in agoraphobic patients receiving DCS or placebo (PBO). Methods73 patients suffering from agoraphobia (with or without panic disorder) were treated with 12 sessions of individual cognitive behavioral therapy including three exposure sessions. Patients were given either PBO or 50mg of DCS after each successful exposure. Multilevel modeling was used to analyze changes in outcomes measured in subjective units of distress (SUDS) over three time points (i.e. the exposure sessions) in the two groups. ResultsWe observed a decline in several SUDS outcomes in the DCS group, namely initial anxiety, maximum anxiety during exposure and within-session habituation, while the PBO group mostly maintained similar levels of anxiety from session to session. Anxiety at the end of exposure appeared to be stable in the DCS group as well. DiscussionOur findings suggest potential short-term effects of DCS on anxiety during exposure. Long lasting and high degree of anxiety over exposure sessions is burdensome for the patients. Thus, modifications to reduce anxiety during exposure or to accelerate the learning process while maintaining the same treatment efficacy could be desirable. However, given the exploratory nature of the analyses, confirmatory studies testing the hypothesis of a decline of SUDS in agoraphobic patients are needed before confident conclusions can be made.

The effects of a sleep intervention in the early COVID-19 pandemic on insomnia and depressive symptoms: Results of a randomized controlled pilot study.

The COVID-19 Pandemic increased the prevalence and severity of insomnia and depression symptoms. The effects of an insomnia intervention on future insomnia and depression symptoms delivered during an ongoing stressor, which may have precipitated the insomnia symptoms, is unknown. We conducted a two-arm randomized controlled pilot study to evaluate whether an insomnia intervention would improve the trajectory of insomnia and depression symptoms in the context of a global pandemic. Forty-nine individuals with clinically significant insomnia symptoms that emerged after the start of the COVID-19 Pandemic were randomized to one of two groups: one group received four sessions of Cognitive Behavioral Therapy for Insomnia (CBT-I) over five weeks via telehealth, and the other was assigned to a 28-week waitlist control group. Participants completed assessments of insomnia and depressive symptom severity at baseline (week 0) and at weeks 1-6, 12, and 28. Linear mixed-effects models were used to evaluate treatment efficacy. The MacArthur model was used to test whether improvement in insomnia symptoms mediated subsequent improvement in mood. The CBT-I group showed improved trajectories of insomnia (b=-1.03, p<0.005, 95% CI [-1.53, -0.53]) and depressive symptoms (b=-0.47, p=0.007, [-0.80, -0.13]) across the 28 weeks compared to the control group. The rate of improvement of insomnia symptoms during treatment mediated the subsequent improvement in depressive symptom severity following treatment (b=2.10, p=0.024, [0.30, 3.90]). Although the sample size was small, these results underscore the potential CBT-I in the context of an ongoing stressor to not only alleviate insomnia symptoms, but also improve depressive symptoms.

Understanding Early Treatment Response in Brief CBT for Nonunderweight Eating Disorders: A Mixed Methods Study.

Early change in eating disorder psychopathology is the most robust predictor of treatment outcomes in eating disorders. However, little is known about what predicts early change. Using mixed-methodology, this study explored predictors of early change in the first four sessions of 10-session cognitive behavioral therapy (CBT-T) for nonunderweight eating disorders. Phase 1: interviews were conducted to explore CBT-T clinicians' perspectives on predictors of early change. Phase 2: robust multiple regressions were undertaken to examine whether any of five variables identified during interviews-diagnosis, wait time, therapeutic alliance, depression, and anxiety-were associated with early change in eating disorder psychopathology. Data were derived from outcome measures for service users (n = 107) receiving CBT-T in a community eating disorder service. Phase 1: eight themes were identified: attitudes to making change, diagnosis, external mitigating circumstances, therapeutic alliance, therapist confidence, pretreatment variables, CBT-T format, and therapeutic suitability. Phase 2: no significant associations were found between the five predictor variables (diagnosis type, wait time, baseline depression, baseline anxiety, and therapeutic alliance) and early change in EDE-Q scores. These results have been certified as computationally reproducible by an independent statistician. Qualitative findings identified several potential predictors of early change in eating disorder psychopathology in CBT-T, however, quantitative data contradicted qualitative findings, finding no significant association for any of the tested variables. Further research is required to clarify theses conflicting findings and to quantitatively explore the additional predictors highlighted during qualitative analysis.

A Psychometric Evaluation of the Parenting Anxious Kids Rating Scale (PAKRS-PR) in a Sample of Families with Clinically Anxious Children.

The Parenting Anxious Kids Rating Scale-Parent Report (PAKRS-PR) measures five types of anxiogenic parenting. The present study aimed to extend the previous psychometric evaluation of the PAKRS-PR to a treatment-seeking sample and examine sensitivity to change over 15 sessions of cognitive behavioral therapy. The sample included 383 parent-child dyads presenting to treatment at a specialty outpatient clinic. Cronbach's α was acceptable for the PAKRS-PR Total scale and several subscales, although the Accommodation/Beliefs and Warmth/Support subscales were in the unacceptable/questionable range. Convergent validity was found to be mixed with the closest relationship between anxiety severity and the Accommodation/Beliefs, Warmth/Support, and Conflict PAKRS-PR subscales. Additionally, the PAKRS-PR Total score and subscales changed significantly throughout treatment, but were not associated with treatment response or child- or clinician-rated treatment outcome measures. Overall, the current findings demonstrate some support for the psychometric properties of the PAKRS-PR; however, further refinement of the PAKRS-PR at the item-level is recommended to further strengthen the measure.

Development and validation of a self-esteem improvement program for family caregivers with dementia ‐ Utilizing ICT

The sense of caregiving burden can be significant among family caring for people with dementia and can impact mental health. Research to find ways to alleviate this burden is extremely important. Dr Yoshihiro Saito, Faculty of Nursing, Reiwa Health Sciences University, Japan, is leading a team working to develop and validate a self-esteem improvement programme designed for family caregivers of those with dementia. The project was inspired by Saito experiencing firsthand the stresses placed on family carers of people with dementia. The goal of the programme is to reduce the self-blame of dementia family caregivers and is informed by Saito’s expertise in cognitive behavioural therapy. A key part of the programme is self-compassion in order to help caregivers realise their worth. Ultimately, the aim is that, through the programme, caregivers can be kinder to themselves and realise the value and significance of their efforts. Alongside heading up this project, Saito is a supervisor for the Cognitive Behavioural Therapy Training Programme of the Ministry of Health, Labour and Welfare in Japan, focusing on popularising cognitive behavioural therapy and training the next generation. In this role, he listens to and reviews recordings of cognitive behavioural therapy sessions, providing practical advice. In the context of Japan’s ageing population, there will be an increase in people with dementia and family caregivers. Therefore, Saitoâ–™s work will be hugely beneficial in assisting those with dementia, caregivers and society.

The relationship between chronotype and treatment time of day on post-treatment depression symptom severity for depressed patients receiving cognitive behavioural therapy

BackgroundMajor depressive disorder (MDD) represents a serious public health problem that affects a quarter billion individuals worldwide. Consequently, there is a need to identify modifiable factors of services that support treatment success. The relationship between circadian preferences (i.e., chronotype), treatment time of day, and outcomes is an understudied research area. Executing optimal treatment timing based on these factors could lead to substantial returns on a modifiable variable. MethodThe present study evaluated the associations between chronotype and treatment time of day on post-treatment depression symptom severity. In a tertiary setting, outpatients with MDD (n = 227) received 14 sessions of cognitive behavioural therapy in a group format, at one of three time of days: morning, afternoon, or evening. Participants completed measures of depression and chronotype at baseline and post-treatment. ResultStatistically significant increases in morningness were found for the afternoon and evening groups, but not the morning group. There was no significant interaction effect between pre-treatment morningness-eveningness scores and treatment time of day on post-treatment depression scores nor treatment response. However, there was a significant interaction effect of change in morningness-eveningness scores and post-treatment depression severity in the afternoon group. LimitationsThe lack of a control group limits conclusions drawn. ConclusionThe results suggest that individual circadian phase may impact treatment outcomes in relation to time of day. Further intentionally designed research is warranted to improve understanding of predictors, moderators, and mediators of patient outcomes based on treatment time of day and circadian phase and amplitude.

Brief Cognitive Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated after discharge from inpatient level of care. Empirically supported inpatient suicide prevention treatments are needed. To determine whether adding an inpatient version of brief cognitive behavioral therapy for suicide prevention to treatment as usual reduces postdischarge suicide attempts, suicidal ideation, and psychiatric readmissions and to determine whether substance use disorder moderates treatment effects. This randomized clinical trial compared treatment as usual (n = 106) to treatment as usual plus brief cognitive behavioral therapy for inpatients (n = 94) at a private psychiatric hospital in Connecticut. Follow-up assessments were completed monthly for 6 months postdischarge. Participants were enrolled from January 2020 through February 2023. Inpatients admitted following a suicidal crisis (past-week suicide attempt or ideation with plan on admission and attempt within previous 2 years) were included. Medical records of consecutive admissions (n = 4137) were screened, 213 were study eligible and randomized, and 200 were analyzed. A total of 114 participants (57.0%) completed 6-month follow-up assessments. Data from medical records were also obtained through 6-month follow-up. Up to 4 individual sessions of brief cognitive behavioral therapy for suicide prevention designed for inpatients. Suicide attempts and readmissions were assessed via blind interviews and medical record review. Suicidal ideation was assessed via self-report. The mean (SD) age among 200 analyzed participants was 32.8 (12.6) years; 117 participants were female and 83 were male. Brief cognitive behavioral therapy-inpatient reduced the occurrence of suicide attempt over 6 months postdischarge by 60% (odds ratio, 0.40; 95% CI, 0.20-0.80; number needed to treat, 7) in the entire patient group, and the rate of psychiatric readmissions by 71% (rate ratio, 0.29; 95% CI, 0.09-0.90) in those without a substance use disorder. The effect of treatment condition on suicidal ideation was less clear, although post hoc analyses indicated less severe suicidal ideation following brief cognitive behavioral therapy-inpatient vs treatment as usual at 1 and 2 months postdischarge. Brief cognitive behavioral therapy-inpatient reduced 6-month postdischarge suicide reattempts and rate of readmissions when added to treatment as usual. Substance use disorder moderated the treatment's effect on readmission rates. Treatment effects on suicidal ideation were less clear. Implementation research is needed to facilitate dissemination. Additional research is also needed to optimize outcomes for individuals with substance use disorders. ClinicalTrials.gov Identifier: NCT04168645.

Emotions observed during sessions of dialectical behavior therapy predict outcome for borderline personality disorder.

We examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Participants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome. More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%-34%). Clients' in-session emotional experiences predict treatment outcome 8-10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Network analyses of ecological momentary emotion and avoidance assessments before and after cognitive behavioral therapy for anxiety disorders

Negative emotions and associated avoidance behaviors are core symptoms of anxiety. Current treatments aim to resolve dysfunctional coupling between them. However, precise interactions between emotions and avoidance in patients’ everyday lives and changes from pre- to post-treatment remain unclear. We analyzed data from a randomized controlled trial where patients with anxiety disorders underwent 16 sessions of cognitive behavioral therapy (CBT). Fifty-six patients (68 % female, age: M = 33.31, SD = 12.45) completed ecological momentary assessments five times a day on 14 consecutive days before and after treatment, rating negative emotions and avoidance behaviors experienced within the past 30 min. We computed multilevel vector autoregressive models to investigate contemporaneous and time-lagged associations between anxiety, depression, anger, and avoidance behaviors within patients, separately at pre- and post-treatment. We examined pre-post changes in network density and avoidance centrality, and related these metrics to changes in symptom severity. Network density significantly decreased from pre- to post-treatment, indicating that after therapy, mutual interactions between negative emotions and avoidance were attenuated. Specifically, contemporaneous associations between anxiety and avoidance observed before CBT were no longer significant at post-treatment. Effects of negative emotions on avoidance assessed at a later time point (avoidance instrength) decreased, but not significantly. Reduction in avoidance instrength positively correlated with reduction in depressive symptom severity, meaning that as patients improved, they were less likely to avoid situations after experiencing negative emotions. Our results elucidate mechanisms of successful CBT observed in patients’ daily lives and may help improve and personalize CBT to increase its effectiveness.

Negative affect variability as a potential mechanism of behavior change in alcohol use disorder treatment.

Negative affect and affect variability figure prominently in models of addictive behaviors but are not without controversy. Negative affect variability may better capture a mechanism of behavior change in alcohol use disorder (AUD) treatment because it contains information about affect regulation, a common clinical target. The aims of this study are to examine the change in: (a) trajectory of negative affect variability, (b) association of negative affect variability and abstinence, and (c) association of negative affect variability and heavy drinking during AUD treatment. This article is a secondary analysis of data drawn from a randomized clinical trial. N = 181 participants diagnosed with Diagnostic and Statistical Manual of Mental Disorders, fifth edition AUD (Mage = 50.8, SDage = 10.6; 51.4% female) received 12 sessions of Cognitive Behavioral Coping Skills Therapy for AUD. Participants completed one daily diary prompt per day for 84 consecutive days. Each day, participants reported on negative affect and number of alcoholic drinks consumed the previous day. Time-varying effect models examined changes in negative affect variability and its associations with abstinence and heavy drinking. Negative affect variability decreased throughout treatment. The positive association between negative affect variability and heavy drinking became nonsignificant (decoupled) midway through treatment. The inverse association between negative affect variability and daily abstinence became nonsignificant (decoupled) at approximately day 75 of 84. When mean levels of NA were added as a covariate, the effects were in the same direction but no longer statistically significant. Reductions in negative affect variability may capture an important change mechanism of behavioral treatments for AUD because it contains information about affect regulation as compared with mean levels of negative affect. Negative affect variability warrants further consideration as a mechanism of behavior change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Mental Imagery Instructions on Patients' and Therapists' Positive Affect and Strength-Based Behaviours Within Psychotherapy Sessions: A Randomized Controlled Process Study.

Increased attention has recently been paid to the well-being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength-based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions. This is a secondary analysis of a randomized controlled trial. Seventy-eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; Mage = 40.31) treated by 13 therapists were selected. PA and strength-based behaviours of patients and therapists were coded on a minute-by-minute basis with the Resource-Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling. Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength-based behaviours were employed in one-fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength-based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend. Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression. ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).

Videoconference-Delivered Cognitive Behavioral Therapy for Parents of Adolescents With Internet Addiction: Pilot Randomized Controlled Trial.

The rise in internet addiction, including web-based gaming and social networking services, is a serious concern. Even with access to medical institutions and counseling services, individuals with internet addiction, particularly adolescents, often refuse medical treatment or counseling. Parent-focused psychological intervention may lead to positive outcomes by improving the parent-adolescent relationship and helping parents identify and modify their adolescent's problematic behaviors, including internet addiction. This study was a pilot randomized controlled trial to test the feasibility of remote cognitive behavioral therapy via videoconferencing for parents of adolescents with internet addiction. A total of 13 parents of adolescents aged 12-20 years with internet addiction were recruited and randomly assigned to either 12 sessions of the videoconference-delivered cognitive behavioral therapy (vCBT) group (n=6, 46%) or the waitlist control group (n=7, 54%). The study period was from March 1, 2018, to March 31, 2022. The primary outcome was the scores of the Young Internet Addiction Test reported by the adolescents. The secondary outcomes were adolescents' hours of internet use per day (Internet Addiction Test), reported by the adolescents and by their parents; the Young Diagnostic Questionnaire, completed by the parents; and the quality of life of the adolescents and the parents, measured by the EQ-5D-5L. These were evaluated at weeks 0 and 13. As the primary outcome, the mean total Internet Addiction Test score decreased from 67.7 (SD 18.3; 6/13, 46%) at week 0 to 56.2 (SD 25.1; 5/9, 56%) at week 13 in the vCBT group, compared to an increase from 66.9 (SD 21.9; 7/13, 54%) to 68.0 (SD 18.7; 4/9, 44%) in the control group. For all outcomes, no significant differences were found between the 2 groups (all P>.05). This study suggested the practical feasibility of vCBT for parents of adolescents with internet addiction. Further large-scale, multicenter randomized controlled trials are necessary to examine the effectiveness. UMIN Clinical Trials Registry UMIN000032483; https://tinyurl.com/yuhen6c9.

(136) “TURN OFF THE RIGIDOMETER” TECHNIQUE FOR ERECTILE DYSFUNCTION AND LITERATURE REVIEW

Abstract Introduction Erectile dysfunction (ED) is the most common sexual dysfunction in men after the age of 50, although it can occur at all ages. We describe a new technique using the Cognitive Behavioral and Sexual Therapy line and review the techniques already published for ED. Objective We have two objectives: 1) To describe the study of a new technique called “Turn off the rigidometer” which aims to stop observing the rigidity of the penis and focus on something erotic. This analysis of penile rigidity is common among those who suffer from ED and only hinders the erection; 2) we list most of the already published techniques that can be used for ED with psychosocial or mixed etiologies. Methods This technique was used in 20 men with ED of psychosocial etiology, lasting less than 7 months. In the “Turn Off the Rigidometer” technique, the man is instructed to stop analyzing rigidity and focus on one of three aspects: 1) the erotic game with the partner; 2) In the part that he considers most erotic in the body of the partnership; 3) fantasize about sexual practices. Literature review from the last 70 years was carried out using English language databases; Results The 20 patients liked the name of the technique and identified with it because they realized that it was analyzing penile rigidity. The average age was 32 years old, all had been in relationships of more than 2 years, and had completed university education. They had already been undergoing treatment for 2 months when they started applying the technique. The 20 men had initial difficulty stopping the stiffness analysis. The correct use of the complete technique with shifting the focus to one of the three options occurred after the fourth attempt. The average duration of treatment was 5 months. Techniques already published: 1) Prohibited coitus; 2) Improve self-esteem; 3) Support; 4) Clarification; 5) Modified Stop-Start; 6) Focusing Sensations I; 7) Focusing sensations II; 8) Paradoxical intention; 9) Strangulation; 10) Erection without Ejaculation and Orgasm; 11) Ejaculation and extravaginal orgasm; 12) Introduction of the penis without ejaculation and orgasm; For fear of performance: 13) Stopping thinking; 14) Distraction from Distraction; 15) Permission for coitus. Conclusions The “Turn Off the Rigidometer” technique proved to be effective in 20 men with psychosocial ED to recover erections together with Cognitive Behavioral and Sexual Therapy sessions. Fifteen psychotherapeutic techniques published in English were found. Disclosure No.

(139) IMPROVEMENTS IN ANCIENT TECHNIQUE TO TREAT HYPOACTIVE SEXUAL DESIRE IN WOMEN

Abstract Introduction Hypoactive Sexual Desire (HSDD), which generates distress, is the most common problem in women in sexological clinics. The Sexual Menu technique was published in 2005 for treatment of HSDD. Scientific knowledge has improved and technology has advanced, making it possible to incorporate some topics into this technique. Objective To describe steps that can be added to the Sexual Menu technique, which is based on thinking about sex several times a day. Consisting of 3 steps, which are homework assignments, between the Cognitive Behavioral and Sexual Therapy sessions. Bring the test results of the suggested additions in a sample of 52 women with HSDD. Methods 52 patients with Hypoactive Sexual Desire agreed to participate in the research knowing that we would use a modification of the aforementioned technique. Below I mention four additions to the original technique. A new item created, step 1b: Question about the film or book analyzing the reasons for the success of the relationship, the strengths and weaknesses of the relationship and the reasons for the breakup. As step 2b, the woman will create a mini video of the couple’s pleasant scenes (sensual and/or sexual) using a cell phone. This will give her easy access to viewing the scenes chosen for the video, several times a day, as they will be on your cell phone. On page 96 of the original technique, the woman is asked to imagine the memorized erotic scenes. In step 4a (created), the woman will be asked to review the mini videos made BEFORE meeting her sexual partner, without the obligation to have sexual desire or to take the initiative. In step 4b, the woman must also imagine, after watching the video on her cell phone, having sex with her partner. These two items cannot be communicated to the sexual partner to avoid generating sexual charges. Results The additions mentioned in the Sexual Menu technique were well accepted by the patients. Characteristics of the women in the sample: the average age was 35 years old, the average relationship was 6 years and 2 months. The average time of existence of the HSDD was 5 years and 1 month. Making mini videos is easy and cheap: step 2b. “Anticipate coitus with her partner in her mind”, in our proposal after watching the cell phone video, science says that it increases endogenous testosterone (Van Anders et all 2007), and it is step 4b. The original technique in its name already talks about thinking about sex several times a day. A 2011 study by Goldey &amp; Van Anders reports that thinking about sex, for women, increases endogenous testosterone. Conclusions The 52 patients reacted positively to the steps added to the Sexual Menu Technique. The average duration of treatment was 6 months and 20 days. This set of techniques will help sexologists improve sexual desire and, as a consequence, women’s sexual health and quality of life. Disclosure No.

Testing a new model of telehealth-delivered treatment for primary care patients with alcohol use disorder: A randomized controlled trial protocol

BackgroundThe majority of adults suffering from alcohol use disorders (AUD) do not receive treatment. To address this gap in care, we must develop new models to increase identification, engagement and delivery of accessible and effective treatment. This paper describes the protocol for a randomized controlled trial (RCT) testing a novel telehealth treatment model for primary care patients with untreated AUD. MethodsWe aim to recruit 300 adults across 2 healthcare systems for this two-arm RCT. Participants, initially identified for recruitment based on AUD-related indicators in their electronic health record (EHR), are RCT-eligible if they meet AUD criteria (mild, moderate, severe), report ≥ 3 drinking days/week in past 30 days, and have not received AUD psychotherapy in the past 90 days. Participants are randomized to an intervention or enhanced usual care control (EUC) condition, both individually-delivered. The intervention includes a telephone-delivered motivational interviewing (MI) engagement session and 8 sessions of MI-Cognitive Behavioral Therapy (MI-CBT). EUC involves AUD psychoeducation, advice to reduce drinking and seek treatment, and provision of community resources. Outcomes will be measured at 3-, 6-, and 12-months; primary outcomes include: AUD psychotherapy initiation and engagement (within the study and external community) and alcohol consumption (percent drinking days and heavy drinking days). ConclusionsThis study addresses whether proactive patient identification and engagement and delivery of patient-centered telehealth psychotherapy to patients with untreated AUD is effective in increasing treatment use and improving alcohol outcomes. If effective, this could be a highly scalable model for reducing the public health impact of AUD. Trial RegistrationClinicalTrials.gov # NCT05410561. University of Michigan HUM00204315. Ann Arbor VA IRB #1655886.

Cognitive Behavior Therapy vs Mindfulness in Treatment of Prolonged Grief Disorder

Although grief-focused cognitive behavior therapies are the most empirically supported treatment for prolonged grief disorder, many people find this treatment difficult. A viable alternative for treatment is mindfulness-based cognitive therapy. To examine the relative efficacies of grief-focused cognitive behavior therapy and mindfulness-based cognitive therapy to reduce prolonged grief disorder severity. A single-blind, parallel, randomized clinical trial was conducted among adults aged 18 to 70 years with prolonged grief disorder, as defined in the International Classification of Diseases, 11th Revision, and assessed by clinical interview based on the Prolonged Grief-13 (PG-13) scale. Those with severe suicidal risk, presence of psychosis, or substance dependence were excluded. Between November 2012 and November 2022, eligible participants were randomized 1:1 to eleven 90-minute sessions of grief-focused cognitive behavior therapy or mindfulness-based cognitive therapy at a traumatic stress clinic in Sydney, Australia, with follow-up through 6 months. Both groups received once-weekly 90-minute individual sessions for 11 weeks. Grief-focused cognitive behavior therapy comprised 5 sessions of recalling memories of the deceased, plus cognitive restructuring and planning future social and positive activities. Mindfulness-based cognitive therapy comprised mindfulness exercises adapted to tolerate grief-related distress. The primary outcome was change in prolonged grief disorder severity measured by the PG-13 scale assessed at baseline, 1 week posttreatment, and 6 months after treatment (primary outcome time point), as well as secondary outcome measures of depression, anxiety, grief-related cognition, and quality of life. The trial included 100 participants (mean [SD] age, 47.3 [13.4] years; 87 [87.0%] female), 50 in the grief-focused cognitive behavior therapy condition and 50 in the mindfulness-based cognitive therapy condition. Linear mixed models indicated that at the 6-month assessment, participants in the grief-focused cognitive behavior therapy group showed greater reduction in PG-13 scale score relative to those in the mindfulness-based cognitive therapy group (mean difference, 7.1; 95% CI, 1.6-12.5; P = .01), with a large between-group effect size (0.8; 95% CI, 0.2-1.3). Participants in the grief-focused cognitive behavior therapy group also demonstrated greater reductions in depression as measured on the Beck Depression Inventory than those in the mindfulness-based cognitive therapy group (mean difference, 6.6; 95% CI, 0.5-12.9; P = .04) and grief-related cognition (mean difference, 14.4; 95% CI, 2.8-25.9; P = .02). There were no other significant differences between treatment groups and no reported adverse events. In this study, grief-focused cognitive behavior therapy conferred more benefit for core prolonged grief disorder symptoms and associated problems 6 months after treatment than mindfulness-based cognitive therapy. Although both treatments may be considered for prolonged grief disorder, grief-focused cognitive behavior therapy might be the more effective choice, taking all factors into consideration. anzctr.org.au Identifier: ACTRN12612000307808.

Zelfopoffering, onderwerping en pleasing bij vrouwen met CVS in vergelijking met vrouwen met reumatoïde artritis: een observationele studie

Self-sacrifice, subjugation and approval-seeking in women with CFS in comparison to women with rheumatoid arthritis: an observational study CFS is a disorder with a multifactorial pathogenesis in which symptoms arise when precipitating factors combine with predisposing factors. An increasing body of research points to a dysfunction of the stress axis and finds evidence for a high prevalence of early childhood trauma, one of the most important vulnerability factors. Several pathways are conceivable through which early trauma may contribute to the vulnerability to or maintenance of the stress response and the symptoms. In this study, the authors used self-report questionnaires to identify maladaptive patterns that often stand out in clinical practice and may play both a predisposing and a maintaining role. These interpersonal patterns have often been adaptive in an early childhood context, but become harmful when they generalize and remain active in adult life. The authors investigated a group of 49 female CFS patients using 3 subscales of the Young Schema Questionnaire measuring the interpersonal styles of self-sacrifice, approval-seeking and subjugation. They included 45 women with a diagnosis of rheumatoid arthritis as a control group. The authors found significantly higher scores in the CFS group for the 3 variables, with a large effect size for each. The present findings have implications for the further research and treatment. These interpersonal patterns are usually very rigid and serve to protect self-esteem and sense of security. The standard treatment of graded exercise and a limited number of sessions of psychoeducation and cognitive behavioral therapy is often insufficient to allow recovery and prevent relapse. Further research is required to substantiate which is the most optimal treatment strategy to mitigate these patterns.

Can cognitive behavioral therapy improve vasomotor symptoms and recurrent depression in postmenopausal women?

The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in the treatment of vasomotor, sexual dysfunction, and recurrent depression in postmenopausal women. This prospective, open study evaluated 112 postmenopausal women with vasomotor symptoms. Sexual dysfunction has cultural, social, biological, and emotional issues and divided into two groups: G1, without depression (n=65) and G2, with recurrent depression (n=47). The subjects underwent 12 sessions of in-person cognitive behavioral therapy and 12 sessions of home-based activity over a period of 6 months. They were evaluated at 3 months following the completion of therapy. Depression, memory, and attention-related functions, as well as climactic symptoms, were assessed using a questionnaire. In the depression questionnaire, the G1 group had a lower initial score than the G2 group (p<0.01). Following 6 months of therapy, both groups had similar improved scores. In the depression questionnaire, the women in group G1 had higher baseline values. In the assessment of vasomotor symptoms, the values in both groups were similar and showed an improvement in vasomotor symptoms after 24 weeks of treatment, but these effects disappeared after the follow-up of 48 weeks in the G2 group. Both groups improved the sexual dysfunction after 24 weeks. Cognitive behavioral therapy may be effective in reducing vasomotor symptoms and ameliorate the sexual dysfunction and recurrent depression in postmenopausal women after 24 weeks of treatment.

Comparison of the Effectiveness of Cognitive Behavioral Therapy and Schema Therapy on Cognitive Emotion Regulation in Patients with Major Depressive Disorder

Objective: The aim of this study was to compare the efficacy of cognitive behavioral therapy and schema therapy on cognitive emotion regulation in patients with major depressive disorder. Methods and Materials: The research employed a quasi-experimental pre-test-post-test design with a control group and a one-month follow-up. The study population included all patients visiting Entekhab-e No and Aryaz clinics in Tehran during the period from February 2021 to May 2021, who were diagnosed with major depressive disorder by a psychiatrist. Forty-five individuals were purposively selected and randomly assigned to two experimental groups and one control group (15 per group). The first and second experimental groups underwent 12 and 8 sessions of cognitive behavioral therapy based on the Rosello protocol (2015) and schema therapy based on Young's protocol (2003), respectively. The research instrument was the Cognitive Emotion Regulation Questionnaire (CERQ) (Garnefski &amp; Kraaij, 2006). Data were analyzed using repeated measures ANOVA, Bonferroni test, and SPSS version 24. Findings: Results showed that both cognitive behavioral and schema therapy interventions significantly improved scores of adaptive emotion regulation and decreased scores of maladaptive emotion regulation compared to the control group (P&lt;0.001), with these effects maintained up to the one-month follow-up period. Additionally, there was a difference in the efficacy of the two intervention methods in increasing adaptive emotion regulation scores and decreasing maladaptive emotion regulation scores (P&lt;0.001), with cognitive behavioral therapy being more effective than schema therapy. Conclusion: Thus, utilizing cognitive behavioral therapy and schema therapy can take an important step in reducing the negative outcomes of emotion regulation deficits in depressed patients.