Behavior Therapy Techniques Research Articles

The Effectiveness of Dialectical Behavior Therapy Techniques Training on Fear of Childbirth in Nulliparous Women With Insecure Attachment to Spouse

Background and Objectives: Delivery is a painful event, and the management fear of childbirth is of utmost importance. Therefore, the aim of this study was to determine the effectiveness of dialectical behavior therapy techniques training on fear of childbirth in nulliparous women with insecure attachment to spouse. Methods: This clinical trial study was performed in 2021 on 60 pregnant women in Birjand in the third trimester of pregnancy. Insecure attachment pregnant mothers were selected by purposive sampling method and randomly divided between three intervention groups 1 (Dialectical behavior therapy techniques training and Lavender aromatherapy), intervention group 2 aromatherapy with lavender and control group (aromatherapy with water). In order to collect data, demographic questionnaires, attachment to spouse and Harman fear of childbirth were used. Data were analyzed in SPSS statistical software version 25. Results: Intervention groups 1 (Dialectical behavior therapy techniques training and aromatherapy) In comparison with aromatherapy with lavender and control group showed significant effect on reducing fear of childbirth (P<0.01). Conclusion: Dialectical behavioral therapy techniques combined with aromatherapy as an effective intervention to reduce fear of childbirth can be use in the health centers in pregnant women with insecure attachment to the husband.

The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders: A Narrative Review of Evidence.

Substance use disorders (SUDs) are characterized by a recurrent and maladaptive use of drugs and/or alcohol. Cognitive behavioral therapies (CBTs) comprise different types of interventions: traditional CBT and the more recent "third wave" behavior therapies, such as acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and schema therapy (ST). We searched English-language articles published between 2014 and present. This review includes randomized controlled trials (RCTs), quasi-RCTs, pilot studies, and reviews of CBTs for SUDs available on PubMed. Results seem to indicate that CBT and MBCT are effective interventions for SUDs; however, the studies showed a high degree of heterogeneity, so no exhaustive conclusions could be outlined at this time. ACT and DBT in SUD management are limited to few studies and results are therefore inconclusive.

The influence of stress during pregnancy on the central nervous system of mother and her child

Pregnant women may experience high levels of stress, including those associated with finding oneself in a new reality. In addition, the new reality is the COVID-19 pandemic, which has contributed to the deterioration of the mental state of many people. Chronic stress can lead to neuroanatomical changes in the mother, but also in her baby. It leads to atrophy of neurons in the hippocampus and prefrontal cortex, and to the growth and enlargement of the amygdala, i.e. those structures that are responsible for emotions. The mother's emotions also shape the synapses in the fetus, and the neurotransmitters secreted by the mother modify the development of the baby's brain. Research is ongoing in many countries on the consequences of anxiety and depression in pregnant women during the COVID-19 pandemic. For this reason, it is important to take care of psychological well-being, for example by using the techniques of cognitive behavioral therapy. Support from relatives during pregnancy and childbirth is also an extremely important element in the proper development of the central nervous system of the mother and her child.

Loss and bereavement in late life (60+): Study protocol for a randomized controlled trial regarding an internet-based self-help intervention

BackgroundThe death of a close person is a highly stressful, yet common life event in later life. While most individuals seem to cope well with bereavement, a substantial proportion of older individuals suffer from prolonged grief symptoms. E-mental health interventions have been shown to be efficient for a variety of psychological illnesses. Yet, there is a large research gap of studies with a special focus on older adults. This study protocol describes a randomized controlled trial for an internet-based self-help intervention addressing bereavement and loss in adults aged 60 years and over. The self-management intervention is based on techniques of cognitive behavioral therapy and consists of 8 modules. The objective of the AgE-health study is to evaluate the effectiveness and acceptability of this intervention in comparison to a bibliotherapy control group. MethodsThe AgE-health study aims at implementing a randomized controlled trial. Eligible participants aged 60+ years will be randomly allocated to an intervention group (access to the intervention) or to an active control group (access to bibliotherapy). Primary outcome is the reduction in grief symptoms (13-item Prolonged Grief Inventory); secondary outcomes are depression, social activity and network, quality of life, self-efficacy, satisfaction with the intervention/bibliotherapy, loneliness, acceptability, up-take and adherence. Assessments will take place before the intervention (baseline) as well as 4 months (follow-up 1) after the intervention. DiscussionThis study addresses an under-recognized and understudied mental health burden in later life and may add valuable insight into our knowledge about the effectiveness of eHealth interventions for loss and bereavement in late life. To our knowledge, the AgE-health study will be the first randomized controlled trial to evaluate the effectiveness of an internet-based intervention targeting prolonged grief in adults aged 60 years and over. Trial registrationThe study has been registered at the German Clinical Trials Register (Identifier: DRKS00020595, Registered 30th July 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020595).

A Brief Comparative Look at Experimental Memory Editing Techniques for Cognitive Dysfunction.

Neuroscience has long sought to develop methods that can "edit" or even "erase" memories, with the aim to provide treatments for memory-related neurological and psychiatric diseases such as anxiety and addiction. Current efforts are heavily focused on modifying cognitive behavioral therapy protocols or pharmacological treatments, but the efficacy and safety of these methods have been called into question by several studies. Advances in modern technology and the rapid emergence of techniques that can directly stimulate/alter neuronal activity, such as neuromodulation, have great potential in achieving the goal of memory modification for treating dementia such as Alzheimer's disease. However, more research and validation studies are required before these memory editing technologies can be applied clinically. In this mini-review, we compare and highlight the advantages and disadvantages of cognitive behavioral therapy, pharmacological methods, and neuromodulation techniques. We believe that neuromodulation techniques will play a key role in overcoming the challenges of translating memory-manipulating techniques to clinical applications.

Evaluation of Before Operational Stress: A Program to Support Mental Health and Proactive Psychological Protection in Public Safety Personnel.

Public safety personnel (PSP; e.g., communications officials, corrections workers, firefighters, paramedics, and police officers) are at risk of developing mental health problems due to experiencing potentially psychologically traumatic events during their career. Research examining evidence-based treatments for psychological injuries resulting from operational duties (also known as operational stress injuries) has not yielded robust results that would indicate ongoing interventions as the best solution for managing PSP mental health injuries; as such, proactive psychological interventions designed to bolster resilience are being considered potentially beneficial for mitigating the impact of occupational stress on PSP. Despite the growing popularity of resilience programs, most are delivered in a single session after an event deemed particularly problematic with no follow-up. Longer interventions may better support sustained resiliency, mitigate the impact of operational stress, and increase positive PSP workplace outcomes. The current article introduces the Before Operational Stress (BOS) program, which was designed for delivery early in a PSP career to enhance self-awareness and healthy relationships. The year-long program is derived from cognitive behavior therapy and group therapeutic techniques to meet program objectives. The current BOS program evaluation demonstrated small, statistically significant improvements in symptoms of PTSD, quality of life, stigma, and perceived social support from baseline (Time 1) to 6 months (Time 4). There were also non-significant improvements observed in symptoms of depression, anxiety, stress, alcohol use, as well as in emotional regulation and resilience. Qualitative results indicated participants positively perceived the BOS program, with participants reporting specific improvements in self-awareness, avoidant behaviors, and relationships with family and colleagues. The BOS program content (e.g., functional disconnection and functional reconnection) and processes (e.g., psychoeducation within a supportive learning structure; mutually empowering group interactions) appear unique relative to other PSP resilience programs, with promising initial results in support of PSP mental health. Recommendations for future research and program development are provided.

Individual counseling using Rational Emotive Behavior Therapy (REBT) techniques to increase confidence students in learning

Self-confidence plays an important role in the learning process at school because with the emergence of self-confidence in students, all the potential possessed by students can be maximally developed, this is because it is supported by confidence, belief in students' attitudes towards their abilities so that they are able to perform well in the field of education. academic, non-academic and social environment in which they are located. The self-confidence that students have makes them feel capable of achieving achievements in school because students have confidence in their abilities. The research method used is an experimental research method. As for the research design, the researcher used a pre-experimental method with the type used was a one-group pretest-posttest design. Using an experimental quantitative approach. In this study, students of class X had low self-confidence. Based on the findings above, it can be concluded that self-confidence can be increased through individual counseling services with a rational emotive behavior therapy (REBT).

G-estimation of causal pathways in vocational rehabilitation for adults with psychotic disorders \u2013 a secondary analysis of a randomized trial

BackgroundVocational rehabilitation (VR) has increasingly become an important intervention targeting poor occupational functioning in schizophrenia. The Norwegian Job Management Program (JUMP), sought to enhance occupational outcomes by augmenting VR with either cognitive behavioral therapy (CBT) techniques aiming to improve psychotic symptoms or cognitive remediation (CR) aiming to improve cognition. CBT is standard treatment in schizophrenia, but recent meta-analyses question the effect of CBT on negative psychotic symptoms. It is of interest to study the causal role of psychotic symptoms and cognitive functioning on occupational functioning.MethodsData from the JUMP VR – program, was reanalyzed with a causal inference method to assess the causal effects of reduced symptoms / improved neurocognitive functioning on occupational functioning measured by number of working hours per week. Participants (N = 131) had been randomized to either VR + CBT (N = 68) or VR + CR (N = 63). Large improvements in number of working hours were demonstrated in both intervention groups (nonsignificant group difference). G-estimation was used to assess the strength and nature of the causal effects, adjusted for time-varying confounding and selection – bias from loss to follow-up.ResultsSignificant causal effects of reduction in each of four dimensions of symptoms and improved neurocognition respectively, on number of working hours were found (separate models). The effect of negative symptoms was the strongest and increased in magnitude during the whole observation period, while the effect of two other symptoms and neurocognition was constant. Adjusted for confounding (including potential feedback), the causal effect of a hypothetical change in negative symptoms equal to the average improvement in the CBT group corresponded to an increase in working hours of 3.2 h per week (95% CI: 1.11, 5.35).ConclusionHigh performance of g-estimation in a small psychiatric data set with few repeated measures and time-varying confounding and effects, was demonstrated.Augmented vocational rehabilitation showed causal effects of intervention targets with the strongest and increasing effect from negative symptoms on number of working hours.Combination of therapy and activation (indirect and direct approach) might explain improvement in both cognition and negative symptoms, and shed some light on effective ingredients for improved treatment of negative symptoms.

Healthy Minds: Group Cognitive-Behavioral Intervention for Sustainable Return to Work After a Sick Leave Due to Depression.

Background Depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated return to work (RTW) interventions for people with common mental disorders. However, a paucity of studies has targeted depressive symptoms in the workplace, as well as work productivity. Objectives This study presents preliminary results on a novel group intervention based on cognitive behavioral principles in order to optimize sustainable RTW, by reducing clinical symptoms (anxiety and depression) and improving work productivity. Method This pilot study followed a quasi-experimental design, with participants randomly receiving the group intervention (N = 19) or only receiving usual services (N = 11, control group). The group intervention called Healthy Minds for Sustainable RTW consists of eight sessions based on cognitive behavioral therapy principles and techniques. Outcome measures on depressive and anxiety symptoms and work productivity were administered at baseline (i.e. the start of return-to-work or gradual RTW), as well 2 months later (post-intervention), and at 6-month follow-up. Results The results did not show a time × group interaction for symptoms of depression or anxiety (p = 0.07). Those who received the group intervention however did see a within-group reduction in anxiety and depressive symptoms over time, clinically significant for the group intervention only. A significant time × group interaction for work productivity was found, with those in the intervention group improving over time compared to the control condition. Conclusion Although replication is needed, these results suggest that a brief group cognitive-behavioral intervention specifically tailored to work-related issues is promising. Future studies are warranted, particularly with larger samples and remote webconferencing delivery.

Engagement and Effectiveness of a Healthy-Coping Intervention via Chatbot for University Students During the COVID-19 Pandemic: Mixed Methods Proof-of-Concept Study.

BackgroundUniversity students are increasingly reporting common mental health problems, such as stress, anxiety, and depression, and they frequently face barriers to seeking psychological support because of stigma, cost, and availability of mental health services. This issue is even more critical in the challenging time of the COVID-19 pandemic. Digital mental health interventions, such as those delivered via chatbots on mobile devices, offer the potential to achieve scalability of healthy-coping interventions by lowering cost and supporting prevention.ObjectiveThe goal of this study was to conduct a proof-of-concept evaluation measuring the engagement and effectiveness of Atena, a psychoeducational chatbot supporting healthy coping with stress and anxiety, among a population of university students.MethodsIn a proof-of-concept study, 71 university students were recruited during the COVID-19 pandemic; 68% (48/71) were female, they were all in their first year of university, and their mean age was 20.6 years (SD 2.4). Enrolled students were asked to use the Atena psychoeducational chatbot for 4 weeks (eight sessions; two per week), which provided healthy-coping strategies based on cognitive behavioral therapy, positive psychology, and mindfulness techniques. The intervention program consisted of conversations combined with audiovisual clips delivered via the Atena chatbot. Participants were asked to complete web-based versions of the 7-item Generalized Anxiety Disorder scale (GAD-7), the 10-item Perceived Stress Scale (PSS-10), and the Five-Facet Mindfulness Questionnaire (FFMQ) at baseline and postintervention to assess effectiveness. They were also asked to complete the User Engagement Scale–Short Form at week 2 to assess engagement with the chatbot and to provide qualitative comments on their overall experience with Atena postintervention.ResultsParticipants engaged with the Atena chatbot an average of 78 (SD 24.8) times over the study period. A total of 61 out of 71 (86%) participants completed the first 2 weeks of the intervention and provided data on engagement (10/71, 14% attrition). A total of 41 participants out of 71 (58%) completed the full intervention and the postintervention questionnaires (30/71, 42% attrition). Results from the completer analysis showed a significant decrease in anxiety symptoms for participants in more extreme GAD-7 score ranges (t39=0.94; P=.009) and a decrease in stress symptoms as measured by the PSS-10 (t39=2.00; P=.05) for all participants postintervention. Participants also improved significantly in the describing and nonjudging facets, based on their FFMQ subscale scores, and asked for some improvements in the user experience with the chatbot.ConclusionsThis study shows the benefit of deploying a digital healthy-coping intervention via a chatbot to support university students experiencing higher levels of distress. While findings collected during the COVID-19 pandemic show promise, further research is required to confirm conclusions.

Short-term therapies (CBT and EMDR) for anxiety reactions and states in healthcare professionals

The relevance of the topic under consideration lies in the need to analyze the effectiveness of short-term methods of psychotherapy to provide prompt psychotherapeutic assistance in dealing with anxiety states and reactions in employees of medical institutions, including during the period of increased stress associated with the spread of the coronavirus infection. The study was conducted on a sample of 60 medical professionals. The experimental group of 30 people was divided into two groups of 15 people (group A and group B) and a control group of 30 people. According to the results of the study, the positive effect of group methods of short-term psychotherapy on reducing the level of anxiety states and reactions in medical professionals was revealed. It was also found that the psychocorrective influence on medical professionals by means of techniques of eye movement desensitization and reprocessing was more effective than by the techniques of cognitive behavioral therapy.

Effectiveness of Delivering Dialectical Behavioral Therapy Techniques by Email in Patients With Borderline Personality Disorder: Nonrandomized Controlled Trial.

BackgroundBorderline personality disorder is a debilitating and prevalent mental health disorder, with often inaccessible treatment options. Electronically delivered dialectical behavioral therapy could be an efficacious and more accessible intervention.ObjectiveWe aimed to evaluate the efficacy of electronic delivery of dialectical behavioral therapy in the treatment of individuals with symptoms of borderline personality disorder.MethodsStudy participants diagnosed with borderline personality disorder were offered either an email-based or in-person group format dialectical behavioral therapy skill-building program. During each session, participants were provided with both the material and feedback regarding their previous week’s homework. Electronically delivered dialectical behavioral therapy protocol and content were designed to mirror in-person content. Participants were assessed using the Self-Assessment Questionnaire (SAQ) and Difficulties in Emotion Regulation Scale (DERS).ResultsThere were significant increases in SAQ scores from pre- to posttreatment in the electronic delivery group (F1,92=69.32, P<.001) and in-person group (F1,92=60.97, P<.001). There were no significant differences observed between the groups at pre- and posttreatment for SAQ scores (F1,92=.05, P=.83). There were significant decreases in DERS scores observed between pre- and posttreatment in the electronic delivery group (F1,91=30.15, P<.001) and the in-person group (F1,91=58.18, P<.001). There were no significant differences observed between the groups for DERS scores pre- and posttreatment (F1,91=.24, P=.63). There was no significant difference in treatment efficacy observed between the 2 treatment arms (P<.001).ConclusionsDespite the proven efficacy of in-person dialectical behavioral therapy in the treatment of borderline personality disorder, there are barriers to receiving this treatment. With the prevalence of internet access continuing to rise globally, delivering dialectical behavioral therapy with email may provide a more accessible alternative to treatment for individuals with borderline personality disorder without sacrificing the quality of care.Trial RegistrationClinicalTrials.gov NCT04493580; https://clinicaltrials.gov/ct2/show/NCT04493580

Mental Health and the Self-Tracking Student

This article examines universities’ adoption of WellTrack—a self-tracking mobile phone application modeled on cognitive behavioral therapy techniques—as a solution to reported increases in the prevalence and severity of student mental health conditions. Drawing from a feminist materialist perspective that understands discourse and the material word as co-produced, this article argues that the app’s design, marketing, and reception are deeply intertwined with the political rationality of neoliberalism, which centers self-responsibility and the market economy. The article first situates the development of the WellTrack app within larger institutional and political shifts towards digital education governance. It then contextualizes the app’s use within the history of college mental health services in the United States, revealing how longstanding socio-medical discourses concerning student wellness individualize structural and systemic factors of ill health. Through close reading and immanent critique of the marketing and media reception of the WellTrack app’s introduction into universities, the article provides an account of how universities are socializing students to relinquish data to private firms in exchange for health services. Students are encouraged to engage in constant self-examination and strive towards a vision of student wellness that precludes an analysis of the structural conditions and intersecting oppressions contributing to poor student mental health. These conditions are social and pervasive, requiring institutional analysis and critique of the university itself.&#x0D;

Impact of the Coronavirus Lockdown on Older Adolescents Engaged in a School-Based Stress Management Program: Changes in Mental Health, Sleep, Social Support, and Routines

The mental health effects of the coronavirus pandemic are likely to be significant and sustained, especially for those who experience adversity or preexisting mental health difficulties. This article examines the experiences of older adolescents during the United Kingdom government’s “lockdown” period (April 2020 to June 2020) on mental health, social support, sleep, and routines using both quantitative and qualitative methods. Participants were enrolled in DISCOVER, a school-based stress management program, in London (N = 107; 72 percent Black, Asian, or minority ethnicity). The Coping with COVID-19 questionnaire was developed and administered online. Changes in mental health, sleep, and routines were reported during the lockdown period as well as increased worry about family members’ physical and mental health. Positive experiences of the lockdown period included improvements in quality of relationships and increased time to spend on hobbies. Participants reported the use of cognitive–behavioral therapy techniques for coping. Results have implications for supporting older adolescents during the pandemic, including on their return to school.

The Use of Dialectical Behavioral Therapy (DBT) Techniques Creatively in the Treatment of Perinatal Mood and Anxiety Disorders

Perinatal Mood and Anxiety Disorders (PMADs) is a serious condition impacting up to 21 percent of woman after the birth of a child (Byrnes, 2018). Jane, a 32-year-old female presented for treatment for anxiety, depression and mood disturbance (5th ed.; DSM-5; American Psychiatric Association, 2013) and in need of feeling more connected to her baby and her life. The use of creative techniques including mindfulness, distress tolerance activity, emotion regulation, and interpersonal skills (Linehan, 2015, 2016) were implemented. The use of these skills can be added to the repertoire of practice of a mental health counselor working with clients with PMADs.

The Use of Dialectical Behavioral Therapy (DBT) Techniques Creatively in the Treatment of Perinatal Mood and Anxiety Disorders

Perinatal Mood and Anxiety Disorders (PMADs) is a serious condition impacting up to 21 percent of woman after the birth of a child (Byrnes, 2018). Jane, a 32-year-old female presented for treatment for anxiety, depression and mood disturbance (5th ed.; DSM-5; American Psychiatric Association, 2013) and in need of feeling more connected to her baby and her life. The use of creative techniques including mindfulness, distress tolerance activity, emotion regulation, and interpersonal skills (Linehan, 2015, 2016) were implemented. The use of these skills can be added to the repertoire of practice of a mental health counselor working with clients with PMADs.

The role of personal anxiety in the development of psychophysiological indicators in adolescent athletes

Objective: to study the role of personal anxiety in the development of psychophysiological indicators in adolescent athletes.Materials and methods. To study the prevalence of high levels of personal anxiety (hereinafter — LT), as well as to determine the characteristics of psychophysiological indicators, the study involved 23 teenagers — boys and girls who were representatives of different sports. Using the device for psychophysiological testing UPFT-1/30 “Psychophysiologist”, indicators of simple visual-motor reaction and the level of LT on the Spielberg scale were obtained. To assess the impact of changes in high LT levels on psychophysiological indicators, 14 adolescent athletes with a high level of personal anxiety were selected and then divided into 2 groups. The experimental group included adolescents who wanted to participate in an experiment on the use of cognitive behavioral therapy techniques to correct high LT levels; the control group included adolescents with high LT levels who were not trained in cognitive behavioral therapy techniques.Results. Every third adolescent athlete had a high level of LT. Adolescent athletes with a high LT level, in contrast to adolescents with an optimal LT level, were less efficient, and, despite a shorter minimum reaction time, made more mistakes. The dynamics of psychophysiological indicators were observed both in the group with intervention and in the group where no cognitive behavioral therapy techniques were performed; however, after studying the difference in the physiological parameters of the central nervous system in the group where there was a change in LT, and in the group where LT either did not change or increased, we found positive changes. Changes in the LT level led to a decrease in the average reaction time, the minimum reaction time, and an increase in the level of stability of reactions.Conclusions. A high level of LT affects the psychophysiological parameters of the central nervous system in adolescent athletes. The use of cognitive behavioral therapy techniques to normalize the LT level of adolescent athletes leads to an improvement in the physiological parameters of the central nervous system.

Co‑occurring Obsessive‑compulsive Disorder, Autism Spectrum Disorder and Intellectual Disability: A Case Report

Autism spectrum disorders encompass a wide range of clinical presentations, including obsessive‑compulsive symptoms. The comorbidity between these disorders is significant, and it has therapeutic and prognostic implications. While there are a few references on the approach of such comorbid presentations, the literature is even scarcer when this co‑occurrence is superimposed on individuals with intellectual disability. We present the case of a 43‑years‑old male patient with comorbid treatment refractory obsessive‑compulsive disorder, autism spectrum disorder and intellectual disability, exhibiting subacute symptomatic recurrence including hetero‑aggressive outbursts and contamination obsessions. The phenomenological features and therapeutic strategies are discussed, highlighting the centrality of a patient‑centered and methodologically pluralistic approach. Symptomatic remission was achieved employing high end doses of fluvoxamine and haloperidol, alongside daily psychotherapy involving both symptom‑directed behavioral therapy and supportive psychodynamic techniques. An integrative approach may be the best option in the stabilization of complex cases as the one presented.

Effects of brief stress management interventions on distress and leukocyte nuclear factor kappa B expression during primary treatment for breast cancer: A randomized trial

BackgroundA randomized controlled trial (RCT) of 5-week stress management interventions teaching cognitive behavioral therapy (CBT) or relaxation training (RT) techniques showed decreases in stress and serum inflammatory markers over 12 months in women undergoing treatment for breast cancer (BCa). To understand the molecular mechanisms involved, we examined the effects of these interventions on the transcription factor NF-κB DNA binding activity in leukocytes in parallel with circulating inflammatory markers, stress management skill efficacy and multiple distress indicators. MethodsThis is a secondary analysis using blood samples of 51 BCa patients (Stage 0–III) with high cancer-specific distress selected from a completed RCT (NCT02103387). Women were randomized to one of three conditions, CBT, RT or health education control (HE). Blood samples and self-reported distress measures (Affects Balance Scale-Negative Affect [ABS-NA], Impact of Events Scale-hyperarousal [IES-H] and intrusive thoughts [IES-I]) were collected at baseline (T0) and 12-month follow-up (T2). Self-reported distress measures and perceived stress management skills (PSMS) were also measured immediately post-intervention (baseline + 2 months: T1). Repeated measures analyses compared changes in distress and NF-κB expression among conditions, controlling for age, stage of cancer, days from surgery to baseline, and receipt of chemotherapy and radiation. Regression analyses related T0 to T2 change in NF-κB expression with T0 to T1 changes in self-reported PSMS and distress measures. Exploratory regression analyses also associated change in NF-κB expression with change in serum cytokines (IL-1β, IL-6 and TNF-α); and s100A8/A9, a circulating inflammatory marker important in breast cancer progression. ResultsThere was a significant condition (CBT/RT, HE)xtime (T0, T2) effect on NF-κB, F(1, 39)= 5.267, p = 0.036, wherein NF-κB expression significantly increased over time for HE but did not change for RT or CBT. Greater increases in PSMS from T0 to T1 were associated with less increase in NF-κB expression over 12 months (β = −0.426, t(36) = −2.637, p = 0.048). We found that women assigned to active intervention (CBT/RT) had significant decreases in ABS-NA (F(1, 40)= 6.537, p = 0.028) and IES-I (F(1, 40)= 4.391, p = 0.043) from T0 to T1 compared to women assigned to HE, who showed no change over time (p’s > 0.10). For women assigned to CBT or RT, lower NF-κB expression at T2 was related to less ABS-NA, IES-H, and IES-I, all p’s < 0.05, although T0–T1 change in distress was not related to T0–T2 change in NF-κB expression for those in an active intervention. ConclusionsBrief CBT or RT stress management interventions can mitigate increases in pro-inflammatory leukocyte NF-κB binding over 12 months of primary treatment in highly distressed BCa patients. These effects are likely brought about by improved stress management skills.

Theoretical Mapping of Suicidal Risk Factors During the COVID-19 Pandemic: A Mini-Review.

Suicide prevention in times of COVID-19 pandemic has become more challenging than ever due to unusual circumstances. The common risk factors identified with regard to suicidal behavior are fear of COVID-19, economic instability, poor access to healthcare facilities, pre-existing psychiatric disorders, and social disconnect. The studies done so far have reported either case studies or have made an effort to understand the risk factors. An understanding of the underlying causal pattern from existing theories, behind these risks, will enable adopting appropriate prevention mechanisms. Hence, this review examines evidence related to risk factors of suicides that occurred during COVID 19 and discusses it in the light of three major theoretical approaches: interpersonal model, stress diathesis model, and cognitive model. The insights obtained from the three viewpoints reveal that perceived burdensomeness, thwarted belongingness, stress sensitivity, cognitive errors such as magnification, catastrophic thinking, arbitrary inference, and mind-reading are likely reasons behind these risk factors for suicide. It is suggested that awareness regarding COVID-19 stressors, use of community-based approaches like gatekeeper training, and brief online psychotherapy by using techniques of mindfulness, interpersonal psychotherapy, and cognitive behavior therapy can be useful in reducing suicide risk during COVID-19.