Clin Psychol Research Articles

The Importance of Practicing at Home During and Following Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Conceptual Review and New Directions to Enhance Homework Using Mhealth Technology

Practicing newly acquired skills in different contexts is considered a crucial aspect of Cognitive Behavioral Therapy (CBT) for anxiety disorders (Peris et al. J Am Acad Child Adolesc Psychiatry 56:1043–1052, 2017; Stewart et al. Prof Psychol Res Pract 47:303–311, 2016). Learning to cope with feared stimuli in different situations allows for generalization of learned skills, and experiencing non-occurrence of the feared outcome helps in developing non-catastrophic associations that may enhance treatment outcomes (Bandarian-Balooch et al. J Behav Ther Exp Psychiatry 47:138–144, 2015; Cammin-Nowak et al. J Clin Psychol 69:616–629, 2013; Kendall et al. Cogn Behav Pract 12:136–148, 2005; Tiwari et al. J Clin Child Adolesc Psychol 42:34–43, 2013). To optimize treatment outcome, homework is often integrated into CBT protocols for childhood anxiety disorders during and following treatment. Nevertheless, practicing at home can be challenging, with low motivation, lack of time, and insufficient self-guidance often listed as reasons for low adherence (Tang and Kreindler, JMIR Mental Health 4:e20, 2017). This conceptual review provides an overview of (1) how existing CBT childhood programs incorporate homework, and empirical evidence for the importance of homework practice, (2) evidence-based key elements of practice, and (3) how mHealth apps could potentially enhance practice at home, including an example of the development and application of such an app. This review therefore sets the stage for new directions in developing more effective and engaging CBT-based homework programs for childhood anxiety disorders.

Understanding Alcohol Consumption and Its Antecedents and Consequences in Daily Life: The Why and the How.

Most of the scientific research on alcohol consumption behavior in humans is laboratory-based, as reflected by the ratio of laboratory vs. real-life contributions to this handbook. Studies in daily life, although having a long history in addiction research (Shiffman et al., Ann Behav Med 16:203-209, 1994), are in the minority. This is surprising, given that patients with substance use disorders are suffering in daily life and not in the laboratory setting. In other words, drinking patterns and symptoms of alcohol use disorder evolve not in the lab but in daily life, where patients show difficulties in limiting their alcohol intake accompanied with all kinds of related problems. The ultimate goal of all interventions, independent of being tailored toward restricted drinking or abstinence, is again an altered behavior in real life. Translated to practice, patients' behavior in the lab may not translate to daily life, often showing minimal ecological validity. Therefore, we have to question to which degree lab-based research findings translate into daily life. Fortunately, the current digital revolution provided us with more and more tools, enabling us to monitor, analyze, and change behavior in human everyday life. Our chapter does not intend to give a comprehensive overview of the daily life research on alcohol consumption over the last few decades as others do (Morgenstern et al., Alcohol Res Curr Rev 36:109, 2014; Piasecki, Alcohol Clin Exp Res 43:564-577, 2019; Shiffman, Psychol Asses 21:486-497, 2009; Votaw and Witkiewitz, Clin Psychol Sci 9:535-562, 2021; Wray et al., Alcohol Res Curr Rev 36:19-27, 2014). Instead, we aim at the following: first, to highlight the key advantages of ecological momentary assessment to motivate scientists to add daily life research components to their laboratory research and, second, to provide some guidance on how to begin with daily life research.

Romanian Version of the Frustration Discomfort Scale (FDS): A Preliminary Validation on a Non-clinical Sample

Low frustration tolerance is one of the key concepts in rational emotional behavior therapy (REBT). The purpose of this study is to explore the factorial structure, reliability, and validity of the Romanian version of the Frustration Discomfort Scale (FDS), developed by Harrington (Clin Psychol Psychother 12(5):374–387, 2005b. https://doi.org/10.1002/cpp.465), within a non-clinical sample (N = 308) of Romanian teachers. For validation purposes, participants also completed several measures such as the Unconditional Self-Acceptance Questionnaire (USAQ) (Chamberlain and Haaga in J Ration Emot Cogn Behav Ther 19(3):163–176, 2001. https://doi.org/10.1023/A:1011189416600), Attitudes and Belief Scale 2 (ABS2) (DiGiuseppe et al. J Ration Emot Cogn Behav Ther 36(1):47–79, 2018. https://doi.org/10.1007/s10942-017-0273-3), Teacher Irrational Belief Scale (TIBS) (Bernard Teacher irrationality and teacher stress, 24th international congress of psychology, Sydney, Australia, 1988), and Pupil Control Ideology Scale (PCI) (Willower et al. The school and pupil control, The Pennsylvania State University, 1967). Confirmatory factor analysis (CFA) suggests that the initial four-factor solution from the scale development study received similar support to the one-factor solution found in some previous studies. Patterns of correlations linking the FDS total sum score versus the FDS 4-factor scale scores with other variables provide some support for the one-factor solution, mainly because it is a more parsimonious solution. Differentiating between several subcomponents of FDS does not bring discriminant validity in our non-clinical sample. Based on current preliminary validation, the FDS is a reliable and valid instrument for assessing frustration discomfort in a Romanian-speaking population as a single-factor construct. Our results do not exclude the possibility that future discriminant validity endeavors could support the utility of treating low frustration tolerance as a multidimensional construct since using a non-clinical sample is likely to impact the factorial structure of the FDS.

#4141 SERUM BICARBONATE AND CKD PROGRESSION: A LONGITUDINAL ANALYSIS BY THE GROUP-BASED TRAJECTORY MODEL

Abstract Background and Aims Follow-up studies in CKD patients showed an inverse relationship between serum bicarbonate and CKD progression, but only sparse longitudinal observations testing this relationship exist. Bicarbonate supplementation slowed the progression rate of CKD in 5 trials, but no such effect was registered in six trials. All these trials had limited power and were at high risk of bias. In the lack of well-designed clinical trials with sufficient power, longitudinal studies provide circumstantial new evidence for the hypothesis that bicarbonate supplements can mitigate the risk of adverse kidney outcomes. Methods We performed a longitudinal study in a cohort of 528 patients with at least 3 longitudinal measurements of bicarbonate over 32 months (inter-quartile range 30 – 36 months). The association between bicarbonate trajectories over time and the incidence rate of renal events (>30% eGFR reduction, dialysis or transplantation) were investigated by a two stages analysis: 1) in the first stage, we identified distinctive group-based bicarbonate trajectories analysis (GBTM, Annu Rev Clin Psychol. 2010;6:109-38); 2) in the second stage we assessed the association between bicarbonate trajectories groups and the risk of renal events by Cox proportional hazard model. Results One hundred and twenty-six patients had renal events on longitudinal observation. Four distinct trajectories of bicarbonate (based on intercept) were identified and labelled as low trajectory [including 11% of patients, mean (± SD) bicarbonate: 19.07± 2.5 mEq/L], moderate [35% of patients, bicarbonate: 21.2± 2.3 mEq/L], moderate-high [42% of patients, bicarbonate: 25.1± 2.2 mEq/L] and high [including 12% of patients, bicarbonate: 27.9± 2.8 mEq/L]. In analyses adjusting for age, gender, smoking, diabetes, total cholesterol, systolic BP, background CV comorbidities, anti-hypertensive drugs, haemoglobin, albumin, phosphate, hs-CRP, 24h proteinuria, and eGFR, the hazard rate (HR) of renal events decreased in a dose-dependent fashion from the lowest bicarbonate trajectory (reference category, HR 1) to the moderate (HR:0.70, 95%CI 0.43-1.14), high moderate (HR:0.54, 95%CI 0.31-0.93), and high bicarbonate category (HR:0.31, 95%CI 0.12-0.80) (P for trend=0.005). Thus, for patients in the high bicarbonate category (27.9± 2.8 mEq/L), there is an 69% risk reduction for a renal composite endpoint. Conclusion In a longitudinal analysis of a cohort of CKD patients, high bicarbonate levels are associated with a substantially reduced risk of renal events. These findings represent a strong call for well-designed, adequately powered randomised trials testing the effect of bicarbonate supplements or pharmacologic interventions that increase serum bicarbonate on renal outcomes. Given the substantial risk reduction in patients in the highest bicarbonate trajectory, these trials are an absolute clinical research priority.

Cultural adaptation of interventions for common mental disorders

Most psychological interventions are developed and the evidence for their efficacy established in Western contexts. Such interventions often need to be culturally adapted when they are used in populations other than those for which they were developed. Cultural adaptation is the systematic modification of an evidence-based treatment or intervention protocol to consider the patient's language, culture, and context. 1 Bernal G Jiménez-Chafey MI Domenech Rodríguez MM Cultural adaptation of treatments: a resource for considering culture in evidence-based practice. Prof Psychol Res Pract. 2009; 40: 361-368 Crossref Scopus (449) Google Scholar Cultural adaptation is widely accepted as essential for the effective implementation of mental health interventions and achievement of mental health equity globally and within populations challenged by health disparities. 2 Wang Z Yang G Guo Y Harnessing the opportunity to achieve health equity in China. Lancet Public Health. 2021; 6: e867-e868 Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar , 3 Ellis DM Draheim AA Anderson PL Culturally adapted digital mental health interventions for ethnic/racial minorities: a systematic review and meta-analysis. J Consult Clin Psychol. 2022; 90: 717-733 Crossref Scopus (4) Google Scholar , 4 Harper Shehadeh M Heim E Chowdhary N Maercker A Albanese E Cultural adaptation of minimally guided interventions for common mental disorders: a systematic review and meta-analysis. JMIR Ment Health. 2016; 3: e44 Crossref Google Scholar However, no systematic overview of studies of culturally sensitive interventions in people of Chinese descent, who represent more than a sixth of the global population had been done Efficacy of culturally adapted interventions for common mental disorders in people of Chinese descent: a systematic review and meta-analysisPsychological interventions can be transported across cultures with appropriate modifications. Adaptations to interventions can be made by modifying evidence-based interventions, or in culturally specific ways that are rooted in the sociocultural context. However, findings are limited by the insufficient reporting of interventions and cultural adaptations. Full-Text PDF Open Access

Study of mentalizing ability in borderline personality disorder: relationship with impulsivity

IntroductionBorderline personality disorder (BPD) is a severe mental disorder characterized by affective, behavioral and relational instability, along with interpersonal hypersensitivity and unstable affective relationships (APA 2013). Poor interpersonal functioning could be associated with critical deficits in the ability to mentalize in these patients, together with high levels of impulsivity. Although most studies have described hypermentalization deficits among BPD patients (Bora Psychol Med 2021;51 2541-2551), existing literature is still scarce on this aspect, as well as its relationship with the impulsive behavior.Objectives1) to assess specific mentalizing deficits in BPD compared to healthy controls in a complex ecological mentalization task; 2) evaluate the relationship between mentalization and impulsivity in BPD.Methods63 patients diagnosed with borderline personality disorder and 31 control subjects were studied using the Movie for the Assessment of Social Cognition -MASC- (Dziobeck et al. J Autism Dev Disord 2006; 36 623-636) and the Barratt Impulsivity Scale -BIS-11- (Patton et al. J Clin Psychol 1995; 51 768-774), as well as other sociodemographic and clinical factors. The clinical research study was approved by the Clinical Research Ethics Committee of the Hospital Clínico San Carlos (Madrid, Spain).ResultsThe results showed significant differences in the scores related to correct mentalization, hypomentalization, and non-mentalizing responses between patients and controls, with BPD patients showing worse performance. A significant negative relationship was also observed between impulsivity scores and correct mentalizing responses in BPD patients.ConclusionsThe results showed a deficit in the ability to mentalize in BPD patients, compared to control subjects, characterized by a hypomentalization and an absence of mentalization. Likewise, this deficit in mentalization ability was related to greater impulsive behavior in patients. These results would be consistent with the hyperarousal hypothesis in BPD, which would reduce inhibitory control, causing mentalization deficits (Euler et al. J Pers Disord. 2021; 35 177-193). Future studies will try to associate specific impulsive behaviors associated with the characteristics of hypomentalization and absence of mentalization observed in our results.Disclosure of InterestNone Declared

Four reasons why we should screen for dissociation in competitive sports

Four reasons why we should screen for dissociation in competitive sports

A scoping review on the methods of assessment and role of resilience on function and movement-evoked pain when experiencing a musculoskeletal injury

BackgroundResilience refers to an individual’s ability to maintain effective functioning, by resisting, withstanding or recovering from stressors or adversity, including pain associated with physical injury (J Clin Psychol Med Settings 28:518–28, 2021). The aim of this scoping review is to determine the role of resilience in the experience of movement-evoked pain (MEP) and return to functional activity following a musculoskeletal injury.MethodsThis review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the scoping review protocol of the Joanna Briggs Institute (JBI). Five databases and one grey literature database were searched using predetermined key words and index terms to capture published and unpublished records on the topic. Two authors independently screened the title and abstract of each record, with the full-text of eligible records being reviewed. Papers were eligible for inclusion if they examined the population, concept and context of interest, were written in English and the full text was available. Data were extracted from each eligible record to guide discussion of the available literature on this topic.ResultsOf 4771 records, 2695 articles underwent screening based on their title and abstract. After title and abstract screening 132 articles were eligible for full text review, with 24 articles included in the final analysis. This review identified that psychological resilience has primarily been investigated in the context of a range of age-related pathologies. The choice of functional and movement-evoked pain assessments in the included studies were often guided by the pathology of interest, with some being general or injury specific.ConclusionThis scoping review identified inconsistent conclusions regarding the role of resilience in the experience of MEP and the ability to return to function for older adults with a musculoskeletal injury. This scoping review highlights the need for longitudinal research to be conducted that allows a broader age range, including younger adults, to determine if multidimensional resilience may promote recovery form musculoskeletal injury.

AAIM Recommendations to Promote Equity in the Clerkship Clinical Learning Environment

AAIM Recommendations to Promote Equity in the Clerkship Clinical Learning Environment

Rewind technique for trauma in ambulance staff

Journal of Paramedic PracticeVol. 14, No. 4 CommentRewind technique for trauma in ambulance staffLyanne PudneyLyanne PudneyEmail:E-mail Address: [email protected]Therapist in Private Practice; Frontline 19 Volunteer with a Research Interest in PTSD in Emergency Services Staff; Colchester, UKSearch for more papers by this authorLyanne PudneyPublished Online:7 Apr 2022https://doi.org/10.12968/jpar.2022.14.4.170AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Adams S, Allan S. Muss' Rewind treatment for trauma: description and multi-site pilot study. Journal of Mental Health. 2018;27(5):468–474. https://doi.org/10.1080/09638237.2018.1487539 Crossref, Google ScholarAdams S, Allan S, Andrews W et al. Four practice-based preliminary studies on Human Givens Rewind treatment for posttraumatic stress in Great Britain [version 2; peer review: 1 approved]. F1000Research 2022, 9:1252. https://doi.org/10.12688/f1000research.25779.2 Crossref, Google ScholarGray RM, Liotta RF. PTSD: Extinction, reconsolidation, and the visual-kinesthetic dissociation protocol. Traumatol. 2012;18(2):3–16. https://doi.org/10.1177/1534765611431835 Crossref, Google ScholarGray R, Budden-Potts D, Bourke F. Reconsolidation of Traumatic Memories for PTSD: A randomized controlled trial of 74 male veterans. Psychotherapy Res. 2017;1–19. Google ScholarMIND. Mental Health in the Emergency Services. Our 2019 Survey Results – Ambulance Service. 2019. https://www.mind.org.uk/media-a/4847/2019-survey-ambulance-service-summary.pdf (accessed 25 March 2022) Google ScholarMuss DC. A new technique for treating post-traumatic stress disorder. Br J Clin Psychol. 1991;30(1):91–92. https://doi.org/10.1111/j.2044-8260.1991.tb00924.x Crossref, Google ScholarNational Institute for Health and Care Excellence. Post-traumatic Stress Disorder Guideline [NG116]. 2018. https://www.nice.org.uk/guidance/ng116/chapter/Recommendations#management-of-ptsd-in-children-young-people-and-adults (accessed 25 March 2022) Google ScholarPudney L. Could the Rewind Technique be offered to Emergency Service Workers with Post-traumatic Stress Disorder (PTSD)? 2018. https://doi.org/10.13140/RG.2.2.35734.42567 Google ScholarStevelink S, Pernet D, Dregan A et al. The mental health of emergency services personnel in the UK Biobank: a comparison with the working population. Eur J Psychotraumatol. 2020;11(1):1799477. https://doi.org/10.1080/20008198.2020.1799477 Crossref, Google ScholarTylee D, Gray R, Glatt SJ, Bourke F. Evaluation of the reconsolidation of traumatic memories protocol for the treatment of PTSD:’ a randomized, wait-list-controlled trial. J Military Veteran Family Health. 2017;3(1):21–33 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 April 2022Volume 14Issue 4ISSN (print): 1759-1376ISSN (online): 2041-9457 Metrics History Published online 7 April 2022 Published in print 2 April 2022 Information© MA Healthcare LimitedPDF download

Complex Moral Injury: Shattered Moral Assumptions.

An infographic model of moral injury (MI) is introduced in this conceptual paper that distinguishes the development of a worldview discrepancy-induced genus of MI, called complex moral injury (C-MI), from a standard expression of moral injury (S-MI), clearly delineated as perpetration-focused and a violation of moral belief in the contemporary view. It builds upon a previous essay that examined the potential of paradoxical circumstance (e.g., clashes of value, competing moral expectations, and moral paradox) to inflict MI among military personnel during wartime (Flemingin J Relig Health 60(5):3012-3033, 2021). Accordingly, it heeds Litz et al.'s recommendation to expand the research of MI beyond the effects of perpetration and investigate the impact of morally injurious events that shake one's core moral beliefs about the world and self(Litz et al. in Clin Psychol Rev 29(8):695-706, 2009). A review of definitional, scale, and qualitative studies shows evidence of a nuanced and complex form of MI that presents as moral disorientation and is a response to a disruption and subsequent failure of foundational moral beliefs to adequately appraise ethical problems and inform moral identity. Interrelations between MI, assumptive world, and meaning theories suggest the mechanism of C-MI and potential therapies. Case studies from a Veterans Administration hospital in the United States and a walk through the diagram will help illustrate the model. Clinical implications of a definition that includes morally injurious events that shatter fundamental moral assumptions are discussed. The role of chaplains in facilitating acceptance and meaning-making processes is recommended for C-MI recovery. Acknowledging the model's need for empirical support, a plausible scale is discussed for future research.

New NICE guideline on chronic fatigue syndrome: more ideology than science?

The National Institute for Health and Care Excellence (NICE) in the UK published a new chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) guideline in October, 2021. 1 National Institute for Health and Care ExcellenceMyalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management. NICE guideline [NG206]. https://www.nice.org.uk/guidance/ng206Date: Oct 29, 2021 Date accessed: January 13, 2022 Google Scholar The previous NICE 2007 guideline recommended cognitive behavioural therapy (CBT) and graded exercise therapy (GET) for people with mild or moderate CFS/ME based on evidence from randomised trials. 2 Baker R Shaw EJ Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance. BMJ. 2007; 335: 446-448 Crossref PubMed Scopus (79) Google Scholar Since then, more randomised trials and systematic reviews have provided additional evidence supporting these recommendations. 3 Price JR Mitchell E Tidy E Hunot V Cognitive behaviour therapy for chronic fatigue syndrome in adults. Cochrane Database Syst Rev. 2008; 3CD001027 Google Scholar , 4 Larun L Brurberg KG Odgaard-Jensen J Price JR Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2019; 10CD003200 PubMed Google Scholar , 5 Castell BD Kazantzis N Moss-Morris R Cognitive behavioral therapy and graded exercise for chronic fatigue syndrome: a meta-analysis. Clin Psychol Sci Pract. 2011; 18: 311-324 Crossref Scopus (133) Google Scholar , 6 White PD Goldsmith KA Johnson AL et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011; 377: 823-836 Summary Full Text Full Text PDF PubMed Scopus (622) Google Scholar , 7 Nijhof SL Bleijenberg G Uiterwaal CS et al. Effectiveness of internet-based cognitive behavioural treatment for adolescents with chronic fatigue syndrome (FITNET): a randomised controlled trial. Lancet. 2012; 379: 1412-1418 Summary Full Text Full Text PDF PubMed Scopus (153) Google Scholar , 8 Gotaas ME Stiles TC Bjørngaard JH Borchgrevink PC Fors EA Cognitive behavioral therapy improves physical function and fatigue in mild and moderate chronic fatigue syndrome: a consecutive randomized controlled trial of standard and short interventions. Front Psychiatry. 2021; 12580924 Crossref PubMed Scopus (6) Google Scholar No new or more effective interventions have been identified. Although we applaud guideline efforts, it is remarkable that recommendations in the 2021 NICE guideline differ substantially from the previous one, and do not include CBT and GET as means to treat CFS/ME. The new guideline presents strengthened evidence, but a major shift in interpretation. How could this happen?

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Trapped: rigidity in psychiatric disorders

In the past decades, it has been shown to be difficult to predict the course of psychiatric disorders, because the mechanisms underlying their development and recovery process remain poorly understood. 1 Dalgleish T Black M Johnston D Bevan A Transdiagnostic approaches to mental health problems: current status and future directions. J Consult Clin Psychol. 2020; 88: 179-195 Crossref PubMed Scopus (82) Google Scholar These difficulties have been attributed to the fact that previous research was mostly performed from a categorical, diagnostic label point of view and on a single level (ie, psychological or biological), typically on the basis of static measures with low ecological validity. 1 Dalgleish T Black M Johnston D Bevan A Transdiagnostic approaches to mental health problems: current status and future directions. J Consult Clin Psychol. 2020; 88: 179-195 Crossref PubMed Scopus (82) Google Scholar To improve the prediction of course of illness, we propose to adopt a transdiagnostic, cross-level, mechanistic approach informed by clinical observations on rigidity in psychiatric patients.

Addressing Disparities for Intersectional BIPOC Communities: The Hood Medicine Initiative Case Study.

Addressing Disparities for Intersectional BIPOC Communities: The Hood Medicine Initiative Case Study.

Facilitators and barriers to living donor kidney transplantation

Facilitators and barriers to living donor kidney transplantation

Mental health care among marginalized populations in the United States

Mental health care among marginalized populations in the United States

Lack of Associations Between C-Reactive Protein and Mood and Anxiety Symptoms in Adolescents.

Introduction: Increased peripheral inflammation has been consistently documented in both adult and pediatric depression. However, elevated levels of C-reactive protein (CRP), a nonspecific biomarker for inflammation, have been primarily reported in adults; whether CRP plays a similar role in adolescent depression has not been conclusively established. In our prior work, we identified relationships between CRP and reward neurocircuitry in adolescents with psychiatric symptoms (N = 64) but not with depressive symptoms. Extending this work, we sought to examine CRP across the full range of mood and anxiety symptom severity in a larger, clinically diverse cohort of psychotropic medication-free adolescents and healthy controls (HCs). Methods: Subjects were adolescents (N = 127, age: 15.17 ± 2.19 years, 78 female) with psychiatric symptoms (n = 96, including previous cohort of 64) and HC (n = 31). All completed a semi-structured psychiatric evaluation and dimensional assessments for depression, anxiety, anhedonia, and suicidality. Group-comparison and correlation analyses utilized nonparametric statistics controlled for body mass index, sex, and age at pFWE < 0.05. Results: No group differences were identified in CRP levels between the clinical cohort and HCs. In addition, correlations between CRP and clinical symptomatology were not significant in either the whole sample or the psychiatric group. Conclusions: We found that, unlike in adults, CRP was not associated with depressive symptoms. This suggests that inflammation in pediatric depression is more narrowly delimited at the onset of psychiatric symptoms and may only become systemic with chronicity.

A 25-Year Review of Nighttime Fears in Children: Past, Present, and Future.

Nighttime fears in children are common, interfere with daily functioning, and result in considerable disruption in the family. The aim of the present review was to examine empirical literature from the past 25years that investigated the assessment of nighttime fears in young children and the efficacy and effectiveness of psychosocial treatments for children's nighttime fears. The last review of this literature was in 1997 and examined studies conducted in and prior to 1995 (King et al. in Clin Psychol Rev 17:431-443, 1997). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review of the literature aimed at providing a synthesis of the Randomized Control Trials (RCTs) and controlled single-case multiple baseline design studies (MBLs) on the treatment of nighttime fears in children. A search of the literature identified 12 articles, with nine studies utilizing a between-group randomized controlled trial design and three studies utilizing a multiple baseline design. Results demonstrated significant improvements in children's nighttime fears and reductions in disruptive nighttime behaviors using behavioral interventions and cognitive-behavioral strategies. This review provides a commentary on the effectiveness and limitations of the assessment and treatment approaches for nighttime fears in children and suggests directions for future research.

Cognitive-Behavioral Strategies to Manage Anxiety

Anxiety disorders are a common mental illness across populations,1,2 with epidemiological studies showing that one-third of the population is affected by an anxiety disorder in their lifetime.3 Recent stressors such as the coronavirus disease 2019 pandemic have significantly worsened anxiety rates internationally,4 and it is expected that the mental health consequences impacting the global population will be long-lasting.5 Despite this significant prevalence of anxiety symptoms, there is a significant access-to-care gap in mental health, where it takes more than 20 years for people in distress to receive evidence-based care in routine practice.6–8 One way to address this difficulty is to increase awareness of evidence-based practices for anxiety, such as cognitive-behavioral therapy (CBT).9 CBT is a short-term, skills-focused treatment aimed at addressing psychological distress and maladaptive emotional responses by targeting the patient's thoughts, behaviors, or both.10 CBT has been shown to be effective for a range of problems, including anxiety disorders and depression.11 This issue of Psychiatric Annals will provide practitioners with a complete and up-to-date review on the cognitive-behavioral strategies that have been shown to be efficacious in addressing anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and comorbid anxiety and depression. Each article highlights a specific disorder, starting with the cognitive-behavioral theoretical understanding for the disorder, the cognitive-behavioral strategies employed, and the empirical evidence supporting their effectiveness for each disorder. [...]the goal of this issue is to equip mental health professionals with the knowledge required to deliver optimal care and to address the growing needs and prevalence of patients with anxiety symptoms. 1. Cognitive-behavioral therapy for adult anxiety disorders in clinical practice:ameta-analysis of effectiveness studies.JConsult Clin Psychol. 2009;77(4): 595–606.