Cognitive Behavioral Therapy Research Articles

Shopaholism – aetiology, characteristics, models and concepts of cognitive-behavioural therapy

The article addresses the issue of shopaholism as a disorder, examining its existing definitions and functioning diagnostic criteria within the context of its exclusion from official disease classifications, despite its increasing prevalence and negative impact on the lives of individuals. The study highlights that, although not formally recognised as a disease entity, shopaholism is discussed in scientific literature under various terms, such as compulsive buying, impulsive buying, or shopping addiction, and can be considered a form of behavioural addiction. The article emphasises the complex aetiology of shopaholism, suggesting that it results from a combination of biological, cognitive, emotional, and social factors. The authors also demonstrate from a cognitive-behavioural perspective how core beliefs, values, and self-esteem may contribute to the development and persistence of the disorder. In addition, the article discusses therapeutic approaches including pharmacotherapy and, above all, cognitive-behavioural psychotherapy, which is emerging as a key approach in the treatment of shopaholism, with efficacy proven by numerous studies. This therapy aims at cognitive restructuring to modify negative thoughts, improve impulse control, and foster healthier coping strategies to deal with negative emotions. The article explores the complexity of shopping addiction, drawing on both historical and contemporary cognitive models to conceptualise individual cases and develop effective therapeutic plans. It also highlights proven techniques and methods. By adopting a cognitive-behavioural perspective, mental health professionals can provide patients with a targeted and personalised treatment. From the perspective of treatment, the key challenge is not abstinence but working with beliefs and values, as well as cognitive and behavioural techniques.

Cognitive behavioural therapy for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis

BackgroundTreatment of fatigue is important for many patients with multiple sclerosis (MS). While pharmacological options have not shown consistent benefit, psychological interventions offer another avenue of treatment. Cognitive behavioural therapy (CBT) involves strategies to change maladaptive cognition and illness behaviours that modulate how patients with MS respond to fatigue. The aim of this study was to perform a systematic review and meta-analysis to determine the effectiveness of CBT for the treatment of fatigue in patients with MS. MethodsFive databases (Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Embase, Emcare and PsycINFO) were searched up until 31 July 2023. Randomised controlled trials involving adult patients with MS and fatigue, comparing CBT with another intervention or usual treatment were included. Studies were required to measure fatigue severity and/or the impact of fatigue as the primary outcome(s). Each study was assessed for bias using the Cochrane Risk of Bias tool version 2. Studies with sufficient data were used for meta-analysis to quantify the short- and long-term effects of CBT on MS-related fatigue. The level of certainty provided by the body of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. ResultsEight studies were included in the review and six studies contributed to the meta-analysis. Most studies had a low overall risk of bias. CBT interventions differed in the number, duration and frequency of sessions, mode of delivery and therapist. There were significant short- (standardised mean difference (SMD) -0.58, 95% confidence interval (95%CI) -0.85 to -0.31, P-value < 0.0001) and long-term (SMD -0.36, 95%CI -0.52 to -0.19, P-value < 0.0001) effects supporting CBT. The evidence provided a low level of certainty for the short-term effect because of heterogeneity of results and possible publication bias, while there was high certainty for the long-term result. ConclusionThe study provides secondary evidence that CBT has moderate short-term and small long-term effects in reducing fatigue in patients with MS. CBT should be regarded as a viable evidence-based intervention, particularly in the absence of established alternatives. Future research should identify the ideal characteristics of a fatigue-specific CBT intervention, patient factors that predict treatment response and strategies to maintain initial improvements over time.

The use of virtual reality in the treatment of mental disorders such as phobias and post-traumatic stress disorder

Mental disorders, such as phobias and post-traumatic stress disorder (PTSD), are a serious health problem that significantly impacts people's quality of life. These disorders can significantly impair the quality of life of patients, so studying ways to treat them using modern methods is important and relevant. The purpose of this study is to evaluate the effectiveness and potential of using virtual reality (VR) technology in the treatment of phobias and PTSD. The methods used in the study include analytical, comparative, and systematization methods. The study has shown that cognitive behavioural therapy and exposure therapy are the main treatments for these disorders. The use of VR in the treatment of mental disorders, including phobias and PTSD, opens up new opportunities for safe and effective exposure to stressful stimuli. It was found that the benefits of using VR in the treatment of mental disorders include safe exposure, an individualized approach to treatment, and the ability to create realistic simulations of stressful situations. The study confirmed that the use of VR in the treatment of phobias allows patients to gradually get used to phobic stimuli and change their negative perceptions and reactions to them. The use of VR in the treatment of PTSD has significant potential, allowing the application of various techniques, including exposure, gradual desensitization, cognitive behavioural therapy, therapeutic recovery, meditation, and relaxation, to alleviate the symptoms of the disorder and improve the quality of life of patients. The findings of the study can serve as a basis for improving clinical practice in psychotherapy and psychiatry, allowing for more effective and individualized care for patients with disorders.

Suicidal Ideation, Clinical Worsening and Outcomes among Child Participants in Trauma-Focused Treatment.

Research on clinical trajectories of children with suicidal ideation (SI) and clinical worsening (CW) during cognitive behavioral therapy (CBT) for childhood trauma is limited. The current study utilized secondary data from a randomized clinical trial comparing Trauma-Focused CBT versus Stepped care CBT to examine (1) clinical profile and outcomes of children with SI, recurrent thoughts of death/dying, and past attempts; and (2) clinical worsening during treatment and difference in outcomes. Children (ages 4-12) and their parents (N = 183) participated and 132 completed treatment. Interviews assessing SI, thoughts of death/dying, past attempts, and number/type of trauma were conducted with children (ages 7-12) and parents. Outcome measures (baseline and post-treatment) completed by parents included child posttraumatic stress symptoms, impairment, and internalizing and externalizing problems and an independent evaluator rated overall severity. Children (ages 7-12), parents and therapists completed ratings during treatment that indicated CW. Results did not differ by treatment group; thus, the pooled sample was used. Children with SI at baseline had higher severity than children without. For completers, no children (n = 14) with SI at baseline had SI at post-treatment. Child (n = 3) and therapist (n = 5) ratings of CW were low. Eighteen children (13.64%) were rated as CW by parents. Most ratings occurred at the beginning of treatment. Children with therapist ratings of CW had higher internalizing problems. Findings suggest that children with SI and CW can improve from trauma-focused CBT. More research is needed on the clinical trajectory of children with SI and trauma, and on clinical tools to monitor CW. Clinical trial registration information: https://clinicaltrials.gov : NCT02537678.

Effects of a combined neuropsychological and cognitive behavioral group therapy on young adults with Fragile X Syndrome: An explorative study

BackgroundFragile X Syndrome (FXS) is an X-linked neurodevelopmental disorder that leads to intellectual disability (ID) along with cognitive-behavioral difficulties. Research on psychosocial treatments in individuals FXS and ID is still lacking. This study aimed to investigate the effectiveness of a combined neuropsychological and cognitive behavioral group therapy (nCBT) among young adults with FXS. MethodTen young adults diagnosed with FXS took part in the second stage intervention of "Corp-osa-Mente" (CoM II), a group nCBT program previously outlined by Montanaro and colleagues in an earlier study, with the participants being the same as in the previous research. This report details the outcomes of an additional twelve-month group sections aimed at enhancing the ability to manage emotions and the socio-communicative skills of these young adults. Caregivers completed measures of adaptive functioning, emotional and behavior problems, executive function, communication skills and family quality of life at pre-treatment (T0) and post-treatment (T1). ResultsCoM II showed a decrease in depressive and anxiety symptoms from T0 to T1, along with increased socio-pragmatic and communication skills from pre-test to post-test intervention. Additionally, our analysis revealed improvements in the adapative behavior of participants and in the family quality of life. ConclusionsThese preliminary findings suggest that young adults with FXS and ID experienced positive outcomes through participation in CoM II, a group nCBT. However, it is recommended to undertake additional methodologically rigorous studies, such as randomized controlled trials (RCTs), to substantiate these initially promising findings.

Effect of Cognitive Behavioural Therapy (CBT) Among Subjects with Alcohol Use Disorder (AUD) in Uganda: A Comparative Study of Treatment Groups

Effect of Cognitive Behavioural Therapy (CBT) Among Subjects with Alcohol Use Disorder (AUD) in Uganda: A Comparative Study of Treatment Groups

Group Dissociation-Focused Cognitive Behavioral Therapy (DF-CBT) in Patients Suffering from a Dissociative Subtype of PTSD: An Exploratory Study

ABSTRACT Dissociation is a widespread difficulty among patients suffering from Posttraumatic Stress Disorder (PTSD). However, there is no gold standard treatment for dissociative symptoms. Recent studies propose a cognitive and behavioral conceptualization for dissociation. The aim of this study was to explore the efficacy of a group program of Dissociation-Focused Cognitive Behavior Therapy (DF-CBT) on dissociative symptoms. We recruited 27 patients suffering from a dissociative subtype of PTSD in a university hospital trauma center. Participants completed questionnaires evaluating dissociation, PTSD, mindfulness abilities, beliefs about emotions, beliefs about dissociation, emotion regulation difficulties, anxiety and depression. Following an initial evaluation, participants undertook 7 sessions of DF-CBT, and were reevaluated after the last session using the same questionnaires. We found a significant reduction of dissociative, PTSD, anxiety, and depression symptoms following DF-CBT. The effect size was noticeable for all variables (.61<d < 1.1). We found an association between the reduction of dissociation and the decrease of negative beliefs about emotions and dissociation, mindfulness difficulties and emotion regulation difficulties. This study provided the first empirical evidence of the efficacy of DF-CBT. The active mechanisms involved in the program seem congruent with proposed models of dissociation. A controlled randomized trial is required for further demonstration.

Insomnia in ambulatory care: A clinical review.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. One-third to one-half of ambulatory care patients report insomnia. The objective of this clinical review is to detail the many causes and evidence-based treatment options for insomnia in outpatients and to recommend screening and summarize evidence for the place in therapy of prescription and nonprescription treatments. This work provides an overview of the literature on insomnia regarding causes, patient assessment, and nonpharmacological and pharmacological treatments. Patients who present with insomnia should be assessed for sleep apnea, restless legs syndrome, narcolepsy, and all contributing medications as well as medical, psychiatric, and substance use disorder diagnoses. The type of insomnia, namely difficulty falling asleep, difficulty maintaining sleep, and early morning awakening with resulting functional impairment, should be documented in addition to whether insomnia is short term or persistent. Cognitive behavioral therapy for insomnia (CBT-I) or digital CBT-I is first-line treatment for all patients with insomnia irrespective of the cause or type. Nonprescription treatments such as antihistamines or melatonin are for select populations. Prescription hypnotics are best utilized on an as-needed basis or for nightly use for less than 6 weeks. Z-hypnotics are safe and effective for insomnia in persons with depression or an anxiety disorder but should be avoided in older individuals or if there is respiratory or cognitive impairment. Orexin receptor antagonists are effective for sleep initiation and maintenance in healthy persons or if there is mild cognitive impairment, but they require further study in individuals with psychiatric and medical diagnoses. Trazodone is the most prescribed off-label treatment due to its efficacy for sleep initiation and maintenance and its lack of abuse potential. Insomnia treatment should be guided by patient age, diagnoses, and type of insomnia. Pharmacological treatments should be used at the lowest effective dose for the shortest duration of time.

Effects of acupuncture combined with five-element music for people with mild/moderate post-stroke depression: A randomized controlled trial

ObjectivesTo evaluate the efficacy and safety of acupuncture combined with five-element music (FEM) as an therapeutic strategy for the physical and mental state of Post-stroke depression patients. Design and settingMulticenter, randomized clinical trial conducted at 3 hospitals in China and enrolling 237 patients with PSD between June 2019 and April 2021. Participants mild/moderate PSD (17-item GRID Hamilton Depression Scale (HAMD) score 7–24) were randomly assigned (1:1) to acupuncture combined with FEM (AFEM) group or cognitive behavioral therapy (CBT) group. Main outcome measuresThe primary outcome was change and differences between the groups in HAMD-17 from baseline to week 12. Secondary outcomes included Fugl-Meyer Assessment Scale score and Stroke-Specific Quality of Life Scale (SS-QOL) score. ResultsThe 237 patients in this intention-to-treat analysis were randomized into either the AFEM group (n=119) or the cognitive behavioral therapy (CBT) group (n=118). Of these 237 participants, 225 (94.9 %) completed all outcome measurements at week 12. The AFEM and CBT groups both showed significant improvement in HAMD-17 from baseline to week 12. Patients in the AFEM group had significantly lower HAMD-17 scores of −3.56 at week 8 (95 % CI,-4.59 to −2.53; p <.001) and −3.50 at week 12 (95 % CI,-4.53 to −2.46; p<.001) than patients in the CBT group. The SS-QOL score improved significantly at week 12. The Fugl-Meyer score was significantly lower in the AFEM group than in the CBT group at week 4, but this difference was not statistically significant upon follow-up at weeks 8 and 12. The incidence of treatment-related adverse events was 2.1 % in the AFEM group, with no serious adverse events reported. ConclusionsThe results suggest that acupuncture and five-element music significantly improve the depressive symptoms in this cohort of Chinese PSD patients, and the toxicities were similar with CBP group. RegistrationThis study registered with the ClinicalTrials.gov Identifier: ChiCTR1900023741.

EFFECTIVENESS OF COGNITIVE-BASED INTERVENTIONS FOR IMPROVING BODY IMAGE OF PATIENTS HAVING BREAST CANCER

Breast cancer is one of the most common tumors among women. CBT is an algorithmic, time-bound method of treatment that concentrates on altering negative cognitive processes and behavioral patterns. Objectives: The main objective of the study is to find the effectiveness of cognitive-based interventions for improving the body image of patients with breast cancer. Methods: This quasi-experimental study was conducted at Khyber Teaching Hospital Peshawar from January 2023 to January 2024. Data were collected from 105 breast cancer patients, all of whom had undergone various treatments such as mastectomy, lumpectomy, or chemotherapy, which resulted in noticeable physical changes. All patients diagnosed with breast cancer and having undergone surgical or medical treatments and experiencing concerns related to body image post-treatment with no prior history of psychiatric disorders were included in the study. Results: Data were collected from 105 patients. The results show that the intervention group experienced a significant improvement in body image, with a 45.6% reduction in Body Image Scale (BIS) scores from 22.8 ± 3.5 pre-intervention to 12.4 ± 3.1 post-intervention (p = 0.001). In contrast, the control group showed only a minimal 3.6% improvement, with scores decreasing slightly from 22.5 ± 3.7 to 21.7 ± 3.4 (p = 0.152). Conclusion: It is concluded that cognitive-based interventions, particularly Cognitive Behavioral Therapy (CBT), are highly effective in improving body image and reducing anxiety and depression in breast cancer patients.

Tackling Cravings in Medical Weight Management: An Update on Pathophysiology and an Integrated Approach to Treatment

Background/Objectives: Food cravings involve a strong drive to consume palatable foods irrespective of nutritional status. Importantly, cravings contribute substantially to the obesity epidemic. Managing hunger alone is insufficient for weight management as this relates only to homeostatic eating and does not address the complex aetiology of hedonic eating and its crucial role in food cravings. Medical weight management clinics and anti-obesity medication trials do not routinely identify and address food cravings. Methods: We conducted a narrative review of the literature consisting of 115 peer-reviewed articles (original articles and reviews). We included articles focused on food craving pathophysiology, assessment, and management strategies providing contrasts against the current medical model of weight management seen in obesity pharmacotherapy trials as well as the current standard of practise. Results: We outline the neurohormonal and psychological drivers of cravings, which lead to a spectrum of eating behaviours, from comfort food eating to binge eating disorders. We provide an overview of ways of identification and measurement options, including their strengths and weaknesses, and an overview of management strategies and their cravings control efficacy, spanning lifestyle modifications like nutrition and sleep, psychological therapies (i.e., cognitive behavioural therapy [CBT], acceptance-based therapies such as mindfulness) and, last but not least, medications that not only are approved for weight reduction but reduce cravings. Finally, based on these findings, we provide a proposed integrated and iterative model that is able to evolve and adapt to the individual over time in tackling cravings for long-term weight loss maintenance. Conclusions: The findings emphasise the importance of cravings management and provide a synthesis on how cravings can be identified in a medical weight management setting, which can be practically implemented in an integrated iterative model spanning anti-obesity medications that have craving control data to evidence-based lifestyle and psychological interventions.

Exploring the Neuropharmacological Terrain of Depression and Anxiety: Mechanisms, Therapies, and Future Avenues

Depression and anxiety are prevalent mental health illnesses that have significant worldwide consequences, impacting millions of individuals who experience chronic feelings of melancholy, excessive worry, and significant limitations in their everyday activities. Major Depressive Disorder (MDD) and several anxiety disorders, such as Generalized Anxiety Disorder (GAD), panic disorder, and social anxiety disorder, are defined by severe symptoms that make their treatment more difficult, especially when these illnesses happen at the same time. Gaining a comprehensive understanding of the neuropharmacological mechanisms that are responsible for these illnesses is of utmost importance in order to facilitate the development of treatments that are very effective. The existing therapy approaches, such as Selective Serotonin Reuptake Inhibitors (SSRIs) and newer antidepressants, provide partial relief but do not work for everyone. This suggests that further research is necessary to explore the underlying neurological causes of these illnesses. Recent developments in the field of neuropharmacology have provided insights into the significance of imbalances in neurotransmitters, specifically serotonin, norepinephrine, and dopamine, in the underlying mechanisms of mood disorders. Disruption of the Hypothalamic-Pituitary-Adrenal (HPA) axis and neuroinflammation are also major factors in the development of these illnesses. This review offers a thorough examination of these pathways, emphasizing the functions of neurotransmitter systems, neurostimulation treatments, and developing pharmaceutical medicines. This study investigates the possibility of new neuropharmacological targets, including NMDA receptor antagonists, AMPA receptor modulators, and neurosteroids, to enhance the effectiveness of treatment. In addition, it discusses non-pharmacological methods such as Cognitive Behavioral Therapy (CBT), physical activity, and mindfulness, highlighting their neuropharmacological foundations and advantages.This review is to provide an in-depth investigation of the current understanding and approaches to addressing depression and anxiety by including latest research findings. The text discusses crucial therapeutic approaches and presents potential areas of future study that could improve treatment results for these prevalent mental health illnesses.

Aerobic Exercise Versus Plyometrics in Reducing Anxiety Levels in College Students With Mild Generalized Anxiety Disorder.

Background Generalized anxiety disorder is one of the most prevalentmental disorders, characterized byexcessive anxiety and worry that affectboth mental and physical health. These pervasive illnesses have a crippling effect on people's everyday lives, quality of life, and wellness and are also highly linked with cardiovascular risk factors. Physical activity-based therapies have shown promising effects in treating a range of mental disorders, from psychosis to dementia. Out of many conventional therapies, aerobic exercise and plyometrics have been found to be effective in reducing anxiety levels. Aim This study aims to compare the effectiveness of aerobic exercise and plyometrics in reducing anxiety levels in college students with mild generalized anxiety disorder. Materials and methods A total of 96 subjects were selected for the studyusing a stratified sampling technique;48 subjects were assigned to the aerobic exercise group (Group A) and 48 to the plyometric group (Group P). Randomization was done using the sealed envelope method. This study includes students aged 18-25 years, both genders, with a body mass index of <30, a Beck Anxiety Inventory (BAI) score of 8-15, and at least six months without practicing any kind of physical activity. The exclusion criteria are subjects with other psychotic disorders, a history of cardiovascular disease, chronic kidney disease, inflammatory disease, malignant conditions, neurological disorders, anemia, with comorbid conditions, who were involved in supportive therapy for anxiety such as cognitive behavioral therapy, use of anxiolytic drugs, females with menstrual disorders, and subjects with recent trauma or injuries (fracture, ligament sprain, or muscle strain). The treatment duration for both groups was three days per week for a total of four weeks. Group A consists of five minutes of warm-up, 30 minutes of walking, and five minutes of cool-down, for a total of 40 minutes. Group P consists of warm-up of five minutes, high knees, single leg hop and jump squats of two sets and 10 repetitions for 30 minutes, and a cool-down of five minutes, for a total of 40 minutes. Conclusion The anxiety levels were analyzed using the BAI, revealing that bothgroups have shown improvements in Beck anxiety scores; however,Group A has shown a comparatively more significant improvement than Group P.

Evaluating the Effectiveness of Cognitive-Behavioral Play Therapy on Reducing Separation Anxiety in Boys in the First Grade of Primary School

Background: Separation anxiety disorder (SAD) is one of the most common disorders among children's behavioral problems, which leads to disruption in academic performance, social adjustment, family life, and peer relationships. Cognitive-behavioral play therapy (CBPT) is one of the appropriate treatment methods for correcting children's behavioral problems. It is designed for children aged three to eight. Objectives: Considering the importance of controlling separation anxiety in primary school children, the main aim of this research was to assess the effectiveness of CBPT in reducing SAD in boys in the first grade of primary education. Methods: A total of 30 primary school students with SAD were selected and then divided into the experimental group (15 students) and the control group (15 students) to conduct the present study. For the control group, no intervention was performed, but CBPT was done in ten sessions for the experimental group. The level of SAD was evaluated in both groups and then compared with each other before and after the intervention. In addition, the level of SAD in both groups was compared between the pre- and post-study stages to assess the effect of CBPT. The statistical analysis of the results was performed using SPSS software version 24 and using relevant tests at the significance level (α = 0.05). Results: The results showed that the average SAD score before the intervention was equal to 78.84 ± 1.26 for the control group and 78.66 ± 1.28 for the CBPT group. The statistical analysis revealed no significant distinction across these average levels (P = 0.975). After the intervention, the average SAD for the control and experimental groups was 77.50 ± 1.65 and 47.75±0.76, respectively, showing a significant difference between the two values (P &lt; 0.001). Conclusions: Based on the findings, CBPT can reduce SAD in primary school children. Therefore, psychologists and educational counselors of elementary school students can recommend using CBPT to treat some behavioral problems of elementary students.

Sosyal Kaygı Bozukluğunda Bilişsel Davranışçı Terapi Olgu Sunumu

In this study, the client's symptoms were characterized as social anxiety disorder based on dsm5 diagnostic criteria. The client is a 24-year-old female university student. The client stated that she had fears of failing, being stupid and being disgraced and mentioned physical symptoms such as hand and voice tremors, nausea and heart palpitations due to these fears. The client, who has beliefs such as inadequate, worthless and I must be successful, shows excessive anxiety and avoidance behaviors in situations such as eating in front of people, speaking in public, making presentations and mixing with people. The client realized that his academic success was jeopardized and his functionality was decreasing and applied for therapy. Cognitive behavioral therapy was used with the client. First, the client was psychoeducated about the therapy and its progress and a therapeutic relationship was developed. In the first stage of the treatment, cognitive processes were emphasized, automatic negative thoughts and core beliefs were identified and questioned, and cognitive restructuring was performed. Then behavioral techniques were practiced. Key words: Social anxiety disorder, anxiety, cognitive behavioral therapy.

Tic disorders in children in the outpatient practice of a medical psychologist

Background. The war in Ukraine is a factor of the psycho-emotional trauma in children. As you know, transient motor tics can be observed in almost 20 % of children in the world. Chronic tic and Tourette’s syndrome are also considered common among children. The purpose is to establish the prevalence of tic disorders among children who consult a medical psychologist, ta­king into account gender and age, to determine the directions of therapy. Materials and methods. The study was conducted from March 2023 to March 2024. Three hundred and five children (168 boys and 137 girls) aged 2 to 17 years were examined, who initially consulted a psychologist at the consultative diagnostic polyclinic of the National Specialized Children’s Hospital OHMATDYT. Results. Tic disorders were found in 31 (10.2 %) children: 15 (10.9 %) girls and 16 (9.5 %) boys. Girls with tics were significantly younger than boys with tics and girls from the comparison group. Chronic tic without vocalization was detected in 20 children, tic cough — in 5, vocal tics — in 3, Tourette’s syndrome in 3 cases (girls aged 8–10). Attention was drawn to the pronounced anxiety of the children, which manifested itself particularly in the subjects of their drawings. None of the children showed signs of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection or pediatric acute-onset neuropsychiatric syndrome. The therapy included educational interventions and cognitive behavioral therapy. Conclusions. Every tenth child, who initially consults a medical psychologist, suffered from tic disorder, which required educational activities and cognitive behavioral therapy.

Perceptions and Effectiveness of a Fully-Automated Brief Behavioral Insomnia Therapy, Delivered by a Virtual Companion, in Older and Young Adults

Abstract Background and Objectives One of the most common sleep disturbances in older people is insomnia. Cognitive-behavioral therapy is the first-line treatment for this condition in older adults, but in-person treatment is costly and often unavailable. In this study, in a group of older and young subjects, we aimed to compare: (1) their initial perceptions of a fully-automated mobile health intervention to manage insomnia, (2) how these perceptions related to treatment completion, and (3) the effects of the intervention on insomnia severity and related outcomes. Research Design and Methods A case series study was conducted with a self-selected sample of older (&amp;gt; 65 years) and young (18-35 years) adults (n=5,660) who downloaded a free app, available in France, that delivers a brief behavioral intervention for insomnia aided by a virtual companion. The 17-day intervention included sleep hygiene and stimulus control recommendations. Primary outcome was treatment completion (yes/no). At the beginning of the intervention, treatment acceptability and trust in the virtual companion were assessed with two short questionnaires (completion rate: 1,597 users). Insomnia was evaluated with the Insomnia Severity Index. Results Logistic regression analyses showed that higher credibility and trust in the app’s virtual companion were associated with higher odds of treatment completion, but only in older adults (Trust scores x Age group: OR=1.12, [95%CI=1.01-1.25], p &amp;lt; .05, and Credibility scores x Age group: OR=1.25, [95%CI=1.06-1.47], p &amp;lt; .01). Within the subset of users who completed the intervention (n=289), insomnia remission (χ2=2.72, NS) and insomnia response rates (χ2=2.34, NS) were comparable across both groups. Discussion and Implications This brief behavioral intervention appears to be efficacious for the self-management of insomnia symptoms in older adults. The integration of persuasive interaction elements, such as avatars and virtual coaches, in fully-automated interventions could be particularly useful to stimulate older adults’ engagement.

Lessons learned from a multimodal sensor-based eHealth approach for treating pediatric obsessive-compulsive disorder.

The present study investigates the feasibility and usability of a sensor-based eHealth treatment in psychotherapy for pediatric obsessive-compulsive disorder (OCD), and explores the promises and pitfalls of this novel approach. With eHealth interventions, therapy can be delivered in a patient's home environment, leading to a more ecologically valid symptom assessment and access to experts even in rural areas. Furthermore, sensors can help indicate a patient's emotional and physical state during treatment. Finally, using sensors during exposure with response prevention (E/RP) can help individualize therapy and prevent avoidance behavior. In this study, we developed and subsequently evaluated a multimodal sensor-based eHealth intervention during 14 video sessions of cognitive-behavioral therapy (CBT) in 20 patients with OCD aged 12-18. During E/RP, we recorded eye movements and gaze direction via eye trackers, and an ECG chest strap captured heart rate (HR) to identify stress responses. Additionally, motion sensors detected approach and avoidance behavior. The results indicate a promising application of sensor-supported therapy for pediatric OCD, such that the technology was well-accepted by the participants, and the therapeutic relationship was successfully established in the context of internet-based treatment. Patients, their parents, and the therapists all showed high levels of satisfaction with this form of therapy and rated the wearable approach in the home environment as helpful, with fewer OCD symptoms perceived at the end of the treatment. The goal of this study was to gain a better understanding of the psychological and physiological processes that occur in pediatric patients during exposure-based online treatment. In addition, 10 key considerations in preparing and conducting sensor-supported CBT for children and adolescents with OCD are explored at the end of the article. This approach has the potential to overcome limitations in eHealth interventions by allowing the real-time transmission of objective data to therapists, once challenges regarding technical support and hardware and software usability are addressed. www.ClinicalTrials.gov, identifier (NCT05291611).

Examining the impact of brief couples-based posttraumatic stress disorder treatments on anger and psychological aggression in veterans and their partners.

Anger can adversely impact functioning in veterans. Psychological aggression, which is related to but distinct from anger, is particularly detrimental to veterans' mental health. Research examining anger and psychological aggression following individual therapy for posttraumatic stress disorder (PTSD) has demonstrated small effect sizes. Treatments that directly target conflict management and interpersonal functioning, both regarding content and delivery to veterans and their loved ones (e.g., couples-based PTSD treatments), may be more effective in alleviating anger symptoms. This study examined whether larger reductions in anger and psychological aggression would be observed in a couples-based intervention compared to an active comparator at posttreatment and follow-up. Data were derived from a randomized trial comparing brief cognitive-behavioral conjoint therapy for PTSD (bCBCT) and PTSD family education (PFE). Participants were 137 veterans and their intimate partners (bCBCT: n = 92, PFE: n = 45). We observed within-condition significant reductions in angry temperament, d = -0.47, p <.001, and angry reaction, d = -0.26, p =.004, among veterans in bCBCT but not PFE, |d|s = 0.13-0.17, ps =.166-.268. Veterans and partners in both conditions reported reductions in psychological aggression, |d|s = 1.09-1.46, ps <.001. There were no significant differences between the treatment conditions on any outcome, ps =.103-.443, and there were no significant changes in anger between posttreatment and follow-up, |d|s = 0.07-0.24, ps =.052-.582. Couples-based interventions for PTSD, including bCBCT and PFE, can be effective in improving aspects of anger among veterans and their intimate partners.

The impact of group cognitive behavioral psychotherapy on disease severity and psychosocial functioning in patients with inflammatory bowel disease: a randomized controlled study.

Patients with inflammatory bowel disease (IBD) often report symptoms of anxiety and depression as well as impaired quality of life (QoL). To date, there are few studies on the effect of psychotherapy on psychological functioning and clinical outcome in patients with IBD. The aim of this prospective, randomized, controlled study was to investigate the effect of a brief psychotherapeutic intervention on psychological distress, QoL, sexual functioning, and inflammation and disease activity indices in patients with IBD. Participants were randomized to receive either group cognitive behavioral therapy or treatment as usual (controls) and were assessed at baseline and after six months using psychometric instruments to assess psychological distress, QoL, and sexual functioning. In addition, laboratory measurements, including levels of C-reactive protein (CRP), cytokines and calprotectin, and calculations of disease activity indices were performed during the two study periods. 80 participants took part in the study. Patients who received psychotherapy reported a significant decrease in anxiety and depression symptoms, a significant improvement in physical functioning, general health, vitality, social functioning and mental health, a decrease in physical pain and a decrease in role limitations caused by emotional problems. CRP levels and the Crohn's disease activity index (CDAI) also decreased significantly at follow-up compared to controls. Group cognitive behavioral therapy is proving to be an important component of holistic care for IBD patients, as it can significantly improve not only patients' psychosocial functioning but also their clinical course by inhibiting inflammation and reducing disease activity.