Combined Cognitive Behavioral Therapy Research Articles

Effectiveness of an innovative treatment protocol for misophonia in children and adolescents: Design of a randomized controlled trial

BackgroundMisophonia is a recently identified disorder in which individuals experience intense, uncontrollable and disproportional irritation, anger or disgust when confronted with specific sounds or stimuli associated with these sounds. Prevalence rates in children and adolescents are currently still to be investigated. The reported average age of onset is around 13 years, in clinical practice children from 8 years old are referred.Misophonia is associated with avoidance and anticipation anxiety, possibly leading to serious educational and social consequences for children and families. Worldwide, no evidence-based treatment exists specifically for children and adolescents with misophonia.This article presents the design of a randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) combined with psychomotor therapy (PMT) for misophonia in children and adolescents (aged 8–18). MethodsIn total, 82 patients will be randomly assigned to a treatment condition or waiting list condition of 3 months (WCG). Treatment consists of 7 weekly group therapy sessions (1.5 h CBT plus 1.5 h PMT) and a follow-up after 3 weeks. Pre and post treatment assessments will be conducted during a baseline assessment, after 3 and 6 months. The primary outcome will be assessed by the Amsterdam Misophonia Scale – Youth (AMISOS-Y) and secondary outcomes (e.g. quality of life) and putative predictors (e.g. parenting burden) will be studied. ConclusionThis trial is the first study worldwide testing the effectiveness of a combined CBT plus PMT protocol for misophonia in children and adolescents. If proven effective, this protocol provides an innovation to improve care for youth with misophonia.

Current evidence for various inpatient psychotherapy programs in the treatment of psychoses-A narrative review article

The analysis of the efficacy of evidence-based psychotherapy for patients with psychotic disorders has mostly been carried out in the outpatient field. In the inpatient field the efficacy is sometimes difficult to assess due to different healthcare systems. The aim of this narrative review is to summarize international guidelines and meta-analyses on the efficacy of inpatient psychotherapeutic treatment strategies for patients with psychotic disorders. Based on this, recommendations for disorder-specific ward concepts for acute and postacute fields are formulated. The German S3 guidelines, international guidelines, current meta-analyses and primary studies on psychological interventions in the treatment of psychotic disorders were included. Based on the results, recommendations for the inpatient psychotherapeutic treatment in various phases of treatment were formulated (acute phase and postacute phase). In the acute phase a combination of cognitive behavioral therapy (CBTp) in the individual setting and family interventions in the group setting as well as metacognitive training (MCT acute) is effective and recommended. In the postacute phase, in addition to individual and group CBTp and family interventions, psychoeducation, social skills training and cognitive remediation have been shown to be effective and are recommended. The suggested recommendations for concrete interventions in various treatment phases and the evidence base are critically discussed and recommendations for the structure of wards are presented.

Preliminary evaluation of music-based emotion-regulation skills to augment CBT for adolescents with ADHD

Adjunctive strategies that effectively incorporate adolescents’ developmental needs may augment the therapeutic benefits of cognitive behavioral therapy (CBT) for adolescents with attention deficit hyperactivity disorder (ADHD). This preliminary study evaluated a combined CBT and music-based treatment designed to enhance emotion-regulation skills in adolescents with ADHD. Utilizing a single-case experimental design, eight adolescents with ADHD were assigned to a 3-week baseline assessment phase followed by 12 weekly individual sessions of treatment and a 2-month follow-up phase. The intervention was effective in reducing the core symptoms of ADHD, such that, participants showed an increase in adaptive emotion-regulation strategies (cognitive reappraisal) and decrease in maladaptive emotion-regulation strategies (expressive suppression). The intervention was also found to be highly acceptable to participants. The findings provide initial support for combining standard CBT with music-based treatment designed to enhance emotion-regulation skills, and add to the growing body of literature showing that adjunctive strategies can augment the therapeutic benefits of CBT for adolescents with ADHD.

Implementation and Preliminary Evaluation of a 12-Week Cognitive Behavioural and Motivational Enhancement Group Therapy for Cannabis Use Disorder.

The purpose of this paper is to provide a preliminary evaluation of treatment outcomes, retention and client satisfaction following a 12-week combined cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) group treatment for cannabis use disorder (CUD) delivered in an outpatient setting. Implementation of the program is also described. A retrospective observational cohort study was conducted using data collected from medical records and self-report assessments. Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto. Cannabis use, cannabis-related problems, craving, withdrawal symptoms, self-efficacy for remaining abstinent, depression and anxiety were assessed pre- and post-treatment. Treatment retention was calculated by inspecting clinic attendance records, and client satisfaction was evaluated using an anonymous feedback survey. Potential predictors of treatment outcomes and retention were investigated in exploratory analyses. Cannabis use was lower and days of abstinence higher post-treatment (vs pre-treatment). Post-treatment improvements in cannabis-related problems, craving, withdrawal symptoms, self-efficacy and mood were also observed. Completion of group treatment (⩾75% of sessions attended) was 57% and moderate levels of treatment satisfaction were reported. This study provides preliminary evidence that a 12-week combined CBT and MET treatment for cannabis use disorder delivered in a novel group setting improves cannabis use outcomes. Potential predictors of reduced cannabis use and retention were identified. Future controlled studies are warranted, and strategies for increasing retention should be explored.

Psychological treatments for excessive gaming: a systematic review and meta-analysis

Despite widespread public interest in problematic gaming interventions, questions regarding the empirical status of treatment efficacy persist. We conducted pairwise and network meta-analyses based on 17 psychological intervention studies on excessive gaming (n = 745 participants). The pairwise meta-analysis showed that psychological interventions reduce excessive gaming more than the inactive control (standardized mean difference [SMD] = 1.70, 95% confidence interval [CI] 1.27 to 2.12) and active control (SMD = 0.88, 95% CI 0.21 to 1.56). The network meta-analysis showed that a combined treatment of Cognitive Behavioral Therapy (CBT) and Mindfulness was the most effective intervention in reducing excessive gaming, followed by a combined CBT and Family intervention, Mindfulness, and then CBT as a standalone treatment. Due to the limited number of included studies and resulting identified methodological concerns, the current results should be interpreted as preliminary to help support future research focused on excessive gaming interventions. Recommendations for improving the methodological rigor are also discussed.

Multimodal Treatment with Cognitive Behavioral Therapeutic Intervention Plus Bladder Treatment Is More Effective than Monotherapy for Patients with Interstitial Cystitis/Bladder Pain Syndrome-A Randomized Clinical Trial.

(1) Background: Introduction: Interstitial cystitis/bladder pain syndrome (IC/BPS) not only induces physiological damage but also greatly affects psychological stress. Multidisciplinary therapy has been recommended for IC/BPS treatment, but clinical trial data of combined bladder therapy and cognitive behavioral therapy (CBT) are lacking. This study evaluated CBT efficacy in patients with IC/BPS. (2) Methods: Patients with IC/BPS were randomized to the bladder monotherapy (BT) or combined CBT (CBT) group. The primary endpoint was the self-reported outcome by global response assessment (GRA). Secondary endpoints included IC symptoms and problem index, bladder pain score, Beck’s anxiety inventory (BAI), and depression inventory, and objective parameters were also compared. (3) Result: A total of 30 patients receiving BT and 30 receiving CBT therapy were enrolled. Significant improvement of the BAI at 8 (p = 0.045) and 12 weeks (p = 0.02) post-treatment was observed in the CBT group, with significantly greater GRA scores at 12 weeks (p < 0.001). Repeated measures analysis of variance showed a significant effect within the CBT group on IC/BPS patients’ self-reported treatment outcomes (p = 0.001) and anxiety severity BAI scores (p = 0.033). (4) Conclusion: A multimodal treatment of CBT combined with suitable bladder treatment more effectively improves anxiety severity and treatment outcomes in patients with IC/BPS.

Effect of the combination of cognitive behavioral therapy and oral paroxetine hydrochloride in patients with post-stroke depression

Purpose: To determine the effects of combined use of cognitive behavioral therapy (CBT) and paroxetine hydrochloride tablets in patients with post-stroke depression (PSD), and its effect on scores on Hamilton Rating Scale for Depression (HAMD) and Stroke Specific Quality of Life Scale (SS-QOL).&#x0D; Methods: Clinical data for 96 patients with PSD who were treated in Dongying Traditional Chinese Hospital, Dongying City, China from June 2018 to June 2019 were retrospectively analyzed. Patients who met the inclusion criteria were divided into treatment group (TG, n = 48) and reference group (RG, n = 48) based on odd and even hospitalization numbers. Both groups received conventional treatment, but RG patients were in addition given clopidogrel, while TG received CBT in combination with paroxetine hydrochloride tablets. Clinical indices were evaluated in both groups before and after treatment. Moreover, therapeutic effects in the two different treatment methods on PSD, as well as on Hamilton Rating Scale for Depression (HAMD) and Stroke Specific Quality of Life Scale (SS-QOL) scores were analyzed.&#x0D; Results: After treatment, TG had lower HAMD score (p &lt; 0.001), lower scores on modified Rankin scale, and few incidences of adverse reactions at 3, 7, 15 and 30 days of treatment (p &lt; 0.05), but higher total clinical effectiveness and mean SS-QOL score (p &lt; 0.05), when compared with RG.&#x0D; Conclusion: Combined use of CBT and oral paroxetine hydrochloride tablets may be a promising strategy for treating depression and enhancing the quality of life of PSD patients, as it greatly improves neurological deficit and prognosis. However, further clinical trials should be carried out prior to introducing it in clinical practice.

Cognitive behavioral therapy for weight management in gynecologic oncology (288)

<b>Objectives:</b> Obesity is an epidemic in gynecologic oncology, leading to an increased risk of surgical complications and poor cancer outcomes. Cognitive-behavioral therapy (CBT) is an effective weight loss strategy. We aimed to determine whether group CBT is an effective weight loss tool when offered in an outpatient gynecologic oncology setting. <b>Methods:</b> We established a CBT-based weight management intervention for gynecologic oncology patients at an NCI-designated cancer center. The intervention was a 12-week group-based weight loss program offered to patients from the gynecologic oncology clinic with body mass indices (BMI) between 25-50 kg/m². Sessions were free of charge, led by a psychologist and dietitian, and transitioned from in-person to tele-visits due to the COVID-19 pandemic. The program combined nutritional education, lifestyle changes, and CBT approaches, with 12 weekly group visits followed by three monthly individual follow-up visits. Each participant was given a goal weight loss of 7% total body weight (TBW). Retrospective data were collected from patients enrolled in the intervention from September 2019 through March 2021. Paired t-tests were performed to compare the pre-program and ending weights for all participants. Weight loss data were tested for normality using the Shapiro-Wilk test. <b>Results:</b> A total of 29 patients were enrolled in four cohorts during the study timeframe. Fifty-nine percent of participants were White, 38% were Black. The mean age among participants was 56 years, and the mean BMI was 41 kg/m². Most participants had a history of endometrial hyperplasia or malignancy (58%) and had stage I disease (59%). Among the participants, 22 (76%) completed the program. The average weight loss among all participants during the 12-week program was 5.6 pounds (CI: -8.9- -2.1, p=0.002), equivalent to an average 2% change in TBW. Among the 22 participants who completed the program, the average weight loss was 7.4 pounds (CI: -11.1- -3.8, p <0.001), equivalent to an average 3% change in TBW. Weight loss was sustained at the 6-month mark, with an average change in TBW of 2-3% when comparing weight at 6 months to pre-program weight. <b>Conclusions:</b> This CBT-based weight loss intervention was feasible and acceptable to gynecologic oncology patients. While the average weight loss fell short of the goal of 7% TBW, the 2-3% change in TBW achieved on average with this intervention was stable over six months. Additionally, retention within the intervention was high and maintained during COVID-19 with tele-visits. Given that weight loss plateaued when transitioning from weekly to monthly sessions, our findings suggest that longer, more intensive treatment may be needed to promote sustainable weight loss among gynecologic oncology patients. Collaboration between psychologists, oncology dietitians, and gynecologic oncologists, with continued support for psychologists and dieticians at cancer centers, is critical to the success of such programs. CBT is a feasible behavioral intervention to add further multidisciplinary efforts to tackle the complexity of obesity in cancer survivors. Table 1

Effectiveness of cognitive behavioural therapy and social skills training in management of conduct disorder.

BackgroundConduct Disorder (CD) is a repetitive disruptive behaviour that violates the rights of others, manifests in rules violation, aggression, hostility, and deceitfulness and has assumed prominence in its association with juvenile offending and criminality in adulthood. Despite this knowledge, little research attention is given to ascertaining effective psychobehavioural interventions to manage this problem, especially amongst Nigerian adolescents.AimThis study examined the efficacy of two psychobehavioural strategies to manage CD amongst in-school adolescents in Ibadan, Nigeria.SettingIbadan, Southwestern Nigeria.MethodA randomised controlled trial (RCT) of adolescents with CD was performed. Sixteen participants (aged 12–17 years) who reported high CD from an assessment of 1006 in-school adolescents of selected secondary schools in Ibadan were randomly grouped to receive either cognitive behavioural therapy (CBT), social skills training (SST) or combined CBT and SST. The Frequency of Delinquent Behaviour Scaling Instrument (FDBSI) was used for assessments.ResultsSignificant reduction in CD was observed among participants exposed to CBT (t[6] = 8.510), p < 0.05) at 8 weeks, SST (t[6] = 12.728), p < 0.05) at 8 weeks, and combined CBT and SST (t[8] = 12.728, p < 0.05) at the 6 week mark of interventions respectively.ConclusionFrom the study, CBT and SST are effective in managing CD. However, the combined psychobehavioural intervention of CBT and SST was more effective in managing CD, based on a faster therapeutic effect than the independent psychobehavioural intervention of CBT and SST.

Forty-Eight Week Outcomes of a Site-Randomized Trial of Combined Cognitive Behavioral Therapy and Medication Management Algorithm for Treatment of Depression Among Youth With HIV in the United States.

Studies suggest that manualized, measurement-guided, depression treatment is more efficacious than usual care but impact can wane. Our study among youth with HIV (YWH), aged 12-24 years at US clinical research sites in the International Maternal Pediatric Adolescent AIDS Clinical Trials Network, found a significant reduction in depressive symptoms among YWH who received a manualized, measurement-guided treatment. This paper reports outcomes up to 24 weeks after the intervention. Eligibility included diagnosis of ongoing nonpsychotic depression. Using restricted randomization, sites were assigned to either combination cognitive behavioral therapy and medication management algorithm tailored for YWH or to enhanced standard of care, which provided psychotherapy and medication management. Site-level mean Quick Inventory for Depression Symptomatology Self-Report (QIDS-SR) scores and proportion of youth with treatment response (&gt;50% decrease from baseline) and remission (QIDS-SR ≤ 5) were compared across arms using t tests. Thirteen sites enrolled 156 YWH, with baseline demographic factors, depression severity, and HIV disease status comparable across arms. At week 36, the site-level mean proportions of youth with a treatment response and remission were greater at combination cognitive behavioral therapy and medication management algorithm sites (52.0% vs. 18.8%, P = 0.02; 37.9% vs. 19.4%, P = 0.05), and the mean QIDS-SR was lower (7.45 vs. 9.75, P = 0.05). At week 48, the site-level mean proportion with a treatment response remained significantly greater (58.7% vs. 33.4%, P = 0.047). The impact of manualized, measurement-guided cognitive behavioral therapy and medication management algorithm tailored for YWH that was efficacious at week 24 continued to be evident at weeks 36 and 48.

Cognitive Remediation and Social Recovery in Early Psychosis (CReSt-R): protocol for a pilot randomised controlled study

BackgroundPsychosis, even in its early stages, is associated with significant disability, causing it to be ranked ahead of paraplegia and blindness in those aged 18–35 in terms of years lived with disability. Current pharmacological and psychological interventions intervention have focused primarily on the reduction of positive symptoms (hallucinations and delusions), with little benefit to domains of psychosis such as cognitive difficulties and social and occupational functioning.Methods/designThe CReSt-R intervention trial is a single center, pilot randomised controlled study based at the National University of Ireland (NUI), Galway. The trial will recruit participants from four clinical sites with assessment and intervention completed by the primary NUI Galway team. The trial will explore the feasibility, acceptability, and effectiveness of a novel psychosocial intervention for early psychosis based on a combined cognitive remediation training and cognitive behavioural therapy approach focused on social recovery. Participants, aged 16–35 within the first 5 years of a diagnosed psychotic disorder, will be recruited from the Children and Adolescent Mental Health Service and the Adult Mental Health Services in the region.DiscussionCognitive remediation training (for improving cognition) and social recovery focused cognitive behavioural therapy, have both separately demonstrated effectiveness. This trial will evaluate the feasibility, acceptability, and explore the efficacy of a treatment approach that combines both approaches as part of an integrated, multicomponent intervention.Trial registrationCognitive Remediation & Social Recovery in Early Psychosis (CReSt-R): ClincialTrials.gov Identifier NCT04273685. Trial registered Feb 18th, 2020. Last updated April 14th, 2021.

A Novel Psychological Group Intervention Targeting Appearance-Related Distress Among People With a Visible Disfigurement (Inside Out): A Case Study

People with a medical condition that leads to visible disfigurement often face significant psychosocial challenges related to their disfigurement, such as psychological distress, negative self-esteem and feelings of shame. In addition, they often encounter social difficulties including stigmatization, dealing with reactions of others and limitations in personal relationships. The availability of evidence-based psychological support tailored to these specific patients’ needs is limited. The aim of this study is to describe the development and content of Inside Out, a 5-session, theory-based psychological group intervention for people with a visible disfigurement due to a medical condition. This group intervention is based on a combination of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Competitive Memory Training. One case, a woman with facial palsy and psychological distress due to appearance-related problems, is presented to illustrate the intervention. This detailed description provides an in-depth illustration of the course and content of this treatment. Qualitative results show that this treatment is feasible and highly valued by the patient. Scores on pre-, post- and 3-month follow-up assessments showed improvements in psychological distress and level of acceptance of the condition. This case study shows how a psychological group intervention might contribute to the improvement of psychological wellbeing in individuals with a visible disfigurement.

From efficacy to effectiveness: child and adolescent eating disorder treatments in the real world (part 1)\u2014treatment course and outcomes

BackgroundFindings from randomised control trials inform the development of evidence-based eating disorder (ED) practice guidelines internationally. Only recently are data beginning to emerge regarding how these treatments perform outside of research settings. This study aimed to evaluate treatment pathways and outcomes for a specialist child and adolescent ED service across a five-year period.MethodsAll consecutive referrals between August 2009 and January 2014 seen at the Maudsley Centre for Child and Adolescent Eating Disorders in London were included. Data are reported on for all young people who were offered treatment (N = 357).ResultsMost young people referred to the service were diagnosed with anorexia nervosa (AN)/Atypical AN (81%). Treatment for AN/Atypical AN (median 11 months) was predominantly ED focused family therapy (99%). Treatment for bulimia nervosa (BN)/Atypical BN (median seven months) was most commonly a combination of cognitive behavioural therapy and ED focused family therapy (87%). At discharge, 77% of the AN/Atypical AN group had a good or intermediate outcome and 59% of the BN/Atypical BN group reported no or fewer than weekly bulimic episodes. 27% of the AN/Atypical AN group had enhanced treatment with either day- and/or inpatient admissions (AIM group). The %mBMI at 3 months of treatment was strongest predictor of the need for treatment enhancement and more modestly EDE-Q and age at assessment. The AIM group at assessment had significantly lower weight, and higher ED and comorbid symptomatology and went on to have significantly longer treatment (16 vs. 10 months). At discharge, this group had significantly fewer good and more poor outcomes on the Morgan Russell criteria, but similar outcomes regarding ED and comorbid symptoms and quality of life. When analysis was adjusted for %mBMI at assessment, 1 and 3 months of treatment, differences in Morgan Russell outcomes and %mBMI were small and compatible with no difference in outcome by treatment group.ConclusionsThis study shows that outcomes in routine clinical practice in a specialist community-based service compare well to those reported in research trials. The finding from research trials that early weight gain is associated with improved outcomes was also replicated in this study. Enhancing outpatient treatment with day treatment and/or inpatient care is associated with favourable outcome for most of the young people, although a longer duration of treatment is required.

Cognitive rehabilitation via head-mounted virtual reality technology in patients with Alzheimer’s disease: A systematic review

Recent clinical research emphasizes utilizing virtual reality (VR) technology in cognitive impairment rehabilitation. The high immersion and polymorphism make a practical option in cases where the current head-mounted devices (HMD). VR has been used in Alzheimer’s disease (AD) patients. The function of HMD is better than traditional therapies in clinical diagnosis; however, its application in treatment for AD patients remains unclear. The Web of Science databases were searched from January 2016 to August 2021. In addition, research or review articles were filtered according to the preferred reporting items for systematic reviews and meta-analyses guidelines. We bring into a total of 11 studies published in recent 5 years which show high degree of clinical feasibility. One study showed combined cognitive-behavioral therapy and VR in designing a reminiscence therapy for dementia patients; five other studies were focused on spatial navigation and posture positioning for AD patients and one of them showed effective clinical feasibility; other two studies were aimed at helping AD patients who lacked of attention and failed to propose unique advantage due to the samples data were not large enough for clinical validation. Last three studies were using a comprehensive task model in overall cognitive level and obtain considerable training in specific AD patients. HMD VR has become a reliable tool for cognitive rehabilitation in AD patients’ prophylactic treatment: Patients with AD in nursing homes and families showed greater interest in VR-based attention and spatial way finding tasks, and their performance was better for a period of time after the end of the task. Combining the VR tasks with clinical cognitive theory and traditional task models will exert more benefits. More clinical case will further determine the potential of VR in AD patients to develop a practical new path for cognitive rehabilitation in the near future.

Site-Randomized Controlled Trial of a Combined Cognitive Behavioral Therapy and a Medication Management Algorithm for Treatment of Depression Among Youth Living With HIV in the United States.

Depression is frequent among youth living with HIV (YLWH). Studies suggest that manualized treatment guided by symptom measurement is more efficacious than usual care. This study evaluated manualized, measurement-guided depression treatment among YLWH, aged 12-24 years at 13 US sites of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network. Using restricted randomization, sites were assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB-R) tailored for YLWH or to enhanced standard of care, which provided standard psychotherapy and medication management. Eligibility included diagnosis of nonpsychotic depression and current depressive symptoms. Arm comparisons used t tests on site-level means. Thirteen sites enrolled 156 YLWH, with a median of 13 participants per site (range 2-16). At baseline, there were no significant differences between arms on demographic factors, severity of depression, or HIV status. The average site-level participant characteristics were as follows: mean age of 21 years, 45% male, 61% Black, and 53% acquired HIV through perinatal transmission. At week 24, youth at COMB-R sites, compared with enhanced standard of care sites, reported significantly fewer depressive symptoms on the Quick Inventory for Depression Symptomatology Self-Report (QIDS-SR score 6.7 vs. 10.6, P = 0.01) and a greater proportion in remission (QIDS-SR score ≤ 5; 47.9% vs. 17.0%, P = 0.01). The site mean HIV viral load and CD4 T-cell level were not significantly different between arms at week 24. A manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH significantly reduced depressive symptoms compared with standard care at HIV clinics.

Preliminary evidence on combined cognitive behavioral therapy and motivational interviewing intervention efficacy to improve employment motivation for persons with intellectual disability

AbstractThis study investigated the efficacy of a combined modified cognitive behavioral therapy (CBT) and motivational interviewing (MI) approach on motivating persons with intellectual disabilities (ID) in obtaining employment. The sample consisted of a total of 52 individuals with ID who were clients of an independent vocational-rehabilitation services provider (females = 42%; males = 58%), ranging in age from 19 to 47. They were randomly assigned to an intervention group (n = 26) and a control group (n = 26). The intervention group received a combined modified CBT and MI intervention and the control group a fact sheet on career-dysfunctional thoughts and lack of motivation to obtain employment. Outcome measures comprised a career-dysfunctional thoughts scale and employment seeking action scale. Results indicated that the intervention group reported higher motivation in obtaining employment than the control. Practitioners seeking to improve employment prospects for persons with ID should consider the use of a combined modified CBT and MI intervention for increasing the chances of employment seeking by people with ID.

Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial

ObjectiveTo explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS).DesignProspective non-randomised controlled pilot study.SettingTertiary care facility with...

Managing job stress among teachers of children with autism spectrum disorders: A randomized controlled trial of cognitive behavioral therapy with yoga.

Background:Job-related stress undermines occupational, personal, and organizational outcomes. Stress symptoms are common among teachers of children with autism spectrum disorders and affect the academic progress of the children. This study investigated the effectiveness of yoga-based cognitive behavioral therapy in reducing occupational stress among teachers of children with autism in Lagos states, Nigeria.Methods:The current study adopted a group-randomized waitlist control (WLC) trial design with pre-test, posttest, and follow-up assessments. Participants included 58 teachers of children with autism in public and private special schools in Lagos state. Participants were randomly assigned to combined cognitive behavioral therapy and yoga (Y-CBT) (N = 29) and WLC (N = 29) groups. The Y-CBT group participated in a 2 hours Y-CBT program weekly for 12 weeks. Three instruments – Demographic Questionnaire, Single-Item Stress Questionnaire, and Teachers’ Stress Inventory (TSI) were used to collect data. Data were collected at baseline; posttest and follow-up evaluations. Data were analyzed using means, standard deviations, t test statistics, repeated measures analysis of variance, and bar charts.Results:Results revealed that all dimensions of job stress (perception of stress sources, stress manifestation, and total TSI scores) reduced significantly at posttest and follow up assessments among the Y-CBT group, compared to the WLC.Conclusion:It was concluded that Y-CBT modalities could help to minimize the perception of stress sources and stress manifestation as well as total TSI scores among teachers of children with autism spectrum disorders.

Changes of functional connectivity of the subgenual anterior cingulate cortex and precuneus after cognitive behavioral therapy combined with fluoxetine in young depressed patients with suicide attempt

This single-center, randomized, single-blind, parallel-controlled study aimed to analyze the changes in resting-state functional connectivity (RSFC) in young patients with a suicide attempt caused by depression before and after cognitive-behavioral therapy (CBT) combined with fluoxetine or fluoxetine alone by functional magnetic resonance imaging (fMRI). Before treatment, functional connectivity of the right subgenual anterior cingulate cortex (R-sgACC), left subgenual anterior cingulate cortex (L-sgACC) and right precuneus (R-PCu) was lower in depressed patients with a suicide attempt than that of healthy controls. After treatment, compared with the fluoxetine group, functional connectivity between the R-sgACC and left posterior cerebellar lobe in the CBT group was increased, while this group also showed increased RSFC between the L-sgACC and right anterior cingulate cortex/ medial prefrontal cortex. On the contrary, the functional connectivity between the R-PCu and right parietal lobe was reduced (P < 0.001). It was also found there were some changes in different brain regions in pre- and post-treatment within both the CBT and MG group. The functional connectivity of the R-sgACC and the left posterior cerebellum lobe was negatively correlated with the SSI score. The functional connectivity of the R-PCu and right middle frontal cortex was negatively correlated with the HAMD score before treatment. After treatment, functional connectivity between the R-PCu and right superior frontal gyrus was positively correlated with the SSI scores in the CBT group. After 8 weeks of combined CBT, the strength of the functional connectivity in the bilateral sgACC and bilateral PCu was significantly changed.

STEPS – Skupinový terapeuticko-edukační program pro sourozence dětí s poruchami autistického spektra: Manuál k vedení programu

David Havelka's publi­cation brings a manual for a therapeutic-educational program for siblings of children with autism spectrum disorders. This is a very neglected group of children, which the author tries to positively influence through a combination of cognitive behavioral therapy and experiential reflective learning. The book brings the theoretical basis from which the author drew, the manual for the program itself, and the final scientific and research evaluation based on the author's disser­tation. The book is clearly structured into six parts, of which the last part is electronic, intended for direct implementation of the program (available on the internet – a link to download materials is given in the book).