Psychological Therapies Research Articles

Mindfulness-based cognitive therapy neurobiology in treatment-resistant obsessive-compulsive disorder: A domain-related resting-state networks approach

Mindfulness-based cognitive therapy (MBCT) stands out as a promising augmentation psychological therapy for patients with obsessive-compulsive disorder (OCD). To identify potential predictive and response biomarkers, this study examines the relationship between clinical domains and resting-state network connectivity in OCD patients undergoing a 3-month MBCT programme. Twelve OCD patients underwent two resting-state functional magnetic resonance imaging sessions at baseline and after the MBCT programme. We assessed four clinical domains: positive affect, negative affect, anxiety sensitivity, and rumination. Independent component analysis characterised resting-state networks (RSNs), and multiple regression analyses evaluated brain-clinical associations. At baseline, distinct network connectivity patterns were found for each clinical domain: parietal-subcortical, lateral prefrontal, medial prefrontal, and frontal-occipital. Predictive and response biomarkers revealed significant brain-clinical associations within two main RSNs: the ventral default mode network (vDMN) and the frontostriatal network (FSN). Key brain nodes —the precuneus and the frontopolar cortex— were identified within these networks. MBCT may modulate vDMN and FSN connectivity in OCD patients, possibly reducing symptoms across clinical domains. Each clinical domain had a unique baseline brain connectivity pattern, suggesting potential symptom-based biomarkers. Using these RSNs as predictors could enable personalised treatments and the identification of patients who would benefit most from MBCT.

Current Understanding of Compulsive Sexual Behavior Disorder and Co-occurring Conditions: What Clinicians Should Know about Pharmacological Options.

Compulsive sexual behavior disorder (CSBD) has recently been recognized as a psychiatric disorder. Pharmacological treatments for CSBD have received little study and thus have limited empirical support. The main objective of the present work is to review existing literature on the efficacy of different drugs on the symptomatology of CSBD, including the subtype of problematic pornography use (PPU). The main pharmacological approaches to treating CSBD have included opioid antagonists (naltrexone and nalmefene), selective serotonin reuptake inhibitors (paroxetine, citalopram, fluoxetine, and sertraline), mood stabilizers (topiramate), tricyclic antidepressants (clomipramine), serotonin antagonist and reuptake inhibitors (nefazodone), and N-acetylcysteine. Since people with CSBD may experience different co-occurring disorders, these should be considered when choosing the best pharmacological treatment. Pharmacological therapy for CSBD/PPU has been suggested as an adjunct to psychological therapies, which, for the moment, have the most empirical evidence. However, to evaluate the efficacy of most of the drugs presented in this narrative review, data to date have only been available from case studies. Thus, empirical support is scant and generalizability of results is limited, highlighting the need for more research in this area.

Learning to cope with the reality of endometriosis: A mixed-methods analysis of psychological therapy in women with endometriosis.

Despite the need and uptake of mental health support by women with endometriosis, no research to date has explored their experience of psychological therapy. We aimed to understand the factors that predict engagement in psychological therapy by Australian women with endometriosis and to qualitative explore their experience of psychological support. Mixed-methods design. A total of 200 women with self-reported endometriosis were recruited from the community. We explored; (1) the demographic and clinical predictors of engagement in psychological therapy, (2) the psychological approaches that seem most valuable to women in the management of endometriosis and (3) their experience engaging in psychological therapy for endometriosis. Nearly half of women reported to have seen a psychologist within the past year, particularly for pain. Younger age (OR, .94; 95% CI, .886-.993), depressive symptoms (OR, 1.05; 95% CI, 1.002-1.099), and working part time compared to full time (OR, 2.17, 95% CI, 1.012-4.668), increased the likelihood of engaging in psychological therapy. Template thematic analysis identified three themes; (1) endometriosis and pain have multi-faceted psychological effects, (2) psychological support is sought to adjust and live with endometriosis and (3) there are helpful and unhelpful psychological tools for women with endometriosis. Our findings support the use of psychological therapy in the management of endometriosis, and the need for psychological therapy to acknowledge the chronicity and impact of symptoms, to enlist multidisciplinary support and to consider alternative options. Further advocacy is required to educate women on the benefits of psychological therapy for endometriosis.

The association between emotional labour, affective symptoms, and burnout in Australian psychologists

ABSTRACT Objective Psychology is a high burnout profession; however, little empirical research has examined the emotional labour (i.e., surface acting, deep acting, expression of naturally felt emotions) of psychologists who provide psychological therapy. The present study examined whether a relationship exists between emotional labour and wellbeing (operationalised as burnout and affective symptoms) in this sample, and whether individual or work-related factors moderate this relationship. Method 113 Australian psychologists who provide regular psychological therapy responded to an anonymous, online, cross-sectional survey. This survey collected information on demographic and workplace variables; it also contained measures of emotional labour and wellbeing. Results The results indicated that, at a bivariate level, surface acting was a significant predictor of adverse wellbeing; deep acting had no predictive qualities; and the expression of naturally felt emotions was a significant predictor of improved wellbeing. Surface acting appeared to be the most salient predictor, and its relationship to burnout was moderated by compensation type. Conclusions Reported rates of burnout were high within our sample, and our findings suggest that the masking of emotions by psychologists (i.e., surface acting) may be a contributing factor to adverse wellbeing. These findings carry implications for psychological training and practice.

Anxiety in Polish adult patients with inborn errors of immunity: a cross-sectional study.

Patients with inborn errors of immunity (IEI) experience recurrent infections, autoimmunity, and malignancies. Owing to repeated medical procedures, the need for constant treatment and surveillance, and the unpredictable course of the disease, patients with IEI are prone to develop mental health disorders, including anxiety. In this study, we aimed to assess the prevalence and level of anxiety symptoms in adult Polish patients with IEI and explore the determinants of anxiety in this group of patients. Data from 105 Polish patients with IEI were collected via the hospital anxiety and depression scale (HADS), brief illness perception questionnaire (B-IPQ), illness cognition questionnaire (ICQ), Pittsburgh sleep quality index (PSQI), and a questionnaire on general health and demographic data. For statistical analyses of data, the normality of distribution of quantitative data was assessed, and internal consistency of tests was investigated using Cronbach's alpha coefficient; moreover, we performed the analysis of correlations and between-group differences, and path analysis to explore causal relationships. Significance was considered at p < 0.050. Thirty-eight (36.2%) patients had anxiety symptoms (HADS-A ≥ 8); 14 (13.3%) patients had severe anxiety (score ≥ 11), and 24 (22.9%) had moderate anxiety (score of 8-10). Patients with poor sleep quality, higher pain frequency, younger age, and no fixed income had higher anxiety scores than others. Emotional and cognitive representations of illness were positively correlated with anxiety levels. Intense anxiety was related to more negative illness perception, higher helplessness, lower illness acceptance, and lower perceived benefits. Anxiety is common in patients with IEI. However, results indicate that it is not related to a more severe course of IEI or several comorbidities, whereas, pain frequency and poor sleep quality were identified to be important clinical factors for anxiety. Because anxiety was related to negative illness perception, psychological therapy may apply to this group of patients.

Weight Loss After Weight-Loss Surgery: The Mediating Role of Dichotomous Thinking.

Overly rigid forms of dietary restraint are associated with poorer weight loss outcomes. Dichotomous ("all or nothing") thinking has been shown to mediate this relationship in non-clinical participants, but this finding has yet to be replicated in clinical samples of individuals who have had weight-loss surgery. A cross-sectional design was used, adopting quantitative questionnaires with 129 individuals who had previously underwent bariatric surgery at least 12months prior to participation. Bootstrapped mediation analysis was used to establish the mediating role of dichotomous thinking. Eating-specific dichotomous thinking was shown to fully mediate the relationship between dietary restraint and post-surgical weight loss. In contrast, no mediation effect was found for generalised dichotomous thinking. Dichotomous thinking specifically about food/eating may play a central role in weight loss maintenance after weight-loss surgery. Pre-surgical assessment of dichotomous thinking, and provision of psychological therapy to think more flexibly about food, is suggested.

Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol

IntroductionKnee osteoarthritis (KOA) is still a challenging degenerative joint disease with high morbidity and disease burden. Early-stage KOA, the focus of this study, could present a Window of Opportunity to...

Classification and a decade-long follow-up of rat bite injuries in the nasal region

BackgroundNasal defects due to rat bites are frequently encountered in rural regions of China. In addition to serving as disease vectors, rats can also inflict bite injuries. In this study, we delineated the characteristics of rat bite injuries in the nasal region and discussed the clinical features observed during a 10-year follow-up period. MethodsWe retrospectively reviewed hospital records for patients admitted due to rat bites. This study outlines the demographics, clinical features, and follow-up outcomes supported by comprehensive photo documentation of the patients’ progress. ResultsTwenty-five patients, with a mean age of 29 years, were admitted due to rat bites. Treatment was provided for three distinct types of injuries: nasal tip defect (type I), nasal defect (type II), and full-thickness nasal defect with loss of surrounding tissues (type III). All patients recovered fully. ConclusionsThe treatment for rat bites should be based on the wound type. The long-term follow-up outcomes are more favorable when fewer subunits of the nose affected. We recommend early surgical intervention, along with psychological therapy, to prevent interference with growth and development.

Difficult-to-treat depression: an integrative approach to therapeutic resistance.

Depression is a prevalent mental disorder that can have severe impacts. Despite medical efforts, some individuals develop treatment-resistant depression (TRD) or difficult-to-treat depression (DTD). TRD includes those unresponsive to standard treatments, whereas DTD encompasses a broader range of factors affecting treatment outcomes. This article examines the distinctions between TRD and DTD, highlighting the need for personalized multidisciplinary approaches. It discusses various therapeutic options, including pharmacological, psychological, and neurostimulation therapies, emphasizing the significance of considering psychosocial factors and individualized care. Raising awareness among the public, experts, and clinicians about the importance of psychosocial and multidisciplinary aspects in managing DTD can help reduce the stigma associated with depression and improve patient quality of life.

Influence of Taekwondo Training as a Martial Art Sport on Enhancing Mental Wellness of Security Officers in Kenya

Purpose: The purpose of this research was to investigate whether or not training in taekwondo as a martial art sport has a positive impact on the mental health of Kenyan security officers.&#x0D; Methodology: The study used a desk top approach where literature was sought from different sources. The research was carried out with consideration given to previous theoretical literature, both published and unpublished.&#x0D; Findings: Problems with mental wellness is a serious societal and work related issue that has numerous ramifications, including far-reaching social and economic impact in Kenyan security officers. However, a significant number of security officers do not seek help when they are experiencing issues with their mental wellness. Research in this area is scant, but there are suggestions that training in Taekwondo as martial arts sport may be an effective sports-based intervention for mental wellness, and that it may provide an affordable alternative to psychological therapy to security officers both public and private.&#x0D; Unique contribution to theory, practice and policy: Uncertainty regarding the validity and trustworthiness of previous research is unfortunately caused by the limited number of studies that are relevant to the topic at hand, in addition to other methodological issues.

Assisted Reproductive Technologies Helping Infertile Couples or Using Minor Girls in Poverty; Boon or Bane?

Abstract: According to WHO data, one in every four couples in developing countries is affected by infertility, and the prevalence remains high year by year. Infertility is considered to be a globally concerned health issue, which affects millions of people of reproductive age worldwide. Nowadays in our modern and developing field of medicine, we have different solutions and treatments for almost each and every disease. Treatment for infertility varies based on the cause, from simple psychological therapy to some complicated procedures. All these procedures are regulated by World Health Organization and their own country’s legislation. Each country has uniqueness in their legislation, but almost all countries mainly focus on ethics, medical outcomes and health of both donor and recipients. However, in some parts of the world, laws are sometimes over-ruled and not abided properly. One of such recent incident took part in southern part of India (4 private hospitals in Tamilnadu, and 2 more hospitals in Andhra Pradesh and Kerala), which made a shocking news for people all over the country. The minor girl aged 16 years was exploited as egg (oocyte) donor. In the modern world, we are focusing and researching more and more on female related health problems, but such incidents worry us. We have a responsibility to prevent from such dreadful incidents in future, since respective governments and courts proceed the case for veracity and justice. As doctors or medical professionals, we have to follow our own medical and professional ethics. And as a citizen, all people including doctors and patients must obey our countries own rules and regulations accordingly. Further we request government authorities to make procedures and laws to be more strict and highly punishable when violated.

Clinical effectiveness of the psychological therapy Mental Health Intervention for Children with Epilepsy in addition to usual care compared with assessment-enhanced usual care alone: a multicentre, randomised controlled clinical trial in the UK

Mental health difficulties are common in children and young people with chronic health conditions, but many of those in need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness of integrated mental health treatment for children and young people with epilepsy, a common chronic health condition known to be associated with a particularly high rate of co-occurring mental health difficulties. We conducted a parallel group, multicentre, open-label, randomised controlled trial of participants aged 3-18 years, attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomised (1:1; using an independent web-based system) to receive the Mental Health Intervention for Children with Epilepsy (MICE) in addition to usual care, or assessment-enhanced usual care alone (control). Children and young people in both groups received a full diagnostic mental health assessment. MICE was a modular psychological intervention designed to treat common mental health conditions in children and young people using evidence-based approaches such as cognitive behaviour therapy and behavioural parenting strategies. Usual care for mental health disorders varied by site but typically included referral to appropriate services. Participants, along with their caregivers, and clinicians were not masked to treatment allocation but statisticians were masked until the point of analysis. The primary outcome, analysed by modified intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at 6 months post-randomisation. The study is complete and registered with ISRCTN (57823197). 1401 young people were potentially deemed eligible for study inclusion. Following the exclusion of 531 young people, 870 participants were assessed for eligibility and completed the SDQ, and 480 caregivers provided consent for study inclusion between May 20, 2019, and Jan 31, 2022. Between Aug 28, 2019, and Feb 21, 2022, 334 participants (mean ages 10·5 years [SD 3·6] in the MICE group vs 10·3 [4·0] in control group at baseline) were randomly assigned to an intervention using minimisation balanced by age, primary mental health disorder, diagnosis of intellectual disability, and autistic spectrum disorder at baseline. 168 (50%) of the participants were female and 166 (50%) were male. 166 participants were randomly assigned to the MICE group and 168 were randomly assigned to the control group. At 6 months, the mean SDQ difficulties for the 148 participants in the MICE group was 17·6 (SD 6·3) and 19·6 (6·1) for the 148 participants in the control group. The adjusted effect of MICE was -1·7 (95% CI -2·8 to -0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients in the MICE group experienced at least one serious adverse event compared with 24 (14%) in the control group. 68% percent of serious adverse events (50 events) were admission due to seizures. MICE was superior to assessment-enhanced usual care in improving symptoms of emotional and behavioural difficulties in young people with epilepsy and common mental health disorders. The trial therefore shows that mental health comorbidities can be effectively and safely treated by a variety of clinicians, utilising an integrated intervention across ages and in the context of intellectual disability and autism. The evidence from this trial suggests that such a model should be fully embedded in epilepsy services and serves as a model for other chronic health conditions in young people. UK National Institute for Health Research Programme Grants for Applied Research programme and Epilepsy Research UK Endeavour Project Grant.

Journal of Clinical Gastroenterology Lectureship Dubai 2022 : Management of Irritable Bowel Syndrome With Diarrhea.

Irritable bowel syndrome (IBS) with diarrhea (IBS-D) affects ~1% of the general population and is characterized by abdominal pain associated with diarrhea. IBS-D symptoms significantly impact the quality of life of patients. Major uncertainties remain regarding the optimal management of these patients. Several therapies have been investigated over the years for the treatment of IBS-D. In the initial management, commonly prescribed approaches with an effect on global IBS symptoms include a low Fermentable Oligo-, Di-, Mono-Saccharides and Polyols diet and probiotics, while antispasmodics are used for targeting abdominal pain and loperamide for diarrhea only. Additional therapeutic options for the relief of global IBS symptoms include rifaximin, 5-HT 3 antagonists, gut-directed psychological therapies, and eluxadoline, while tricyclic antidepressants can target abdominal pain and bile acid sequestrants diarrhea. Promising evidence exists for the use of mesalazine and fecal microbiota transplantation in IBS-D, although further evidence is needed for definitive conclusions regarding their efficacy.

Complexity of mentalization.

The ability to understand other people’s emotions, thoughts, and behaviors is associated with an individual’s ability and his attitude in the context of relationships. The development of this process is associated with different psychosocial factors: parental competence, building a secure attachment and reduced risk of violence in the family as well as the future intrapersonal relationships and social reality of one person Mentalization is empirically associated with resolving psychological tasks in normative dilemmas and also, can influence on the outcome of personal and situational crises. And so forth, passing through the different stages of life and prevention of dysfunctional patterns in the family is facilitated. This text aims to investigate the main characteristics of mentalization, its connection with the etiopathogenesis of some main mental disorders, their course and prognosis. Several studies in recent years confirmed that these connections can enroll mentalization to prevention and psychological therapy in some mental disorders and dysfunctional thinking patterns. On the other hand, it serves as a basis for psychotherapeutic competence expressed in the ability to connect, differentiate, and separate, as the main interactional stages of the psychotherapeutic process.

STRESS-INDUCED HYPERTHERMIA (LITERATURE REVIEW)

Stress-induced hyperthermia (SIH) is a physiological response of the body to psychological stress. Currently, 88 % of the population is in a state of chronic stress. Psychogenic hyperthermia is more common in young women. Psychogenic fever is not associated with an immunological inflammatory process, there is no increase in inflammatory mediators. The mechanism of the development of stress-induced hyperthermia is the activation of the sympathoadrenal system, vasoconstriction, an increase in the level of corticosterone and the thermogenesis of brown fat. Constant sympathetic stimulation leads to the formation of thermogenin-expressing loci in white adipose tissue. Dopaminergic and noradrenergic compounds do not affect the intensity of hyperthermia. Taking nonsteroidal analgesics does not affect this type of hyperthermia. Antipsychotics are ineffective for psychogenic hyperthermia. Effective drugs that have anxiolytic properties, which significantly reduce the basal body temperature when the dose is increased. Serotonergic receptors play a key role in modulating behavioural, autonomic, and endocrine responses to stress. Effective GABA agonists and antidepressants. For the treatment of the chronic variant of SIH, the use of fluoxetine is recommended. Psychoeducation is used as non-medicinal methods of treating functional fever; psychotherapy with an adjustment environment (verbal or non-verbal release of unreacted negative emotions and conflicts); cognitive-behavioral or other psychological therapy, meditation, relaxation training; yoga and practices aimed at reducing stress and mental disorders.

The Mental Well-Being and Inclusion of Refugee Children: Considerations for Culturally Responsive Trauma-Informed Therapy for School Psychologists

Refugee children displaced by war suffer incredible amounts of physical and psychological trauma during and post-displacement. War is not partial to children, and they are subjected to as much extreme violence as adults. This paper explores the mental health of refugee children following war and was guided by the research question: What are the mental health experiences of refugee children displaced by war situations? A secondary data analysis was conducted on publicly available documentary short films and instructional videos on psychological therapy with refugee children and families. The data were analysed through Qualitative Conventional Content Analysis (QCCA). Three major categories emerged regarding the well-being of refugee children: (1) children are not spared from war trauma, (2) children live in perpetual fear and anxiety, and (3) war-related violence ignites aggressive behaviours in children. To increase positive mental health outcomes, school psychologists need to implement trauma-informed therapy that focuses on decreasing psychosocial reactions to war. Culturally responsive therapy is recommended as it places indigenous ways of being at the centre of the healing process.

Psychological predictors of performance-based physical functioning among pediatric pain program participants.

The purpose of the present study was to evaluate changes in performance-based physical functioning and investigate psychological predictors of physical functioning over time in pediatric patients with chronic pain who completed an interdisciplinary rehabilitation intensive outpatient program (IOP). Participants (N = 55; mean age = 14.92 years; 12.7% male, 87.3% female; 83.6% White, 5.6% African-American/Black; 9.1% Latinx) completed baseline measures assessing pain intensity and modifiable psychological factors (i.e., pain catastrophizing, kinesiophobia, anxiety and depressive symptoms). Participants were administered performance-based assessments of physical functioning (i.e., physical endurance, high-level motor abilities) before and after IOP completion. Pain intensity was not significantly associated with physical functioning at either timepoint. There was significant improvement on measures of physical functioning after completion of the IOP when controlling for the effects of sex, race, and ethnicity. Depressive symptoms were associated with baseline physical endurance, β=-.28, p = .047, while pain catastrophizing was associated with baseline gross motor abilities, β=-.28, p = .032. Participation in an IOP led to significant improvement in physical endurance and high-level motor ability. Depressive symptoms and pain catastrophizing were associated with physical functioning at baseline but not post-program completion. Integration of pain psychology and physical therapy in an IOP can help address the interrelated psychological and physical factors impacting physical functioning to improve outcomes for children with chronic pain.

Music therapy for depression: is it music to our ears?

SUMMARYMusic therapy has been a recognised form of therapy for mental illness for many years. This commentary on a Cochrane Review on music therapy for depression sheds light on the evidence. It aims to give further clinical context to the findings, to help guide practice and examine music therapy as an evidence-based practice. The review compares music therapy plus ‘treatment as usual’ (TAU) with TAU alone, music therapy with psychological therapy, and ‘active’ with ‘receptive’ music therapy (the two main types of music therapy). The review points to music therapy being beneficial for people with depression when combined with TAU (versus TAU alone) in the short term, as well as improving anxiety and functioning. We need more evidence looking at longer-term outcomes, comparing music therapy with psychological therapies and comparing different forms of music therapy.

Roles and competencies of the clinical psychologist in adult diabetes care-A consensus report.

Psychological care is recognised as an integral part of quality diabetes care. We set out to describe the roles and competencies of the clinical psychologist as a member of the multidisciplinary adult diabetes care team, focused on secondary care. The authors are clinically experienced psychologists involved in adult diabetes care, from Australia, Europe and North America, and active members of the international psychosocial aspects of diabetes study group. Consensus was reached as a group on the roles and competencies of the clinical psychologist working in adult diabetes secondary care, building both on expert opinion and a selective review and discussion of the literature on psychological care in diabetes, clinical guidelines and competency frameworks. The clinical psychologist fulfils multiple roles: (1) as a clinician (psychological assessment and therapy), (2) as advisor to the healthcare team (training, consulting), (3) as a communicator and promotor of person-centred care initiatives and (4) as a researcher. Four competencies that are key to successfully fulfilling the above-mentioned roles in a diabetes setting are as follows: (a) specialised knowledge, (b) teamwork and advice, (c) assessment, (d) psychotherapy (referred to as STAP framework). The roles and competencies of clinical psychologists working in diabetes extend beyond the requirements of most university and post-graduate curricula. There is a need for a comprehensive, accredited specialist post-graduate training for clinical psychologists working in diabetes care, building on the proposed STAP framework. This calls for a collaborative effort involving diabetes organisations, clinical psychology societies and diabetes psychology interest groups.

The effectiveness of psychodynamic therapy in an NHS psychotherapy service: outcomes for service-users with complex presentations

Complex and enduring mental health problems require greater treatment resources, usually in the form of multidisciplinary support, including providing psychological therapies. This paper reports on an NHS, tertiary-level specialist psychotherapy service offering Psychodynamic therapies with longer-term, exploratory transdiagnostic approaches to support complexity and sustained personality functioning. This paper adopts a naturalistic study design evaluating the effectiveness of Psychodynamic therapy using pre- and post-outcomes across a 10-year period. A total of n = 474 participants self-report pre- and post-outcome measures were used as the marker of effectiveness along with therapist assessments during intake and engagement. The findings showed that Psychodynamic therapy was effective in reducing psychological distress based on service-user self-report and therapist assessments. While intake scores varied by socio-demographic factors, the rate of change across most groups was similar. There were several limitations relating to data quality and completeness which reflect the naturalistic design. Despite the limits of a naturalistic design, this study provides evidence of support for the place of Psychodynamic therapies within NHS mental health care, catering to those with complex and enduring mental health problems.