Anxiety and cancer treatment: Response to stressful radiotherapy.

Conducted a study with 19 White female cancer patients (aged 23–78 yrs) to document the magnitude of anxiety Ss experienced in response to one particularly stressful form of radiation treatment. In addition, the change in anxiety responses with repeated exposures and individual differences among Ss was explored. As the time for internal radiotherapy treatment neared, subjective and physiologic indicants of anxiety and distress among the Ss significantly increased. By 24 hrs posttreatment, anxiety for all Ss remained elevated. A subset of the Ss who required 2 applications of radiotherapy continued to respond negatively during the 2nd treatment. Data on individual differences in anxiety responses suggest that those with low levels of pretreatment anxiety experienced considerable disruption posttreatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping child flood victims using group EMDR intervention in Argentina: Treatment outcome and gender differences.

A comprehensive group intervention with 124 children who experienced disaster-related trauma during a massive flood in Santa Fe, Argentina, in 2003 is illustrated, utilizing a one-session group eye movement desensitization and reprocessing (EMDR) protocol. A posttreatment session was done 3 months after the treatment intervention to evaluate results. Results of this one-session treatment procedure, utilizing the EMDR-Integrative Group Treatment Protocol, showed statistically significant reduction of symptoms immediately after the intervention. These statistically significant differences were sustained at posttreatment evaluation 3 months later, as measured by psychometric scales, and by clinical and behavioral observation. Data analysis also revealed significant gender differences. Despite methodological limitations, this study supports the efficacy of EMDR group treatment in the amelioration and prevention of posttraumatic stress disorder symptoms, providing an efficient, simple, and economic (in terms of time and resources) tool for disaster-related trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory remediation after severe closed head injury: Notebook training versus supportive therapy.

Evaluated the effectiveness of a 9-wk memory notebook treatment for closed-head injured (CHI) participants with documented memory deficits. Eight participants who had sustained a severe CHI more than 2 yrs earlier were allocated to receive either notebook training or supportive therapy. The notebook training group reported significantly fewer observed everyday memory (EMF) failures on a daily checklist measure than the supportive therapy group. Although in the same direction, this finding no longer reached significance at follow-up. No significant treatment effects were found for the laboratory-based memory measures at posttreatment or follow-up. Although the present results are to be considered preliminary because of the small sample size, they suggest that notebook training has the potential to help individuals compensate for everyday memory problems and that the methods used to measure training efficacy are important. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder.

This study investigated the extent to which providing cognitive restructuring (CR) with prolonged imaginal exposure (IE) would lead to greater symptom reduction than providing IE alone for participants with posttraumatic stress disorder (PTSD). Fifty-eight civilian survivors of trauma with PTSD were randomly allocated to IE/CR, IE, or supportive counseling (SC). Treatment involved 8 individual weekly sessions with considerable homework. Independent assessments were conducted pretreatment, posttreatment, and at 6-month follow-up. IE/CR and IE resulted in reduced PTSD and depression compared with SC at posttreatment and follow-up. Further, IE/CR participants had greater reductions in PTSD and maladaptive cognitive styles than IE participants at follow-up. These findings suggest that providing CR in combination with IE may enhance treatment gains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating comorbid panic disorder in veterans with posttraumatic stress disorder.

This study compares the effectiveness of panic control treatment (PCT) with that of a psychoeducational supportive treatment (PE-SUP) in treating panic disorder among a veteran sample with a primary diagnosis of chronic posttraumatic stress disorder (PTSD). Thirty-five patients randomized to receive 10 individual sessions of either PCT or PE-SUP underwent assessments at pretreatment, at 1-week posttreatment, and at a 3-month follow-up. Intent-to-treat analyses of covariance showed that PCT participants significantly improved on panic severity at posttreatment and panic fear at the 3-month follow-up. The PCT group also showed significant reductions in anxiety sensitivity at posttreatment and follow-up compared with that of the PE-SUP group. A significantly higher proportion of persons (63%) in the PCT group was panic free by the follow-up period compared with that of the PE-SUP group (19%). Patient self-report and clinician ratings showed no changes in general anxiety, depression, and PTSD symptoms in either group. These findings indicated that PCT was superior to an active control therapy in reducing the frequency, severity, and distress associated with panic disorder and suggested that brief cognitive-behavioral therapy for panic is effective for persons with chronic PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual versus group therapy for obesity: Effects of matching participants to their treatment preferences.

This study examined the effects of matching participants to treatments on the basis of their preferences for either individual or group therapy for obesity. Seventy-five obese adults who expressed a clear preference for either individual or group therapy were randomly assigned to either their preferred or their nonpreferred treatment modality within a 2 (individual vs group therapy)?×?2(preferred vs nonpreferred modality) factorial design. At posttreatment, group therapy produced significantly greater reductions in weight and body mass than individual therapy, and no significant effects were observed for treatment preference or the interaction for treatment preference by type of therapy. All treatment conditions showed equivalent improvements in psychological functioning. These findings suggest that group therapy produces greater weight loss than individual therapy, even among those clients who express a preference for individual treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling

Acute stress disorder (ASD) is a precursor of chronic posttraumatic stress disorder (PTSD). Twenty-four participants with ASD following civilian trauma were given 5 sessions of either cognitive-behavioral therapy (CBT) or supportive counseling (SC) within 2 weeks of their trauma. Fewer participants in CBT (8%) than in SC (83%) met criteria for PTSD at posttreatment. There were also fewer cases of PTSD in the CBT condition (17%) than in the SC condition (67%) 6 months posttrauma. There were greater statistically and clinically significant reductions in intrusive, avoidance, and depressive symptomatology among the CBT participants than among the SC participants. This study represents the 1st demonstration of successful treatment of ASD with CBT and its efficacy in preventing chronic PTSD.     

Relapse in Alcohol- and Drug-Disordered Adolescents With Comorbid Psychopathology: Changes in Psychiatric Symptoms.

This study examined reciprocal relationships between posttreatment substance use and psychiatric symptoms in adolescents with both a substance use disorder and an Axis I mental health disorder. Participants (13-18 years old) were recruited from inpatient treatment centers and interviewed during treatment and monthly for 6 months. Participants who relapsed (N = 103; 48% female) reported the incidence and severity of psychiatric symptoms experienced before and after their 1st posttreatment substance use. The number of symptoms and depression symptoms experienced were related to use of stimulants and other drugs during relapse. There was evidence for both self-medication (symptom reduction) and rebound (symptom exacerbation) effects of substance use on symptom severity. These results demonstrate that, for adolescents with both substance use and mental health disorders, psychiatric symptoms are 1 factor influencing posttreatment substance use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief Relationship Therapy for Alcoholism: A Randomized Clinical Trial Examining Clinical Efficacy and Cost-Effectiveness.

The purpose of this study was to examine the clinical efficacy and cost effectiveness of brief relationship therapy (BRT), a shortened version of standard behavioral couples therapy (S-BCT), with alcoholic male patients (N = 100) and their nonsubstance-abusing female partners. Participants were randomly assigned to 1 of 4 treatment conditions: (a) BRT, (b) S-BCT, (c) individual-based treatment (IBT), or (d) psychoeducational attention control treatment (PACT). Equivalency testing revealed that, compared with those assigned to S-BCT, participants who were randomly assigned to BRT had equivalent posttreatment and 12-month follow-up heavy drinking outcomes. Moreover, at 12-month follow-up, heavy drinking and dyadic adjustment outcomes for patients who received BRT were superior to those of patients who received IBT or PACT. BRT was significantly more cost effective than the S-BCT, IBT, or PACT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of patient and therapist evaluations of time-limited psychotherapy.

Obtained empirical data regarding the degree of congruence between therapists' and patients' evaluations of brief psychotherapy on a session-by-session basis and posttreatment and compared these data with predictions derived from J. Mann's (1973) model of the process of brief psychotherapy. 28 17–34 yr old students who were seen in brief psychotherapy (6–22 sessions) by 6 university mental health staff served as Ss. Patients and therapists completed an evaluative questionnaire at the conclusion of each session and at 1–4 wks posttreatment. Sessions were treated as falling into the early, middle or final phase of treatment by dividing the total number of sessions into equal thirds. Without exception, patients' evaluations were higher than those of therapists, both session-by-session and posttreatment. Therapists gave evidence of appreciating this discrepancy but underestimated its magnitude. Results are viewed as largely consistent with predictions derived from Mann's model of brief psychotherapy and as lending support to the model's validity. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder.

This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure, cognitive restructuring, and anxiety management. CBT-hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure. In terms of treatment completers (n = 69), fewer participants in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group. CBT-hypnosis resulted in greater reduction in reexperiencing symptoms at posttreatment than CBT. These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overgeneral autobiographical memory in depressed adolescents with, versus without, a reported history of trauma.

Autobiographical memory retrieval is fundamental to the developing self-concept in adolescence, to emotion regulation, and to social problem solving and has been shown to be compromised in adolescents diagnosed with depression (R. J. Park, I. M. Goodyer, & J. D. Teasdale, 2002). The authors of the present study assessed autobiographical memory overgenerality in a sample of depressed adolescent participants with, versus without, a reported history of trauma and never-depressed control participants by using an emotion word-cueing paradigm. The authors' analyses showed for the first time that adolescents with major depression and with no reported history of trauma exhibited an overgeneral memory bias. They also revealed that depressed adolescents who reported a history of trauma retrieved fewer overgeneral memories than did depressed adolescents who reported no history of trauma. Among depressed adolescents who reported a history of trauma, more severe posttraumatic stress symptoms were associated with less overgenerality. Possible accounts of these findings are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of malingered head injury on the Wechsler Memory Scale—Revised.

39 head-injured outpatients were compared with 39 age-matched Ss who were instructed to malinger head trauma symptoms on the Wechsler Memory Scale—Revised (WMS—R) and Wechsler Adult Intelligence Scale—Revised (WAIS—R). Head-injured Ss were selected who were not involved in litigation or pursuing a Worker's Compensation claim. Groups did not differ significantly on IQs or memory indexes. Discriminant function analyses based on the WMS—R subtests and indexes were able to accurately classify 91% and 83% of the cases, respectively. Decision rules were cross-validated on published data from several independent studies and statistically by means of the jackknife procedure. Head-injured Ss appear to show a pattern of WMS–R scores that can be discriminated from the profile produced by individuals who attempt to malinger head trauma symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual-route theories of pronouncing printed words: What can be learned from concurrent task performance?

K. R. Paap and R. W. Noel (see record 1991-29435-001) found that a 5-digit memory load speeded pronunciation of low-frequency exception words, despite slowing other word types. They argued that the memory load diverted attention from phonological assembly and prevented it from competing with retrieved phonology so that words most susceptible to such competition—low-frequency exception words—were facilitated. This attentional account was tested against alternatives based on cross talk among lexical or sublexical codes. Initial results supported lexical cross talk: Digit and noun loads produced a weak release-from-competition (RFC) effect, but random shapes and pseudowords produced no such effect, despite requiring more attention. However, subsequent analyses of individual differences showed that not all participants possessed a dual-route architecture in which low-frequency exception words were suffering competition. Among those who were candidates for a dual-route architecture, all memory loads produced RFC; among those who were not, no RFC was found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of malingered head injury on the Wechsler Adult Intelligence Scale—Revised.

Nonlitigating head injured patients (N?=?67) were compared with 67 age-, IQ-, and occupation-matched participants who were instructed to malinger head trauma symptoms on the Wechsler Adult Intelligence Scale—Revised (WAIS—R). Discriminant function analysis based on the WAIS—R subtests and a Vocabulary-Digit Span difference score were able to accurately classify 79% and 71% of the cases, respectively. Decision rules cross-validated successfully in several independent groups of clinical malingerers. Head injured patients seem to show a pattern of WAIS—R subtest scores that can be discriminated from the profile produced by individuals who attempt to malinger head trauma symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral couples therapy for female substance-abusing patients: Effects on substance use and relationship adjustment.

Married or cohabiting female drug-abusing patients (N=75) were randomly assigned to either a behavioral couples therapy condition (BCT, n=37), which consisted of group, individual, and behavioral couples therapy sessions, or to an equally intensive individual-based treatment condition (IBT; n=38), which consisted of group and individual counseling. During most of the 1-yr follow-up, compared with participants who received IBT, those who received BCT reported (1) fewer days of substance use, (2) longer periods of continuous abstinence, (3) lower levels of alcohol, drug, and family problems, and (4) higher relationship satisfaction. However, differences in relationship satisfaction and number of days of substance use dissipated over the course of the posttreatment follow-up period and were not significantly different by the end of 1 yr. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of maternal social skills in multiproblem families: Effects on the mother-child relationship.

Tested a two-step infant preventive intervention model: Step 1 was for the mother to improve her interpersonal competence with other adults; Step 2 was for her to learn more optimal parenting behavior. Ss were 147 multiproblem mothers and their infants. Assessed the mothers' adult social skills pre- and posttreatment. Measured the percentage of treatment goals attained during treatment, and mother–child interactive quality posttreatment. Data partially supported the model: For women who began the program with low social skills, the attainment of treatment goals was positively related to posttreatment social skills (Step 1), which, in turn, were positively related to the quality of mother–child interaction (Step 2). For those women who began with high social skills, the treatment was unrelated to posttreatment social skills or to mother–child interaction. Additional analyses explored the factors associated with individual differences in delivery of services and response to treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative effects of cognitive-behavioral and brief psychodynamic psychotherapies for depressed family caregivers.

Clinically depressed family caregivers (N?=?66) of frail, elderly relatives were randomly assigned to 20 sessions of either cognitive-behavioral (CB) or brief psychodynamic (PD) individual psychotherapy. At posttreatment, 71% of the caregivers were no longer clinically depressed according to Research Diagnostic Criteria (RDC), with no differences found between the 2 outpatient treatments. The results suggested therapy specificity; there was an interaction between treatment modality and length of caregiving on symptom-oriented measures. Clients who had been caregivers for a shorter period showed improvement in the PD condition, whereas those who had been caregivers for at least 44 mo improved with CB therapy. These findings suggest that patient-specific variables should be considered when choosing treatment for clinically depressed family caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)