Reasoning, Emotions, and Delusional Conviction in Psychosis.

The aim of the study was to elucidate the factors contributing to the severity and persistence of delusional conviction. One hundred participants with current delusions, recruited for a treatment trial of psychological therapy (PRP trial), were assessed at baseline on measures of reasoning, emotions, and dimensions of delusional experience. Reasoning biases (belief inflexibility, jumping to conclusions, and extreme responding) were found to be present in one half of the sample. The hypothesis was confirmed that reasoning biases would be related to delusional conviction. There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction. Emotional states were not associated with the reasoning processes investigated. Anxiety, but not depression, made an independent contribution to delusional conviction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-Analysis of Cognitive-Behavioral Treatments for Generalized Anxiety Disorder: A Comparison With Pharmacotherapy.

The efficacy of (cognitive) behavioral therapy ([C]BT) for generalized anxiety disorder was investigated and compared with the efficacy of pharmacological therapy using meta-analytic techniques. A total of 65 (C)BT studies and pharmacological studies were included. (C)BT was more effective than control conditions. The results of the comparison between (C)BT and pharmacotherapy varied according to the meta-analytic methods used. Conclusions about differences in efficacy between therapy approaches are limited when all available studies are included owing to a number of factors that influence effect sizes. When only those studies that directly compared both therapies were included in the analysis, there were no significant differences in efficacy. Attrition rates were lower for (C)BT, indicating that it is better tolerated by patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy of obesity and eating disorders.

Difficulties associated with eating behavior, existing on a broad continuum from uncomplicated overeating to psychopathologically disordered eating, is a growing area of concern within the medical and mental health communities. Psychologists are often called upon to conduct diagnostic assessments in order to identify issues or disorders that may require attention and provide psychotherapeutic interventions ranging from supportive to more intensive therapy. Over the past several years, there have been increased efforts to develop safe and efficacious pharmacologic treatments for obesity and eating disorders. This article provides psychologists with a review of the most currently used pharmacologic interventions for eating dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delusional thinking and cognitive organization in schizophrenia.

A delusion can be conceptualized as a form of cognitive reorganization; according to this interpretation a delusion serves to integrate into a meaningful and acceptable whole data which otherwise would be anxiety provoking. On the assumption that the utilization of delusions is representative of a generalized cognitive technique for dealing with ambiguous inputs it was hypothesized that delusional schizophrenics should manifest a stronger tendency to integrate ambiguous stimuli in a laboratory situation than nondelusional schizophrenics. To test the hypothesis 24 delusional and 25 nondelusional schizophrenics were compared on the McGill Closure Test. The results supported the hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delusional thinking and the induction process in schizophrenia.

A perceptual information-processing task was presented to minimally delusional schizophrenics, maximally delusional schizophrenics, and normal Ss. The point of emergence of their 1st response was utilized as an index of the degree to which they tended to structure ambiguous stimuli on the basis of inadequate premises. The hypothesis that the 2 schizophrenic groups would differ on the experimental task was not verified. The majority of schizophrenic Ss, however, responded either too early or too late, if the mean score of the normal group is regarded as the optimal response level. Additional data were gathered in an attempt to uncover historical or behavioral correlates of these test differences. The only difference found was in educational level. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is There a Link Between Adolescent Cigarette Smoking and Pharmacotherapy for ADHD?

There is continuing concern that pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD) may raise the risk of smoking (the gateway hypothesis). Alternatively, unmedicated people with ADHD may use nicotine to improve attentional and self-regulatory competence (the self-medication hypothesis). From a community sample of 511 adolescents participating in a longitudinal health study, 27 were identified as having ADHD, and 11 of these were receiving pharmacotherapy. Self-report surveys, electronic diaries, and salivary cotinine all indicated that adolescents treated with pharmacotherapy for ADHD smoked less than their untreated counterparts over 2 years of high school. These convergent findings from 3 disparate indicators lend support to the self-medication hypothesis over the gateway hypothesis, although alternative explanations need further study. The findings also suggest that early treatment of psychological and behavioral problems may prevent or delay smoking initiation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Challenge Tests and Panic Disorder: Implications for Clinical Assessment.

The growing body of research on procedures designed to induce symptoms of panic (challenge tests) has prompted practicing psychologists to consider using challenge tests for assessment of panic disorder. This article overviews the empirical literature on the neurobiological and psychological factors involved in the panicogenic effects of challenge tests and, in doing so, outlines strengths and weaknesses of using challenge tests as assessment tools in clinical settings. It is suggested that challenge tests are useful for understanding a client's phenomenological experience of panic and as a tool for planning and evaluating treatment, though they are not ideal for differential diagnosis. Practicing psychologists can draw on the included recommendations when considering adopting challenge tests in applied settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol, Tobacco, and Drug Use Disorders and Personality Disorder Symptoms.

In a nonclinical sample of 395 young adults, the authors evaluated the relations between major personality traits, Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) personality disorder symptoms, and DSM-IV alcohol use disorders (AUDs). Consistent with previous findings, traits related to disinhibition and negative affectivity were consistently associated with AUDs, as were Cluster B personality disorder symptoms (especially antisocial and borderline disorder symptoms). Multivariate analyses revealed that Cluster B symptoms were significantly associated with AUDs above and beyond what was accounted for by personality traits. Further, the authors found differential patterns of relations between other substance use disorders (SUDs; i.e., tobacco dependence and drug use diagnoses) and personality disorder symptoms. Overall, these results suggest that personality disorder symptoms predict unique variance in SUDs that reflect maladaptive aspects of personality traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy in Autism and Related Disorders.

Autistic disorder is characterized by qualitative impairment in the areas of social interaction and communication, as well as stereotypic, repetitive patterns of behavior. In addition to the core features of autism, many individuals display a range of behavioral concerns including anxiety, aggression, agitation, overactivity, self-injury, and stereotypic behavior. Recent prevalence estimates indicate that over 45% of individuals with autism are prescribed psychotropic medications for management of associated behavioral disorders. Yet, there remain considerable gaps in our knowledge of medication efficacy and safety in this population. This article provides an overview of the research in this area, including efficacy and potential side effects of the most commonly prescribed psychotropic medications for children and adolescents with autism. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pediatric psychopharmacology: A review of new developments and recent research.

Advances in psychopharmacology have revolutionalized the management of emotional and behavioral disorders in children and adolescents. Recent developments in pediatric psychopharmacology and the prevalence of pharmacotherapy for various psychological disorders in children are examined, and clinical updates for classes of psychotropics are provided. Issues including monitoring and assessing drug effects, acceptability and satisfaction, and the social, political, and cultural issues surrounding the use of psychotropics in children are discussed. The authors conclude that the current clinical use of psychotropics in children exceeds extant efficacy and safety data. The involvement of practicing psychologists in pediatric psychopharmacology and the need for a firm empirical foundation for pediatric psychopharmacology are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy for postacute traumatic brain injury: A literature review for guidance in psychological practice.

Objectives: The purpose of this review is to educate and guide the actions of rehabilitation psychologists by providing a summary of the current literature on pharmacotherapies and treatment effectiveness for the chronic sequelae associated with severe traumatic brain injury (TBI). A number of medications are reviewed for use in treating deficits in arousal, cognition, function, and other problems associated with TBI. Findings for their use in this population are summarized. Cautions, limitations, and directions for future research are discussed. Conclusions: Pharmacological management of chronic symptoms of TBI is commonplace in rehabilitation practice. Clear clinical guidelines for the use of pharmacotherapy in TBI are lacking, however, because of the few conclusive findings regarding the effectiveness of any particular agent. Rehabilitation psychologists frequently encounter patients treated with numerous medications and, therefore, need to be aware of potential effects on cognitive and functional abilities. Additionally, rehabilitation psychologists should be aware of available and empirically supported pharmacotherapies as they are in a position to comprehensively assess the patient and provide requested consultation to the treating physician concerning the patient's need for and likelihood of benefiting from various pharmacological agents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"The Problem of Validity in Field Studies of Psychological Disorder": Erratum.

Reports an error in the original article by Bruce P. Dohrenwend and Barbara Snell Dohrenwend (Journal of Abnormal Psychology, 1965, 70[1], 52-69). The footnote identification in Table 6 (page 62) in the original article is incorrec. The correct version is given here. (The following abstract of this article originally appeared in record 1965-08281-001.) Results of over 25 attempts to count untreated cases of psychological disorder in community populations are reviewed, and the problem of validity in the measures of disorder is analyzed. Evidence of validity is found to be scant. The position is taken that, with no generally accepted criteria available, and no universe of content agreed upon, construct validity takes on added importance. A lead to 1 possible nomological net for the construct of psychological disorder is the consistent finding that the lowest socioeconomic stratum has the highest rate of symptomatology. This lead is developed with reference to the transcience of symptomatology found in extreme situations, in contrast to the persistence of symptomatology observed in patients and in studies of experimental neurosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Cancer.

In this study, the authors investigated the relationship between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) following cancer diagnosis. Patients who were recently diagnosed with 1st onset head and neck or lung malignancy (N = 82) were assessed for ASD within the initial month following their diagnosis and reassessed (n = 63) for PTSD 6 months following their cancer diagnosis. At the initial assessment, 28% of patients had ASD, and 32% displayed subsyndromal ASD. At follow-up, PTSD was diagnosed in 53% of patients who had been diagnosed with ASD and in 11% of those who had not met criteria for ASD; 36% of patients with PTSD did not initially display ASD. In this study, the authors question the use of the ASD diagnosis to identify recently diagnosed patients at risk of PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Cognitive-behavioral therapy for bipolar disorder and Cognitive therapy for delusions, voices, and paranoia.

Reviews the books, Cognitive-behavioral therapy for bipolar disorder by Monica Ramirez Basco and A. John Russo (see record 1996-98072-000) and Cognitive therapy for delusions, voices, and paranoia by Paul Chadwick, Max Birchwood, and Peter Trower (see record 1996-97983-000). The mental health service system is largely based on the oft encountered, often implicit, belief among professionals that, since Schizophrenia, Bipolar Disorder, and other severe forms of mental illnesses have been shown to have a biological basis, there is no point in providing psychotherapy for individuals afflicted with these disorders. These two books represent a welcome exception to this situation. While different in many ways, including their treatment goals and many of their theoretical underpinnings, both books represent an attempt to allow the severely mentally ill to benefit from techniques which have been demonstrated to be effective for less severely disturbed populations. Both approaches illustrate ways that the severely mentally ill may be able to be helped through psychosocial intervention, and both acknowledge the importance of client collaboration in treatment, a consideration easy to overlook when the client has a severe mental illness. The books are also similar in that neither one offers sufficient empirical data to support the effectiveness of its approach. The two books reviewed here represent, in the reviewer's opinion, significant contributions to the field of psychotherapy. Even if the clinician takes issue with the techniques presented or with the theoretical assumptions underlying the approaches, he/she should come away with a renewed appreciation of the importance of including the client in treatment planning, even if the client has a severe mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary evidence for cognitive mediation during cognitive-behavioral therapy of panic disorder.

Cognitive-behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1 of these interventions were assessed before and after acute treatment, and after a 6-month maintenance period. Multilevel moderated mediation analyses provided preliminary support for the notion that changes in panic-related cognitions mediate changes in panic severity only in treatments that include CBT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized trial of telephone psychotherapy and pharmacotherapy for depression: Continuation and durability of effects.

Randomized trial evidence and expert guidelines are mixed regarding the value of combined pharmacotherapy and psychotherapy as initial treatment for depression. This study describes long-term results of a randomized trial (N = 393) evaluating telephone-based cognitive-behavioral therapy (CBT) plus care management for primary care patients beginning antidepressant treatment versus usual care. In a repeated measures linear model with adjustment for baseline scores, the phone therapy group showed significantly lower mean Hopkins Symptom Checklist (HSCL) Depression Scale scores (L. Derogatis, K. Rickels, E. Uhlenhuth, & L. Covi, 1974) from 6 months to 18 months versus usual care, F(1, 336) = 11.28, p = .001. Average HSCL depression scores over the period from 6 months to 18 months were 0.68 (SD = 0.55) in the telephone therapy group and 0.85 (SD = 0.65) in the usual-care comparison group. Addition of a brief, structured CBT program can significantly improve clinical outcomes for the large number of patients beginning antidepressant treatment in primary care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral health in the pediatric primary care setting: Needs, barriers, and implications for psychologists.

Pediatric primary care providers (PPCPs) are increasingly being called on to assess children and adolescents for emotional and behavioral disorders, as well as to manage their care. The authors present the results of a survey of PPCPs regarding their comfort in assessing or diagnosing and treating or managing 19 emotional and behavioral problems, their expectations of how reasonable it is for PPCPs to assess and treat disorders, the actions they would take, barriers they face, and interest in developing formal relationships with mental health specialists. The authors discuss implications and opportunities for psychologists. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Empirical Validation and Psychometric Evaluation of the Brief Fear of Negative Evaluation Scale in Patients With Social Anxiety Disorder.

The Brief Fear of Negative Evaluation Scale (BFNE; M. R. Leary, 1983a) is often used to assess fear of negative evaluation, the core feature of social anxiety disorder. However, few studies have examined its psychometric properties in large samples of socially anxious patients. Although the BFNE yields a single total score, confirmatory factor analysis indicated a 2-factor solution to be more appropriate, with the 1st factor consisting of all straightforwardly worded items (BFNE-S) and the 2nd of all reverse-scored items (BFNE-R). Support was obtained for the convergent and discriminant validity of the BFNE and BFNE-S, but not the BFNE-R. These results suggest that standard scoring of the BFNE may not be optimal for patients with social anxiety disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Mental Disorder and Criminal Responsibility.

Reviews the book, Mental Disorder and Criminal Responsibility edited by Stephen J. Hucker, Christopher D. Webster and Mark H. Ben-Aron (1981). This book comprises a dozen papers, by judges, lawyers, psychiatrists, psychologists and a professor of English language and literature, all intended to elucidate the concept of criminal responsibility. The Editors' intent was to accomplish this by bringing together "the perspectives of all the professional disciplines whose specialties intersect in this area." Given that goal, the papers are a mixed bag. Three of them, written by members of the legal profession are thoughtfully cogent; the others make, at best, modest contributions and, at worst, add confusion to an appreciation of the issues. Achievement of the book's goals is impeded also, by the omission of several of the "professional disciplines whose specialties intersect in this area," notably philosophy, sociology, history and criminology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)