Psychotherapy in the veterans health administration: Missed opportunities?

Informed by data on the dose-response effect, the authors assessed use of psychotherapy in the Veterans Health Administration (VA). The authors identified 410,923 patients with newly diagnosed depression, anxiety, or posttraumatic stress disorder using VA databases (October 2003 through September 2004). Psychotherapy encounters were identified by Current Procedural Terminology codes for the 12 months following patients' initial diagnosis. Psychotherapy was examined for session exposure received within the 12-month follow-up period and time (in days) between diagnosis and treatment. Of the cohort, 22% received at least one session of psychotherapy; 7.9% received four or more sessions; 4.2% received eight or more sessions; and 2.4% received 13 or more sessions. Delays between initial mental health diagnosis and initiation of care averaged 57 days. Patient variables including age, marital status, income, travel distance, psychiatric diagnosis, and medical-illness burden were significantly related to receipt of psychotherapy. Treatment delays and general underuse of psychotherapy services are potential missed opportunities for higher-quality psychotherapeutic care in integrated health care settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding a link between sexual harassment and eating disorder symptoms: A mediational analysis.

Using data from 3 samples of working women and men, the present study examines the association between sexual harassment and eating disorder symptoms by studying the processes that may underlie this relationship. The results of structural equation modeling suggest a link between sexual harassment and eating disorder symptoms among women and indicate that this relationship is mediated by psychological distress, self-esteem, and self-blame. Further, sexual harassment was found to predict eating disorder symptoms among women even when experiences of sexual assault were included in the model. No relationship was found between sexual harassment and eating disorder symptoms among men. The theoretical and clinical implications of these results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

L'effet du niveau d'experiencing du client et de l'aidant sur l'abandon d'un processus thérapeutique.

Studied the effect of client and therapist level of experiencing, beginning with the initial stage of psychological counseling, on early termination of therapy. Human subjects: 32 male and female Canadian adults (mean age 30–32 yrs) (personality disorders, neuroses, or interpersonal problems) (clients of therapists). 19 normal male and female Canadian adults (mean age 31 yrs) (graduate students) (therapists). Clients were subdivided into 2 groups: those who had terminated therapy (early or late), and those who had not terminated therapy. Ss were interviewed. Levels of experiencing were compared for the 2 groups of clients and for therapists who had counseled these clients. Tests used: The Global Assessment Scale, Psychiatric Symptom Index (F. Ilfeld, 1976), and Experiencing Scale (P. Mathieu-Coughlan and M. Klein, 1984). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking cessation may not improve quality of life in atherosclerotic patients.

The benefits of smoking cessation on patients' medical conditions are well documented. Cardiovascular patients who quit smoking significantly reduce their risk of a new event compared with those who continue smoking. Several studies have found that smoking is related to poor quality of life (QoL). In cardiovascular patients, however, less attention has been given to the effect of smoking cessation on patients' QoL. The present study examined the extent to which smoking cessation leads to changes in QoL in these patients within the first year of follow-up. Data were collected in the context of a randomized clinical trial. Smoking outpatients (N = 346) with atherosclerotic disease were included and received medical treatment. They were randomized to receive either nicotine replacement therapy (NRT) or NRT plus a behavioral intervention meant to promote smoking cessation. At baseline, sociodemographic and clinical characteristics were established. Generic and disease-specific QoL as well as smoking status were assessed at baseline and with three follow-up measurements. Multilevel modeling showed that generic and disease-specific QoL in atherosclerotic patients improved significantly within the first year of follow-up. No main differences were found between quitters and smokers in terms of improvement in QoL. In fact, some subgroups reported a poorer QoL after smoking cessation: More highly educated patients reported lower general QoL (p < .05), and patients suffering from coronary artery disease who had a low level of education (p < .01) and patients suffering from peripheral arterial disease who had low nicotine dependency (p < .01) reported lower disease-specific QoL. Atherosclerotic patients' QoL improved significantly but was not enhanced by smoking cessation activities.     

Positive mood and executive function: Evidence from Stroop and fluency tasks.

Contrasting predictions have been made about the effects of positive mood states on the performance of frontal lobe tests that tap executive functions such as inhibition, switching, and strategy use. It has been argued that positive mood is likely to improve some cognitive processes, particularly those dependent on the frontal cortex and anterior cingulate of the brain. However, there is some evidence that happy mood may impair executive functioning. The current experiments investigated the effects of positive mood on Stroop and fluency tests, which are frequently used to assess executive function. Positive mood impaired performance on a switching condition of the Stroop test, but improved performance on a creative uses test of fluency. The effect of positive mood on an executive task may therefore depend on whether a task is inherently motivating or is impaired by diffuse semantic activation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)