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Introduction: This study was aimed to compare of the effectiveness of group cognitive-behavioral therapy and methadone maintenance therapy on changing beliefs toward substance abuse among addicted people. Method: The research method was a quasi-experimental pretest-posttest with witness group. 30 addicted people who were referred to the addiction treatment centers selected by available sampling, and they randomly assigned to three groups namely: cognitive-behavioral therapy, methadone maintenance therapy and witness groups. Substance abuse beliefs questionnaire was administered among all participants before and after intervention. Results: Results showed that in both experimental groups, beliefs toward drug was reduced significantly in comparison with witness group. Conclusion: Cognitive-behavioral therapy can be changed on cognitive mediator variables, like beliefs toward substance therefore, it can reduce the risk of relapse. However, the programs of treatment of substance abuse should be targeted this type of intermediate variables.

This article addresses the efficacy of Cognitive-Behavior Therapy and the increasing global popularity of the approach among various cultures with a broad range of emotional and behavioral disorders. The article specifically discusses future direction in the field and implications for practitioners in various cultures.

OBJETIVO: verificar a resposta dos pacientes com transtorno de pânico com agorafobia à modelo proposto de terapia cognitivo-comportamental (TCC) nos dois subtipos respiratórios de transtorno de pânico: o subtipo respiratório (SR) e subtipo não respiratório (SNR) Amostra randomizada por sorteio com 50 pacientes diagnosticados segundo o Manual Diagnóstico e Estatístico dos Transtornos Mentais. A medicação: antidepressivos tricíclicos ou inibidores seletivos de recaptação da serotonina. Setenta e sete ponto seis porcento da amostra de pacientes de ambos os grupos apresentaram o SR e 22,4 % o SNR. Os pacientes do SR, responderam satisfatoriamente ao tratamento com técnicas da TCC, reduzindo ansiedade, sintomas respiratórios e os ataques de pânico. Os pacientes do SR melhoraram, segundo a escala de avaliação global do funcionamento, de 55,8 para 70,9 em comparação com o SNR.The objective of the present study was to verify the response of patients with panic disorder (agoraphobia) to existing cognitive-behavior therapy models (CBT) of two respiratory subtypes of panic disorder (PD): respiratory subtype (RS) and non respiratory subtype (NRS). We randomly selected a sample of 50 patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The medication used was tricycle or selective serotonin reuptake inhibitor antidepressants. Seventy-seven point six percent of the patients from both groups showed RS and 22.4% the NRS. The RS patients responded satisfactorily to the treatment with techniques of CBT decreasing anxiety, breathing symptoms and panic attacks. According to the global functioning assessment scale, RS patients improved from 55.8 to 70.9 in comparison with NRS ones.

Purpose: This study compared the effectiveness of group cognitive-behavioral therapy based on coping skills (CBT) and methadone maintenance therapy (MMT) in improvement of emotional regulation strategies and prevention of relapse. Method: The method of the present study was semi-experimental research design (pre-test-post-test with witness group). For sampling 45 substance abuse people who had referred to addiction treatment centers were selected and assigned to three groups of cognitive behavior therapy, methadone maintenance treatment and witness group randomly. The participants in all three groups completed the emotional intelligence questionnaire before and after the intervention. Data were analyzed by covariance method. Results: The results showed that cognitive-behavior therapy in comparison to methadone maintenance therapy and witness group led to significant improvement of emotional regulation in substance abusers, but there was no significant difference between the methadone maintenance treatment group and control group. Also, the rate of relapse in individuals who assigned to cognitive-behavior therapy group in comparison to methadone maintenance therapy and the witness group was significantly lower, but there was no significant difference between methadone therapy and witness. Conclusion: Cognitive-behavior therapy was an effective treatment that can change the cognitive and behavioral variables related to substance abuse, such as emotional regulation strategies. Thus, results suggested that drug abuse treatment programs must target these mediator variables.

The aim of this review article is to provide an integrative perspective by combining basic assumptions of cognitive behavioral therapy (CBT) with neuroscience research results. In recent years, interdisciplinary research in the field of neuroscience has expanded our knowledge about neurobiological correlates of mental processes and changes occurring in the brain due to therapeutic interventions. The studies are largely based on non-invasive brain imaging techniques, such as functional neuroimaging technologies of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The neuroscientific investigations of basic CBT hypotheses have shown that (i) functional and non-functional behavior and experiences may be learned through lifelong learning, due to brain neuroplasticity that continues across the entire lifespan; (ii) cognitive activity contributes to dysfunctional behavior and emotional experience through focusing, selective perception, memory and recall, and characteristic cognitive distortion; on a neurobiological level, there is a relationship between top-down and bottom-up regulation of unpleasant emotional states; and (iii) cognitive activity may be changed, as shown by therapeutic success achieved by metacognitive and mindfulness techniques, which also have their neurobiological correlates in the changes occurring in the cortical and subcortical structures and endocrine and immune systems. The empirical research also shows that neurobiological changes occur after CBT in patients with arachnophobia, obsessive-compulsive disorder, panic disorder, social phobia, major depressive disorder and chronic fatigue syndrome.disorder and chronic fatigue syndrome.

Riccardo Dalle Grave1, Simona Calugi1, Elena Centis2, Rebecca Marzocchi2, Marwan El Ghoch1, Giulio Marchesini21Department of Eating & Weight Disorder, Villa Garda Hospital, Garda (VR), Italy; 2Unit of Metabolic Diseases & Clinical Dietetics, Alma Mater Studiorum – University of Bologna, Bologna, ItalyAbstract: Lifestyle modification based on behavior therapy is the most important and effective strategy to manage the metabolic syndrome. Modern lifestyle modification therapy combines specific recommendations on diet and exercise with behavioral and cognitive strategies. The intervention may be delivered face-to-face or in groups, or in groups combined with individual sessions. The main challenge of treatment is helping patients maintain healthy behavior changes in the long term. In the last few years, several strategies have been evaluated to improve the long-term effect of lifestyle modification. Promising results have been achieved by combining lifestyle modification with pharmacotherapy, using meals replacement, setting higher physical activity goals, and long-term care. The key role of cognitive processes in the success/failure of weight loss and maintenance suggests that new cognitive procedures and strategies should be included in the traditional lifestyle modification interventions, in order to help patients build a mind-set favoring long-term lifestyle changes. These new strategies raise optimistic expectations for an effective treatment of metabolic syndrome with lifestyle modifications, provided public health programs to change the environment where patients live support them.Keywords: metabolic syndrome, obesity, lifestyle modification, cognitive behavior therapy

Se describe el caso clínico de una mujer de 53 años con trastorno de estrés postraumático (TEPT), a raíz de un accidente ferroviario en Galicia (España) en julio 2013. El accidente le supuso diferentes lesiones e intervenciones quirúrgicas. El impacto a nivel psicológico aparece de forma demorada, presentando, además de sintomatología TEPT, alta ansiedad, síntomas depresivos y alta irritabilidad. En el tratamiento se aplicó “exposición prolongada” enmarcada en un tratamiento cognitivo-conductual más amplio, en el que se incluyó reestructuración cognitiva y entrenamiento en regulación emocional, para abordar las interpretaciones disfuncionales que favorecían la aparición de la ira. Se describe la aplicación del tratamiento y las principales dificultades encontradas, principalmente la evitación de la exposición al recuerdo del trauma y la solicitud de la paciente del cese anticipado del tratamiento. Se presentan los resultados, incluyendo los seguimientos a 1, 3, 6 y 12 meses, y se discute la evolución de la paciente.

En este trabajo se muestra la efectividad o utilidad clínica de la terapia cognitivo-conductual centrada en el trauma (TCC-CT) cuando se aplica por videoconferencia a un paciente de 52 años víctima directa de un atentado terrorista sufrido hace 30 años, que presentaba trastorno por estrés postraumático (TEPT), trastorno depresivo mayor, fobia social y trastorno obsesivo-compulsivo. Tras 36 sesiones de tratamiento, se produjo una reducción clínicamente significativa de la sintomatología postraumática, ansiosa y depresiva, la cual se mantuvo estable a largo plazo. La TCC-CT aplicada por videoconferencia parece ser efectiva cuando se utiliza con víctimas del terrorismo que sufren TEPT y otros trastornos comórbidos a muy largo plazo, aunque la comorbilidad y la cronicidad parecen requerir un aumento en el número de sesiones.

Violência sexual é um grave problema de saúde pública, pois atinge todas as classes sociais, etnias, religiões e culturas, em especial crianças e adolescentes do sexo feminino. O objetivo do presente estudo é relatar o impacto de uma intervenção cognitivo-comportamental em uma adolescente de 13 anos, vítima de tentativa de estupro. O processo, de 45 sessões, distribuídas em avaliação inicial, intervenção, avaliação final e follow-up, utilizou entrevista semidirigida, critérios diagnósticos do DSM-IV, o Inventário de Depressão para Crianças (CDI), técnicas cognitivo-comportamentais e orientações à mãe. Na avaliação inicial verificaram-se dificuldades escolares, problemas comportamentais, sintomas indicativos de estresse pós-traumático e sintomas moderados de depressão, intensificados pelo episódio da violência. Observaram-se também repetições de padrões transgeracionais: comportamento promíscuo, etilismo, violência sexual e instabilidade nos relacionamentos. Os resultados demonstraram redução das queixas iniciais, aquisição de novo repertório comportamental, melhor funcionamento psicossocial e impacto positivo da intervenção. Os dados indicam necessidade de inclusão dos familiares no processo.La violencia sexual es un problema grave de la salud pública: alcanza todas las clases sociales etnias, religiones y culturas, en especial niños y adolescentes del sexo feminino. El objetivo del actual estudio es decir el impacto de la intervención cognitivo-comportamental en una adolescente de 13 años, víctima de un intento de violación. El proceso, de 45 sesiones, distribuido en la evaluación inicial, intervención, evaluación final y acompanãmiento, entrevista semidirigida, criterios diagnósticos del DSM-IV, inventario de depresión para los niños (CDI), técnicas cognitivo-comportamentales y orientación con la madre. En la primera entrevista fueron diagnosticadas dificultades en la escuela, problemas comportamentales, síntomas indicativos del estrés post-traumático y los síntomas moderados de la depresión, agravados por el episodio de la violencia. También fueron observadas repeticiones de padrones transgeneracionales: el comportamiento promiscuo, el alcoholismo, el abuso sexual y la inestabilidad en las relaciones. Resultados muestran la reducción de las quejas iniciales, la adquisición del nuevo repertorio comportamental, mejor funcionamiento psico social y el impacto positivo de la intervención. Los datos indican la necesidad de la inclusión de las familias en el proceso.Sexual violence is a serious problem of public health: it reaches all social classes, ethnics, religions and cultures, specially children and adolescents of the female sex. The objective of the present study is to describe the impact of a cognitive-behavior intervention on a 13-year-old adolescent, victim of rape attempt. The process included 45 sessions, distributed in initial evaluation, intervention, final evaluation and follow-up. It also used semi-directed interview, DSM-IV diagnostic criteria, Children’s Depression Inventory (CDI), cognitive-behavior techniques, and mother counseling. On the first interview the therapist identified school and behavior problems, symptoms of pos-traumatic stress disorder and moderate symptoms of depression, intensified by the episode of violence. Transgerational standard repetition was also observed: promiscuous behavior, alcoholism, sexual violence and relationship instability. Results demonstrated reduction of the initial complaints, acquisition of new behavior repertoire, better psicossocial functioning and positive impact of the intervention. The data indicate the need for inclusion of the family in the process.

The purpose of this study was to compare the efficacy of the cognitive-behavior therapy (CBT), exposure and response prevention (ERP) and Fluoxetine in the obsessive-compulsive patients. The experimental design was selected and 59 patients with obsessive-compulsive disorder (OCD) diagnosis were randomly assigned to 4 groups: cognitive-behavioral therapy, exposure and response prevention, Fluoxetine and waiting-list. Patients in the four groups were seleted with respect to the variables such as age, sex, academic and marital status. For gathering data Moudsley Obsessive-Compulsive Inventory (MOCI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI) were used as instruments. The patients of the four groups completed these three questionnaires in 3 stages (pre test, post test, follow-up with 2 months interval). The data were analysed by multivariate analyses of Anova (MANOVA-1 way), and post hoc test (T tukey). The findings indicated the treatment effect of CBT on OCD severity was more significant than Fluoxetine in short-term and long-term (P

O transtorno de pânico (TP) caracteriza -se por ataques agudos de ansiedade frequentes e recorrentes. A actual concepção para o TP realça o medo das sensações corporais a partir do momento em que o indivíduo associa de forma equivocada as sensações físicas que se apresentam como sendo prenúncio de uma doença grave e/ou morte iminente, não conseguindo interpretá -las como mecanismos fisiológicos naturais. Relatamos três casos graves de TP do subtipo respiratório, com agorafobia, cujos sintomas de hiperventilação predominavam sobre os demais. O tratamento consistiu na prescrição de antidepressivos tricíclicos e no encaminhamento para sessões de terapia cognitivo -comportamental (TCC). O objectivo do relato dos casos é demonstrar a evolução satisfatória do tratamento com a técnica dos exercícios de indução de sintomas (EIS) em ambiente de laboratório para a redução e/ou extinção dos sintomas hiperventilatórios, entre outros. Esse procedimento foi considerado fundamental na evolução do tratamento e permitiu preparar os doentes para enfrentarem situações agorafóbicas subsequentes.Panic disorder (PD) is characterized by frequent and recurrent acute panic attacks. The current cognitive conception for PD enhances the fear of corporal sensations, when the individual define his physical sensations as being related to a serious disease or imminent death, not interpreting them as natural physiologic mechanisms. We reported three severe cases of PD of the respiratory subtype, with agoraphobia, whose symptoms of hyperventilation predominated on clinical picture. The treatment consisted on tricycles antidepressant and cognitive-behavior therapy (CBT) sessions. The objective of reporting the cases is to demonstrate the satisfactory evolution of the treatment with the technique of panic symptoms induction exercises (SIE) in controlled laboratory environment. On that way, reducing or extinguishing hyperventilation symptoms. This procedure was considered very important in the evolution of the treatment and allowed us to prepare the patients to face subsequent agoraphobic situations.

O uso de realidade virtual (RV) é útil no tratamento de exposição em pacientes com transtorno de pânico (TP). Em ambientes virtuais, os pacientes experimentam alterações fisiológicas, psíquicas e somáticas similares aos sintomas em situações da vida real, facilitando o processo de habituação. OBJETIVO: Divulgar o panorama atual do uso de RV no tratamento do TP. MÉTODO: A literatura sobre o tratamento do TP a partir da RV foi revisada com metodologia sistemática na base de dados PubMed, por meio das palavras-chave: virtual reality e panic disorder. RESULTADOS: O tratamento do TP com RV está em geral associado a bons resultados e à boa aceitabilidade por parte dos pacientes. São poucos os estudos que mensuram respostas fisiológicas durante a exposição, apesar da importância destes dados para avaliação da eficácia do tratamento. CONCLUSÕES: Apesar da utilidade do tratamento do TP por RV ser verificada nos estudos, constata-se necessidade de estudos controlados e protocolos de tratamento padronizados.Virtual reality (VR) is a valuable tool in exposure treatment of panic disorder (PD). In virtual environments the patients experience similar physiological, psychic and somatic changes as in real life situations facilitating the habituation process. OBJECTIVE: We intend to divulge the current panorama of VR in treatment of PD. METHOD: The literature on VR treatment for PD was revised with a systematic methodology in the PubMed database, using the keywords: virtual reality and panic disorder. RESULTS: Virtual exposure treatment of PD usually shows good results and a great patient acceptability. Only a few studies measure physiological responses during the exposure despite the importance of these data for evaluation of the treatment effectiveness. CONCLUSIONS: Although the VR treatment for PD usefulness is clear in the trials, a lack of controlled studies and standardized treatment protocols are verified.

Work-related stress presents a significant impact on work performance and physical health. It has been associated with the onset of a multitude of symptoms that can lead to occupational stress diseases, namely Adjustment Disorder and Post-Traumatic Stress Disorder. The literature has evidenced that "exposure therapy" of cognitive-behavioral training (CBT-E) seems to be the most effective technique to manage stress symptoms, including work stress diseases, and several studies have considered Virtual Reality (VR) as an adjuvant tool to exposure-based psychotherapy (CBT-VR) for the treatment of multiple psychiatric disorders. The aim of this study is to evaluate the effectiveness of CBT with exposure to stressful work scenarios in imaginative (CBT-E) and in immersive virtual reality (CBT-VR) scenarios in a group of workers affected by work-related stress disorders and compare the clinical and physiological outcomes between the two exposure techniques. A long-term goal would be to develop an evidence-based rehabilitation program as a treatment for the reintegration into work of patients affected by these psychiatric disorders.

Motivation is a key ingredient in the successful treatment of pediatric obsessive-compulsive disorder (OCD). As a first-line treatment, cognitive-behavior therapy (CBT) requires extensive client engagement, including participating in exposures and doing homework tasks. A lack of motivation to comply with these tasks may seriously affect treatment outcome. This case study identifies factors interfering with motivation and illustrates motivational strategies to enhance compliance of a child with OCD. The patient was an 11-year-old boy with severe OCD and symptoms of oppositional defiant disorder (ODD). He had extensive OCD-related avoidance behavior but denied the presence of symptoms or did not acknowledge them as a problem. In this article, we discuss the different techniques used to enhance motivation, which subsequently led to a favorable outcome. [ABSTRACT FROM AUTHOR]

Homework assignments have been shown to produce both causal and correlational effects in prior meta-analytic reviews of cognitive behavior therapy (CBT), but this research area has been characterized by a focus on the amount of compliance (i.e., quantity), and little is known about the role of skill acquisition (i.e., quality). A landmark study by Neimeyer and Feixas (1990) showed stronger homework-outcome relations when quality was assessed, but previous reviews have not considered whether the same pattern is evident across studies. Seventeen studies of CBT (N = 2,312 clients) published following calls for research on homework quality were included in the current meta-analysis. In the present review, homework compliance relations were demonstrated when outcome was assessed at posttreatment (quality Hedges' g = 0.78, 95% Confidence Interval [CI] = 0.03 to 1.53, k = 3, n = 417; quantity g = 0.79, 95% CI = 0.57 to 1.02, k = 15, n = 1537) and at follow-up (quality g = 1.07, 95% CI = 0.06 to 2.08, k = 3, n = 417; quantity g = 0.51, 95% CI = 0.28 to 0.74, k = 7, n = 1291). All effect sizes were different from 0, ps < .05. Differences that were obtained in homework-outcome relations among sources of compliance data (client, therapist, objective) were tentative due to overlapping CIs, but suggest a potential moderating effect. If confirmed by further research, the present findings would suggest that trial methods capable of assessing both quantity and quality have been an important omission in research on homework-outcome relations in CBT. [ABSTRACT FROM AUTHOR]

Objective To explore the efficacy of cognitive-behavior therapy (CBT) for patients with comorbid generalized anxiety disorder (GAD) and insomnia using 2 sequential treatments. Method Using a single-case methodology, 10 women (mean age = 45) with chronic insomnia and GAD were randomly assigned to CBT for GAD followed by CBT for insomnia, or to CBT for insomnia followed by CBT for GAD. Sleep and anxiety were measured via diagnostic interviews, daily diaries, and self-report questionnaires. Results Time series analyses, group effect sizes, and indications of clinically significant change revealed improvements on anxiety, worry, and sleep after CBT for GAD. Following CBT for insomnia, positive changes were observed on sleep and, to a lesser extent, anxiety and worry. Conclusions In the presence of comorbid GAD and insomnia, initiating treatment for GAD first produced superior clinical benefits in anxiety and sleep. The addition of insomnia-specific treatment led to additional improvements in worry and sleep quality. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of comorbid anxiety or depressive disorders on treatment response to cognitive-behavior therapy (CBT) for insomnia, behavior therapy (BT), or cognitive therapy (CT). Method: Participants were 188 adults (117 women; Mage = 47.4 years) with chronic insomnia, including 45 also presenting a comorbid anxiety or mild to moderate depressive disorder. They were randomized to BT (n = 63), CT (n = 65), or CBT (n = 60). Outcome measures were the proportion of treatment responders (decrease of ≥8 points on the Insomnia Severity Index; ISI) and remissions (ISI score < 8) and depression and anxiety symptoms. Results: Proportion of treatment responders and remitters in the CBT condition was not significantly different between the subgroups with and without comorbidity. However, the proportion of responders was lower in the comorbidity subgroup compared to those without comorbidity in both the BT (34.4% vs. 81.6%; p = .007) and CT (23.6% vs. 57.6%; p = .02) alone conditions, although remission rates and prepost ISI change scores were not. Pre to post change scores on the depression (–10.6 vs. –3.9; p < .001) and anxiety measures (–9.2 vs. –2.5; p = .01) were significantly greater in the comorbidity subgroup relative to the subgroup without comorbidity but only for those treated with the full CBT; no difference was found for those treated with either BT or CT alone. Conclusions: The presence of a comorbid anxiety or mild to moderate depressive disorder did not reduce the efficacy of CBT for insomnia, but it did for its single BT and CT components when used alone. [ABSTRACT FROM AUTHOR]

Most research designs utilized in clinical studies of cognitive therapy of depression haven't sufficiently included the influence of treatment. Thus, in the present study we aimed at identifying the causal attributional predictors and their mediating role in the reduction of depression. We constructed three study groups in order to take into account the role of therapy. In our sample we employed a number of 13 inpatients diagnosed with depression from Arad and Nucet hospitals (the Pharmacotherapy group), the Cognitive-behavioral group was constructed of 12 participants from rural and urban backgrounds with no prior admissions to hospitals for dispositional or other psychological disturbances and a control group consisted of 13 randomly sampled participants from the population. The patients within the neuropsychology clinics have undergone specific treatment. The cognitive-behavioral group underwent the following therapeutic strategies and intervention techniques: 1. problem conceptualization; 2. choosing a therapeutic strategy; 3. choosing an intervention technique; 4. evaluation of the efficacy of these intervention techniques. The results obtained in our study show that a set of socio-cognitive constructs play a mediator role in the cognitive behavior therapy. Even in such a case it seems that they are not a sufficient cause due to the fact that the relationship between the modifications at the socio-cognitive level and the later improvement depressive in symptoms has not been justified in pharmacotherapy. [ABSTRACT FROM AUTHOR]

Depression is the most common mental illness in the elderly, and cost-effective treatments are required. Therefore, this study is aimed at evaluating the effectiveness of a mindfulness-based cognitive therapy (MBCT) on depressive symptoms, mindfulness skills, acceptance, and quality of life across four domains in patients with late-onset depression. A single case design with pre- and post-assessment was adopted. Five patients meeting the specified inclusion and exclusion criteria were recruited for the study and assessed on the behavioral analysis pro forma, geriatric depression scale, Hamilton depression rating scale, Kentucky inventory of mindfulness skills, Acceptance and Action Questionnaire II, The World Health Organization quality of life Assessment Brief version (WHOQO-L-BREF). The therapeutic program consisted of education regarding the nature of depression, training in formal and informal mindfulness meditation, and cognitive restructuring. A total of 8 sessions over 8 weeks were conducted for each patient. The results of this study indicate clinically significant improvement in the severity of depression, mindfulness skills, acceptance, and overall quality of life in all 5 patients. Eight-week MBCT program has led to reduction in depression and increased mindfulness skills, acceptance, and overall quality of life in patients with late-life depression. [ABSTRACT FROM AUTHOR]

Study Objectives: This study evaluated the efficacy of a brief group-based program of cognitive-behavior therapy for insomnia (CBTi) for older adults suffering from chronic insomnia with short objective sleep relative to those with long sleep duration.Method: Ninety-one adults (male = 43, mean age = 63.34, standard deviation (SD) = 6.41) with sleep maintenance insomnia were selected from a community-based sample. The participants were classified as short sleepers (SS; <6 h total sleep time) or long sleepers (LS; ≥6 h total sleep time) based on one night of home-based polysomnography. Participants were randomly allocated to a 4-week, group-based treatment program of CBTi (N = 30 SS; N = 33 LS) or to a wait-list control condition (N = 9 SS, N = 19 LS). One-week sleep diaries, actigraphy, and a comprehensive battery of questionnaires were used to evaluate the efficacy of CBTi for those with short objective sleep relative to those with long sleep duration. Outcome measures were taken at pretreatment, posttreatment, and a 3-month follow-up.Results: CBTi produced robust and durable improvements in quality of sleep, including reduced wake after sleep onset and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes about Sleep Scale, and gains on the Sleep Self-Efficacy Scale. All improvements were significant relative to their respective SS or LS wait-list group. The benefits of CBTi were comparable with those who had short and long objective sleep before the treatment.Conclusions: Older adults suffering from chronic insomnia with short objective sleep received comparable therapeutic benefits following CBTi relative to those with long objective sleep duration. [ABSTRACT FROM AUTHOR]

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Negative thoughts, experienced by 80% to 99% of the non-clinical population, have been linked to the development of psychopathology. The current study aimed to compare a cognitive restructuring and cognitive defusion technique for coping with a personally relevant negative thought. Over a 5-day period, participants used either a restructuring, defusion, or control strategy to manage a negative thought. Pre- and post-intervention participants reported (a) believability of the thought, (b) discomfort associated with the thought, (c) negativity associated with the thought, and (d) willingness to experience the thought. Daily online questionnaires assessing the total frequency of negative thought intrusions and their level of willingness to experience the negative thought were also used. Also, 10 positive and negative self-statements were rated on the same scales, and self-report measures of mood and psychological flexibility were completed. Findings indicated that defusion lowered believability, increased comfort and willingness to have the target thought, and increased positive affect significantly more than the control and cognitive restructuring. Within groups, cognitive restructuring also made significant gains in target thought discomfort, negativity, and “willingness to have” in the same direction as defusion but the no-instruction control did not. Negative thought frequency was reduced in the defusion group, maintained in the restructuring group, and increased in the no-instruction control group. Similar trends emerged from the secondary outcome measures, that is, the effects of the strategies on the positive and negative self-statements. The current findings support the efficacy of using defusion as a strategy for managing negative thoughts. [ABSTRACT FROM AUTHOR]

Cognitive models of social anxiety disorder propose self-focused attention as a key maintenance factor of the disorder. However, whether this holds true for different cultural contexts has not been investigated. The present experiment investigated the influence of self-construal (interdependent versus independent) on self-focused attention in high and low socially anxious individuals. Eighty-seven participants, divided into high versus low socially anxious and interdependent versus independent self-construal, performed a self-focused attention probe detection paradigm. A reaction time metric relating to attention deployment on the self versus the other served as an index of self-focused attention. In individuals with an interdependent self-construal those who are highly socially anxious showed decreased self-focused attention compared to those who are low socially anxious. In individuals with an independent self-construal the effect of social anxiety was less strong and in the opposite direction (but congruent with cognitive models). These results indicate that self-focused attention in social anxiety depends on self-construal. These findings implicate different therapies for people with social anxiety disorder, depending on their self-construal. [ABSTRACT FROM AUTHOR]

Background: Due to the complex nature and varied symptoms of obsessive-compulsive disorder, different treatments can be used. Objective: The aim of present study was to compare the efficacy of cognitive-behavior therapy (CBT) and meta-cognitive therapy (MCT) on reducing the symptoms of washing compulsions, anxiety and depression. Method: To do so, 6 women with OCD (pure washing), were selected based on the structured clinical interview for DSM-IV (SCID), and were assigned randomly to CBT or MCT group. In each group, patients received the relevant therapies in 12 one-hour sessions. Research tools included Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Obsessive-Compulsive Inventory (OCI-R) that were completed by patients in pretest, posttest, follow up 1 and follow up 2. Finally, data was analyzed both individually and in group. In individual analysis, we used diagrams, visual analysis and calculating the effect size, while in group analysis, the analysis of variance with one between group factor (two group of therapies) and one within group factor (time of tests) was used. Result: The results indicated that CBT was more effective than MCT in reducing washing compulsions symptoms. However, MCT was more effective than CBT in reducing anxiety and depression. Conclusion: Considering these results, it can be suggested that MCT is more appropriate that the CBT for refractory patients. However, definitive conclusion about the efficacy of these therapies requires more studies. [ABSTRACT FROM AUTHOR]

A new understanding of the mechanisms of memory retrieval and reconsolidation holds the potential for improving exposure-based treatments. Basic research indicates that following fear extinction, safety and fear memories may compete, raising the possibility of return of fear. One possible solution is to modify original fear memories through reconsolidation interference, reducing the likelihood of return of fear. Postretrieval extinction is a behavioral method of reconsolidation interference that has been explored in the context of conditioned fear and appetitive memory paradigms. This meta-analysis examines the magnitude of postretrieval extinction effects and potential moderators of these effects. A PubMed and PsycINFO search was conducted through June 2014. Sixty-three comparisons examining postretrieval extinction for preventing the return of fear or appetitive responses in animals or humans met inclusion criteria. Postretrieval extinction demonstrated a significant, small-to-moderate effect (g = .40) for further reducing the return of fear in humans and a significant, large effect (g = 0.S9) for preventing the return of appetitive responses in animals relative to standard extinction. For fear outcomes in animals, effects were small (g = 0.21) and nonsignificant, but moderated by the number of animals housed together and the duration of time between postretrieval extinction/extinction and test. Across paradigms, these findings support the efficacy of this preclinical strategy for preventing the return of conditioned fear and appetitive responses. Overall, findings to date support the continued translation of postretrieval extinction research to human and clinical applications, with particular application to the treatment of anxiety, traumatic stress, and substance use disorders. [ABSTRACT FROM AUTHOR]

Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated. [ABSTRACT FROM PUBLISHER]

Background and objectives The biased interpretation of ambiguous social situations is considered a maintaining factor of Social Anxiety Disorder (SAD). Studies on the modification of interpretation bias have shown promising results in laboratory settings. The present study aims at pilot-testing an Internet-based training that targets interpretation and judgmental bias. Method Thirty-nine individuals meeting diagnostic criteria for SAD participated in an 8-week, unguided program. Participants were presented with ambiguous social situations, were asked to choose between neutral, positive, and negative interpretations, and were required to evaluate costs of potential negative outcomes. Participants received elaborate automated feedback on their interpretations and judgments. Results There was a pre-to-post-reduction of the targeted cognitive processing biases ( d = 0.57–0.77) and of social anxiety symptoms ( d = 0.87). Furthermore, results showed changes in depression and general psychopathology ( d = 0.47–0.75). Decreases in cognitive biases and symptom changes did not correlate. The results held stable accounting for drop-outs (26%) and over a 6-week follow-up period. Forty-five percent of the completer sample showed clinical significant change and almost half of the participants (48%) no longer met diagnostic criteria for SAD. Limitations As the study lacks a control group, results lend only preliminary support to the efficacy of the intervention. Furthermore, the mechanism of change remained unclear. Conclusion First results promise a beneficial effect of the program for SAD patients. The treatment proved to be feasible and acceptable. Future research should evaluate the intervention in a randomized-controlled setting. [ABSTRACT FROM AUTHOR]

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