Core body temperature changes in school-age children with circadian rhythm sleep–wake disorder

Objective/backgroundCore body temperature (CBT) is considered a valuable marker for circadian rhythm. This study aimed to investigate the changes in CBT that are associated with the symptoms of circadian rhythm sleep–wake disorder (CRSWD) post-treatment in children.Patients/methodsTwenty-eight school-age children [10 boys and 18 girls; mean age (±standard deviation), 13.68 ± 0.93 years] who were admitted to our hospital with CRSWD underwent treatment for 6–8 weeks according to the following protocol: lights-out for sleep at 21:00; phototherapy for waking at 6:00 or 7:00; light exercise everyday (eg, a 20- to 30-min walk). CBT was continuously measured for 24 h on the first day of admission and on the first day after treatment.ResultsThe mean time of sleep onset/offset (±standard deviation; in hours:minutes) 1 week before admission and 1 week after treatment were 23:53 ± 2:26/9:58 ± 2:15 and 21:17 ± 0:19/6:46 ± 0:32, respectively. The mean times of sleep onset and offset measured post-treatment were significantly earlier than those measured pre-treatment (p < 0.001). The mean CBT and mean minimum CBT during sleep were significantly lower on the first day post-treatment than on the first day of admission (p = 0.011 and p < 0.001, respectively).ConclusionsSymptom improvements in patients with CRSWD were associated with a decrease in CBT during sleep, suggesting that CBT may be a biomarker for improvements in CRSWD. These results help elucidate the cause of this sleep disorder.     

Combining CBT and Behavior-Analytic Approaches to Target Severe Emotion Dysregulation in Verbal Youth With ASD and ID

ABSTRACT

This article presents an individual intervention combining cognitive-behavioral and behavior-analytic approaches to target severe emotion dysregulation in verbal youth with autism spectrum disorder (ASD) concurrent with intellectual disability (ID). The article focuses on two specific individuals who received the treatment within a therapeutic school setting. Single-subject methodology utilizing a nonconcurrent multiple-baseline design across behaviors and participants was used to evaluate the intervention. The two participants presented with severe behavioral challenges, including physical aggression and verbal threats to harm others. Results suggest positive outcomes, including a reduction in the frequency and intensity of severe aggressive behavior and an increase in the use of coping skills, self-advocacy, and social participation. The planning and implementation of specific skills-generalization strategies was one innovative element of the intervention that proved to be pivotal to its successful application. Assessment and treatment techniques for different intervention phases are detailed along with two case examples. Intervention challenges, treatment outcomes, and future directions for clinical research are discussed.     

Virtual reality exposure in anxiety disorders: Impact on psychophysiological reactivity

Objectives. Anxiety disorders are among the most frequently encountered psychiatric disorders. Recommended treatments include cognitive behavioural therapy (CBT) and/or medication. In recent years, beneficial effects of virtual reality (VR) exposure therapy have been shown, making this technique a promising addition to CBT. However, the ability of VR to mimic threatening stimuli in a way comparable to in vivo cues has been discussed. In particular, it has been questioned whether VR is capable of provoking psychophysiological symptoms of anxiety. Since psychophysiological arousal is considered a prerequisite for effective exposure treatment, this systematic review aims to evaluate the evidence for the potential of VR exposure to evoke and modulate psychophysiological fear reactions. Methods. PubMed and PsycINFO/Academic Search Premier databases were searched. Thirty-eight studies investigating challenge or habituation effects were included. Results. VR exposure does provoke psychophysiological arousal, especially in terms of electrodermal activity. Results on psychophysiological habituation in VR are inconclusive. Study design and methodological rigour vary widely. Conclusions. Despite several limitations, this review provides evidence that VR exposure elicits psychophysiological fear reactions in patients and healthy subjects, rendering VR a promising treatment for anxiety disorders, and a potent research tool for future investigations of psychophysiological processes and their significance during exposure treatment.     

网络成瘾者脑诱发电位P300变化及其认知行为治疗：3个月追踪

探讨网络成瘾行为认知功能相关事件相关电位P300成分的变化,以及网络成瘾P300成分与认知行为治疗的关系。结果发现：与正常对照者相比,网络成瘾者P300的潜伏期显著延长（N2：P =0.035; P3a：P =0.031; P3b：P =0.043）,而两者P300波幅却没有明显差异。经过3个月的认知行为治疗,网络成瘾者P300潜伏期恢复至正常水平（P3a：P =0.045; P3b：P =0.062）。表明网络成瘾者存在着一定程度的认知功能缺损,临床心理治疗可改善其认知缺损。     

Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study

Background

Repetitive transcranial magnetic stimulation (rTMS) is considered an efficacious non-invasive neuromodulation treatment for major depressive disorder (MDD). However, little is known about the clinical outcome of combined rTMS and psychotherapy (rTMS + PT). Through common neurobiological brain mechanisms, rTMS + PT may exert enhanced antidepressant effects compared to the respective monotherapies.

新冠肺炎疫情下健康焦虑的心理机制及干预策略:认知行为理论的视角

本文从认知行为理论的视角分析了新冠肺炎疫情下健康焦虑的特点和心理机制,并从评估、心理教育、认知重建、改变注意聚焦、接纳情绪和躯体感觉、行为改变这六个维度总结心理干预的策略,以期为专业人员在疫情中后期和疫情结束后对存在健康焦虑的个体进行心理干预提供参考。     

Effect of exercise-based cardiac rehabilitation on anxiety and depression in patients with myocardial infarction: A systematic review and meta-analysis

Background

Cardiac rehabilitation (CR) has been shown to provide the best social, psychological and physical conditions for patient recovery after myocardial infarction (MI).

Prevalence of severe fatigue among adults with cystic fibrosis: A single center study

Background

With life expectancy increasing among patients with cystic fibrosis (CF), the prevalence of complications such as fatigue is also expected to increase. Our aim was to investigate the prevalence of severe fatigue among adults with CF and to identify factors associated with fatigue.

Concurrent alcoholism and social anxiety disorder: a first step toward developing effective treatments

BACKGROUND: Social anxiety disorder (also called social phobia) is an anxiety disorder in which affected individuals fear the scrutiny of others. Clinical reports suggest that individuals with social anxiety disorder often use alcohol to alleviate anxiety symptoms, a practice that leads to alcohol abuse and/or dependence in approximately 20% of affected individuals. The present study investigated whether simultaneous treatment of social phobia and alcoholism, compared with treatment of alcoholism alone, improved alcohol use and social anxiety for clients with dual diagnoses of social anxiety disorder and alcohol dependence. METHODS: The design was a two-group, randomized clinical trial that used 12 weeks of individual cognitive behavioral therapy for alcoholism only (n = 44) or concurrent treatment for both alcohol and social anxiety problems (n = 49). Outcome data were collected at the end of 12 weeks of treatment and at 3 months after the end of treatment. RESULTS: Results with intent-to-treat analyses showed that both groups improved on alcohol-related outcomes and social anxiety after treatment. With baseline scores covaried, there was a significant effect of treatment group on several drinking measures. Counter to the hypothesis, the group treated for both alcohol and social anxiety problems had worse outcomes on three of the four alcohol use indices. No treatment group effects were observed on social anxiety indices. CONCLUSIONS: Implications for the staging of treatments for coexisting social phobia and alcoholism are discussed, as well as ways that modality of treatments might impact outcomes.