A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations

BackgroundIrritable bowel syndrome (IBS) is a chronic and debilitating medical condition with few efficacious pharmacological or psychosocial treatment options available. Evidence suggests that visceral anxiety may be implicated in IBS onset and severity. Thus, cognitive-behavioral treatment (CBT) that targets visceral anxiety may alleviate IBS symptoms.MethodsThe current study examined the efficacy of a CBT protocol for the treatment of IBS which directly targeted visceral sensations. Participants (N = 110) were randomized to receive 10 sessions of either: (a) CBT with interoceptive exposure (IE) to visceral sensations; (b) stress management (SM); or (c) an attention control (AC), and were assessed at baseline, mid-treatment, post-treatment, and follow-up sessions.ResultsConsistent with hypotheses, the IE group outperformed AC on several indices of outcome, and outperformed SM in some domains. No differences were observed between SM and AC. The results suggest that IE may be a particularly efficacious treatment for IBS.ConclusionsImplications for research and clinical practice are discussed.     

认知诊断CAT中项目曝光控制方法的比较

项目曝光率关系到题库建设和测验安全,是计算机化自适应测验(Computerized Adaptive Testing, CAT)需要考虑的重要问题。在认知诊断 CAT 情形下,首先基于传统 CAT 中 a-分层方法的思想提出按项目信息量对题库分层的分层多阶段(Stratified Multistage, SM)选题方法;然后将 SM 方法与项目合格(Item Eligibility, IE)方法相结合得到SMIE方法。在此基础上,开展模拟研究比较SM、IE、SMIE、最大修正优先指标(Maximum Modified Priority Index, MMPI)方法、限制阈值(Restrictive Threshold, RT)方法和限制进度(Restrictive Progressive, RPG)方法的选题表现。总体上,它们的测量精度从高到低依次为IE、SM、SMIE、RT、RPG和MMPI方法;项目曝光分布均匀性的优劣次序为MMPI、RPG、SMIE、RT、SM和IE方法;SMIE和RT方法能较好地平衡测量精度和项目曝光均匀性要求。     

Exploring how consumer cooperatives might strategically incorporate social media to distribute wine

This research advances our understanding of disruptions to marketing channels in the digital world by investigating the viability of consumer cooperative systems which are envisioned as multi-actor constructed networks using social media (SM) platforms. It introduces the concepts of “social media consumer wine cooperator” as a new distribution channel for wine and investigates the consumer's intention to participate in an SM and become a wine cooperator. Relying on the uses and gratifications theory (UGT), we adopted a quantitative research inquiry with data gathered using an online survey involving a sample of 486 French consumers. We empirically tested the relationships among four factors: attitude toward buying wine based on SM recommendations, perceived risks, intention to buy wine on SM, and consumer intention to become an SM wine cooperator. Findings indicate that the intention to be an SM wine cooperator is positively correlated with attitude toward buying wine based on SM recommendations and the intention to purchase wine on SM. To finish with, we link the concept of the consumer wine co-op to the current debate in the literature on centralized versus decentralized (built on top of blockchain networks) social media platforms, opening the door for future research avenues.     

Expanding Treatment Options for Children With Selective Mutism: Rationale,Principles, and Procedures for an Intensive Group Behavioral Treatment

Children with selective mutism (SM) experience significant challenges in a variety of social situations, leading to difficulties with academics, peers, and family functioning. Despite the extensive evidence base for cognitive-behavioral interventions for youth anxiety, the literature has seen relatively limited advancement in specialized treatment methods for SM. In addition, geographic disparities in SM treatment expertise and the roughly 6-month duration of some of the supported SM treatment protocols can further restrict the accessibility and acceptability of quality SM care. Intensive group behavioral treatment (IGBT) for SM was developed to expand the portfolio of evidence-based SM treatment options by offering brief, but high-dose, expert SM intervention in a group format for youth ages 3–10 years that can be completed in 1 week. In this article, we outline IGBT for SM program, which has already received initial support in a waitlist-controlled trial. Our presentation is organized around the five main components of the treatment model: (1) individual “lead-in” sessions, (2) camp (i.e., all-day group sessions for children held in a simulated classroom setting, with an emphasis on graduated exposures and structured reinforcement), (3) parent training, (4) school outreach, and (5) booster treatment, as needed. We conclude with a discussion of clinical considerations and future directions for further IGBT refinement and evaluation.     

Social Media Use and Creativity: Exploring the Influences on Ideational Behavior and Creative Activity

This study explored the relationship between social media (SM) use and creativity. The data collected from 407 participants included indicators such as time spent using SM, frequency of SM use, purposes for using SM, and the nature of SM use. The data involved two aspects of creativity: ideational behavior and creative activity and accomplishment. Correlational analyses indicate that SM use is positively related to both creativity measures. Overall, the active use of SM (e.g., sending a post) is more related to creativity than the passive use (e.g., reading others’ posts); and the link between creativity and SM use is more evident for certain platforms (i.e., Twitter) than others (e.g., Instagram). Ideational behavior and creative activity were also found to be higher among those who use SM primarily for expressing their ideas and opinions, gleaning information on topics to discuss and self‐education and learning compared with those who use it primarily for entertainment or relaxation. None of the creativity measures used was related to extraversion and excessive use of SM. Our findings indicate that SM is not necessarily a negative factor for creativity; it may even be a useful platform to support new ideas and projects.     

Selective Mutism in Children: Comparison to Youths With and Without Anxiety Disorders

Fifteen children with selective mutism (SM), 15 children with anxiety disorders (AD) without selective mutism, and 15 children without anxiety disorders or selective mutism (CN) were compared to examine the relationship between selective mutism and anxiety. Data were collected from children (age 4–10 years), parents, teachers, and clinicians. Results indicated that children with SM closely resemble children with AD. All children with SM received a diagnosis of social anxiety disorder and 53% received a diagnosis for an additional anxiety disorder. In addition, the SM and AD groups differed substantially from controls with respect to parent- and teacher-rated internalizing behavior problems. No differences among the groups were found with respect to parent-and teacher-reported externalizing behavior problems. The results are consistent with prior research emphasizing the association between selective mutism and anxiety disorders, and suggest that selective mutism may be conceptualized, assessed, and treated as an anxiety-related problem.     

Behavioral and Socio-emotional Functioning in Children with Selective Mutism: A Comparison with Anxious and Typically Developing Children Across Multiple Informants

We examined differences among 158 children, 44 with selective mutism (SM; M = 8.2 years, SD = 3.4 years), 65 with mixed anxiety (MA; M = 8.9 years, SD = 3.2 years), and 49 community controls (M = 7.7 years, SD = 2.6 years) on primary caregiver, teacher, and child reports of behavioral and socio-emotional functioning. Children with SM were rated lower than controls on a range of social skills, but the SM and MA groups did not significantly differ on many of the social skills and anxiety measures. However, children with SM were rated higher than children with MA and controls on social anxiety. Findings suggest that SM may be conceptualized as an anxiety disorder, with primary deficits in social functioning and social anxiety. This interpretation supports a more specific classification of SM as an anxiety disorder for future diagnostic manuals than is currently described in the literature. The present findings also have implications for clinical practice, whereby social skills training merits inclusion in intervention for children with anxiety disorders as well as children with SM.     

Component analysis of verbal versus spatial working memory training in adolescents with ADHD: A randomized,controlled trial

Adaptive training of working memory (WM) using the Cogmed-RM intervention has recently shown some efficacy as an alternative treatment for ADHD, but this intervention may not be optimally designed. A recent component analysis of WM has suggested that maintenance in primary memory (PM) appears to be largely intact whereas recall from secondary memory (SM) appears to be deficient in ADHD relative to age-matched controls. However, extrapolating from basic research, there is reason to believe that Cogmed-RM may target the PM component more than the SM component; though training with spatial exercises may target the SM component more than training with verbal exercises. To investigate, participants diagnosed with ADHD were randomly assigned to either a verbal training condition (n?=?24) or a spatial training condition (n?=?23) using a randomized, controlled design, and both groups were instructed to complete at least 20 days of training. The PM and SM components of WM were assessed immediately before and after training using both verbal and spatial free recall tasks. The main findings showed that both versions of the intervention enhanced the maintenance of information in PM regardless of test modality, but not the recall of information from SM. Therefore, the component of WM that is improved by Cogmed-RM is not the same component of WM that is deficient in ADHD.     

Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder

In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.

     

用科学的证据和科学的管理指引心血管疾病的防治

心血管疾病的防治不仅仅是心血管医生的问题,还是一个在循证医学引领下的一个全民生活方式改变的问题,也需要多学科相关专业的联盟,涉及心血管疾病治疗规范的形成与普及,对于疾病发生、发展各个阶段的科学管理更是冠心病的防治效果的重要保障。本文针对心血管病冠心病预防的具体实施,从几方面打开了一个全新的视野。     

Personality Correlates of the Common and Unique Variance Across Conduct Disorder and Substance Misuse Symptoms in Adolescence

Externalising behaviours such as substance misuse (SM) and conduct disorder (CD) symptoms highly co-occur in adolescence. While disinhibited personality traits have been consistently linked to externalising behaviours there is evidence that these traits may relate differentially to SM and CD. The current study aimed to assess whether this was the case, after examining the nature of the relationship between SM and CD symptoms in an adolescent sample (N?=?392), using structural equation modelling. Similar to those found in adults (Krueger et al. Journal of Abnormal Psychology 116: 645-666, 2007), results showed that CD and SM symptoms were organized hierarchically, with symptoms explaining a single broad, coherent construct of externalising behaviour, but also explaining specific factors of SM and CD that vary independently from the general externalising factor. Furthermore, disinhibited personality traits related differentially to these factors, with results showing that, even controlling for inhibited personality traits, impulsivity was associated with CD and the common variance shared by CD and SM, while sensation seeking was specifically associated with SM only. Hopelessness was also associated with the common variance shared by SM and CD. Results confirm impulsivity, hopelessness and sensation seeking as key correlates of externalising behaviour problems in adolescence, identifying them as clear targets for intervention and prevention strategies.     

Mental imagery and the distinction between primary and secondary memory

Previous research has shown that the imageability of stimulus material affects the secondary memory (SM) component of free recall, but not the primary memory (PM) component, and that a negative recency effect is only observed for material of high imageability. It was found that interactive imagery instructions affected the SM component, but not the PM component; separative imagery instructions led to an increased PM component and a reduced SM component. A negative recency effect can be observed in an initial, delayed recall test. However, it is removed by imagery mnemonic instructions. This supports the idea that the negative recency effect is caused by the fact that subjects do not normally image the last few words presented in a free-recall task.     

打坐健身机制新探

打坐是一种席地端坐时将两腿交叉相压并调息入静的锻炼方式。打坐行为历史悠久,具有良好的健身作用,近年还发现对心脑血管疾病有一定治疗康复作用。但在中国由于打坐经常被认为属于宗教修炼而被普通大众忽视。本文将打坐与宗教分离开来,通过现代医学理论从调整呼吸、入静、远程缺血预适应保护等对神经系统、内脏功能（肺、消化系统、心血管系统及淋巴循环功能）的影响方面探讨了打坐的健身机制,为进一步研究并向大众推广这种安全有效的健身方法提供一管之见。特别是对心血管系统的保护作用值得进一步研究利用。     

Application of the dual-component model of working memory to ADHD:Greater secondary memory deficit despite confounded cognitive differences

The dual-component model postulates that working memory capacity consists of two dissociable components: maintenance in primary memory (PM) and retrieval from secondary memory (SM). Recent application of this model to attention-deficit/hyperactivity disorder (ADHD) has revealed that the SM component is more deficient than the PM component across both verbal and spatial modalities. The present study attempts to strengthen this conclusion by addressing two weaknesses in the previous study. First, the present study shows that the SM component continues to be more deficient than the PM component across both modalities under conditions in which (1) all participants were instructed to use the same recall strategy (resulting in the exclusion of fewer participants); and, (2) individual differences in this strategy were controlled. Second, the present study also documents a group difference in word reading efficiency that is confounded with diagnostic status and that might have influenced estimates of PM and SM capacities in the verbal modality. However, although the SM component is more deficient than the PM component in the ADHD group, the magnitude of this interaction does not vary as a function task modality. These findings are interpreted to suggest that the pattern of WM deficiencies observed are part of a causal pathway that can lead to the symptoms of ADHD, as well as to impairments in reading (and intelligence) due to overlapping cue-dependent retrieval mechanisms. These findings provide additional support for the notion that the SM component of WM is an important and neglected target for treatment.     

Two models of adolescent self-mutilation

Currently little research exists examining the theoretical underpinnings of self-mutilation (SM) in community samples of adolescents. Two models, the hostility and anxiety reduction models, were simultaneously tested in order to determine whether SM in adolescence was characterized by greater feelings of anxiety and hostility. Four hundred and forty students were screened for the presence of SM. Sixty-one students who indicated that they hurt themselves as well as a comparison group of non-SM students completed the Hostility and Direction of Hostility Questionnaire (HDHQ), the Beck Anxiety Inventory (BAI), and an interview. Results indicate support for the hostility model of SM. Students who SM reported significantly more anxiety and more intropunitive and extrapunitive hostility. In addition, prior to self-mutilating feelings of both hostility and anxiety were described. Results are discussed with reference to both theoretical models.     

Burn-out

At first the concept of burnout will be critically reflected in the context of the discussion in a position paper of the German Society for Psychiatry Psychotherapy and Neurology. An investigation of preventive stress management interventions at the workplace will be reported. The treatment concept of the day clinic of the Department for Psychosomatic Medicine and Psychotherapy of the Munich-Harlaching hospital for occupational stress-related disorders will be presented. An empirical study of the effectiveness of this treatment will be reported comparing patients with occupational stress-related disorders (n?=?95) to other patients treated in the day clinic during the same time interval (n?=?154). Furthermore, a qualitative analysis of 102 patient charts with occupational stress-related disorders will be described. Two case histories typical for mental health disease with burnout syndrome are presented to illustrate the conclusions.     

Fabry disease in genetic counseling practice: recommendations of the National Society of Genetic Counselors

The objective of this document is to provide health care professionals with recommendations for genetic counseling and testing of individuals with a suspected or confirmed diagnosis of Fabry disease, with a family history of Fabry disease, and those identified as female carriers of Fabry disease. These recommendations are the opinions of a multicenter working group of genetic counselors, medical geneticists, and other health professionals with expertise in Fabry disease counseling, as well as an individual with Fabry disease who is a founder of a Fabry disease patient advocacy group in the United States. The recommendations are U.S. Preventive Task Force Class III, and they are based on clinical experience, a review of pertinent English-language articles, and reports of expert committees. This document reviews the genetics of Fabry disease, the indications for genetic testing and interpretation of results, psychosocial considerations, and references for professional and patient resources. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a healthcare provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

Investigating the variability of memory distortion for an analogue trauma

In this paper, we examine whether source monitoring (SM) errors might be one mechanism that accounts for traumatic memory distortion. Participants watched a traumatic film with some critical (crux) and non-critical (non-crux) scenes removed. Twenty-four hours later, they completed a memory test. To increase the likelihood participants would notice the film's gaps, we inserted visual static for the length of each missing scene. We then added manipulations designed to affect people's SM behaviour. To encourage systematic SM, before watching the film, we warned half the participants that we had removed some scenes. To encourage heuristic SM some participants also saw labels describing the missing scenes. Adding static highlighting, the missing scenes did not affect false recognition of those missing scenes. However, a warning decreased, while labels increased, participants' false recognition rates. We conclude that manipulations designed to affect SM behaviour also affect the degree of memory distortion in our paradigm.     

P50 Suppression in Children with Selective Mutism: a Preliminary Report

Evidence suggests that children with selective mutism (SM) display significant aberrations in auditory efferent activity at the brainstem level that may underlie inefficient auditory processing during vocalization, and lead to speech avoidance. The objective of the present study was to explore auditory filtering processes at the cortical level in children with SM. The classic paired-click paradigm was utilized to assess suppression of the P50 event-related potential to the second, of two sequentially-presented clicks, in ten children with SM and 10 control children. A significant suppression of P50 to the second click was evident in the SM group, whereas no suppression effect was observed in controls. Suppression was evident in 90% of the SM group and in 40% of controls, whereas augmentation was found in 10% and 60%, respectively, yielding a significant association between group and suppression of P50. P50 to the first click was comparable in children with SM and controls. The adult-like, mature P50 suppression effect exhibited by children with SM may reflect a cortical mechanism of compensatory inhibition of irrelevant repetitive information that was not properly suppressed at lower levels of their auditory system. The current data extends our previous findings suggesting that differential auditory processing may be involved in speech selectivity in SM.