Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States. 相似文献
Objective: The study set out to investigate socio-economic, biomedical, health and behavioural and psychological factors in childhood and adulthood associated with the prevalence of asthma in adulthood, drawing data from The National Child Development Studies (NCDS), a birth cohort in the UK.
Design: The National Child Development Study, a nationally representative sample of 17,415 babies born in Great Britain in 1958 and followed up at 7, 11, 33 and 50 years was used.
Main Outcome Measure: The prevalence of asthma at age 50 was the outcome measure. The analytic sample consists of 5118 participants with complete data on a set of measures at birth, at ages 7, 11, 33 and 50 years.
Results: Using logistic regression analyses, results showed that childhood asthma (OR = 6.77: 4.38–10.48, p < .001) and respiratory symptoms (OR = 1.83: 1.18–2.86, p < .01), maternal smoking during pregnancy (OR = 1.26: 1.00–1.59, p < .05), Body and Mass Index (BMI) (OR = 1.03: 1.02–1.05, p < .001), traits Neuroticism (OR = 1.13: 1.01–1.21, p < .05) and Conscientiousness (OR = 0.76: 0.76–0.96, p < .01), as well as sex (OR = 1.49: 1.15–1.94, p < .001) were all significantly associated with the prevalence of asthma in adulthood.
Conclusion: The study shows that both childhood and adulthood psychological and sociological factors are significantly associated with the prevalence of asthma in adulthood, though more work need to be done in this area. 相似文献
Reading the non‐verbal cues from faces to infer the emotional states of others is central to our daily social interactions from very early in life. Despite the relatively well‐documented ontogeny of facial expression recognition in infancy, our understanding of the development of this critical social skill throughout childhood into adulthood remains limited. To this end, using a psychophysical approach we implemented the QUEST threshold‐seeking algorithm to parametrically manipulate the quantity of signals available in faces normalized for contrast and luminance displaying the six emotional expressions, plus neutral. We thus determined observers' perceptual thresholds for effective discrimination of each emotional expression from 5 years of age up to adulthood. Consistent with previous studies, happiness was most easily recognized with minimum signals (35% on average), whereas fear required the maximum signals (97% on average) across groups. Overall, recognition improved with age for all expressions except happiness and fear, for which all age groups including the youngest remained within the adult range. Uniquely, our findings characterize the recognition trajectories of the six basic emotions into three distinct groupings: expressions that show a steep improvement with age – disgust, neutral, and anger; expressions that show a more gradual improvement with age – sadness, surprise; and those that remain stable from early childhood – happiness and fear, indicating that the coding for these expressions is already mature by 5 years of age. Altogether, our data provide for the first time a fine‐grained mapping of the development of facial expression recognition. This approach significantly increases our understanding of the decoding of emotions across development and offers a novel tool to measure impairments for specific facial expressions in developmental clinical populations. 相似文献
The regulated trafficking of GluR1 contributes significantly to synaptic plasticity, but studies addressing the function of the GluR1 C-terminal PDZ-ligand domain in this process have produced conflicting results. Here, we resolve this conflict by showing that apparently similar C-terminal mutations of the GluR1 PDZ-ligand domain result in opposite physiological phenotypes during activity- and CamKII-induced synaptic plasticity. 相似文献
There is converging evidence that 1%-2% of women develop post-traumatic stress disorder (PTSD) as a result of childbirth. The current study aimed to explore the long-term effects of childbirth-related PTSD on women, their relationship with their partner and their relationship with their child. Semi-structured interviews were carried out with six women who reported clinically significant PTSD after birth, ranging from 7 months to 18 years beforehand. Interviews were transcribed and analysed using thematic analysis. Childbirth-related PTSD was found to have wide-ranging effects on women and their relationships. Women reported changes in physical well-being, mood and behaviour, social interaction, and fear of childbirth. Women reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for events of birth. The mother-baby bond was also seriously affected. Nearly all women reported initial feelings of rejection towards the baby but this changed over time. Long-term, women seemed to have either avoidant or anxious attachments with their child. It is concluded that childbirth-related PTSD can have severe and lasting effects on women and their relationships with their partner and children. Further research is needed to compare this to normal difficulties experienced by women after having children. 相似文献