Economic Impact of Third-Wave Cognitive Behavioral Therapies: A Systematic Review and Quality Assessment of Economic Evaluations in Randomized Controlled Trials

The term third-wave cognitive behavioral therapy (CBT) encompasses new forms of CBT that both extend and innovate within CBT. Most third-wave therapies have been subject to randomized controlled trials (RCTs) focused on clinical effectiveness; however, the number and quality of economic evaluations in these RCTs has been unknown and may be few. Evidence about efficiency of these therapies may help support decisions on efficient allocation of resources in health policies. The main aim of this study was to systematically review the economic impact of third-wave therapies in the treatment of patients with physical or mental conditions. We conducted a systematic literature search in PubMed, PsycINFO, EMBASE, and CINALH to identify economic evaluations of third-wave therapies. Quality and Risk of Bias (RoB) assessment of economic evaluations was also made using the Drummond 35-item checklist and the Cochrane Collaboration’s tool for assessing risk of bias, respectively. Eleven RCTs were included in this systematic review. Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and extended Behaviour Activation (eBA) showed acceptable cost-effectiveness and cost-utility ratios. No study employed a time horizon of more than 3 years. Quality and RoB assessments highlight some limitations that temper the findings. There is some evidence that MBCT, MBSR, ACT, DBT, and eBA are efficient from a societal or a third-party payer perspective. No economic analysis was found for many third-wave therapies. Therefore, more economic evaluations with high methodological quality are needed.     

Basolateral amygdala noradrenergic activity is involved in the acquisition of conditioned odor aversion in the rat

Conditioned odor aversion (COA) is the avoidance of an odorized-tasteless solution (the conditioned stimulus, CS), the ingestion of which precedes toxicosis. Previous works have shown that the basolateral nucleus of the amygdala (BLA) is involved in the acquisition, and more precisely, the control of the CS memory trace, of COA. Since catecholamine depletion of the amygdala induced a deficit in the potentiated version of COA, this study investigated the role of the adrenergic system in the BLA during COA. Male Wistar rats bilaterally implanted with cannulae aimed at the BLA were microinjected with the beta-adrenergic antagonist propranolol (1 microg/0.2 microl) during the acquisition (5 min before the CS presentation, pre-CS, or immediately after, post-CS) or during the retrieval test (5 min before test, pre-test). Results showed that pre-CS, but neither post-CS nor pre-test, infusions of propranolol impaired COA, suggesting that beta-adrenergic system activity in the BLA is involved in the acquisition but not the expression of COA. Moreover, the fact that pre-CS, but not post-CS, treatment disrupted COA suggests that beta-adrenergic system in the BLA is involved in the initiation but not the maintenance of the CS memory trace during COA acquisition.     

Commuting Conversions vs. the Standard Conversions of the “Good” Connectives

Commuting conversions were introduced in the natural deduction calculus as ad hoc devices for the purpose of guaranteeing the subformula property in normal proofs. In a well known book, Jean-Yves Girard commented harshly on these conversions, saying that ‘one tends to think that natural deduction should be modified to correct such atrocities.’ We present an embedding of the intuitionistic predicate calculus into a second-order predicative system for which there is no need for commuting conversions. Furthermore, we show that the redex and the conversum of a commuting conversion of the original calculus translate into equivalent derivations by means of a series of bidirectional applications of standard conversions. Presented by Heinrich Wansing and Jacek Malinowski     

Does hand dominance affect the use of motor abundance when reaching to uncertain targets?

This study investigated hemispheric differences in utilizing motor abundance to achieve flexible patterns of joint coordination when reaching to uncertain target locations. Right-handed participants reached with each arm to the same central target when its final location was certain or when there was a 66% probability that its location could change after movement initiation. Use of greater motor abundance was observed when participants reached to the central target under target location uncertainty regardless of the arm used to reach. Joint variance associated with variability of movement direction was larger when reaching with the left, non-dominant arm. This arm also exhibited higher hand path variability compared to the dominant arm. These arm differences were not found when the final (central) target location was known in advance. The results provide preliminary evidence for a greater ability of the dominant (right) arm/left hemisphere to decouple directions in joint space. That is, to increase the use of motor abundance without simultaneously inducing unwanted hand path variability requires that joint variations be restricted to a limited subspace of joint space. Hemispheric differences in motor planning did not appear to account for arm differences related to the use of motor abundance.     

State and Trait Anger Predicting Creative Process Engagement—The Role of Emotion Regulation

Drawing on the specific emotion approach, and based on the emotional regulation theory and cognitive and activation perspectives on emotions, this study examined the differentiated impact of state and trait anger on creative process engagement (CPE) and the moderating influences of emotion reappraisal and suppression. Data were obtained from daily surveys (N = 422) of 98 employees from three consultancy companies. Hierarchical linear modeling analysis revealed that trait anger has a stronger impact on CPE than state anger does. Furthermore, the relationship between state anger and CPE is stronger when emotion reappraisal is lower, rather than higher, and the relationship between trait anger and CPE is also stronger when emotion suppression is lower, rather than higher.     

Studying psychotherapy change in narrative terms: The innovative moments method

This paper aims to describe the Innovative Moments (IM) Coding System (IMCS), an idiographic and transtheoretical methodology that allows the identification of IMs—markers of changes in the client's initial maladaptive framework of meaning—throughout psychotherapy. The present study introduces the theoretical background underlying this methodology, along with the main empirical findings resulting from former studies that have applied this tool to clinical data. The IMCS application is also detailed: the coding phases, the training steps and inter‐rater agreement measures. In order to illustrate the application of IM coding, a case study is presented. Although a partial coding was used, the results are in line with previous research. Discussion is centred on the usefulness of the IMCS for the advance of process research in psychotherapy, and the potential use of this methodology in group format.     

j. Kellenberger,Kierkegaard and Nietzsche: Faith and Eternal Acceptance

International Journal for Philosophy of Religion -     

Automatic detection of bunches of grapes in natural environment from color images

Despite the benefits of precision agriculture and precision viticulture production systems, its rate of adoption in the Portuguese Douro Demarcated Region remains low. We believe that one way to raise it is to address challenging real-world problems whose solution offers a clear benefit to the viticulturist. For example, one of the most demanding tasks in wine making is harvesting. Even for humans, the environment makes grape detection difficult, especially when the grapes and leaves have a similar color, which is generally the case for white grapes. In this paper, we propose a system for the detection and location, in the natural environment, of bunches of grapes in color images. This system is able to distinguish between white and red grapes, and at the same time, it calculates the location of the bunch stem. The system achieved 97% and 91% correct classifications for red and white grapes, respectively.     

Role of cholinergic system on the construction of memories: taste memory encoding

There is a large body of evidence suggesting that cholinergic activity is involved in memory processes. It seems that cholinergic activity is essential to learn several tasks and recent works suggest that acetylcholine plays an important role during the early stages of memory formation. In this review, we will discuss the results related to taste memory formation, focusing particularly on the conditioned taste aversion paradigm. We will first give evidence that nucleus basalis magnocellularis is involved in taste memory formation, due to its cholinergic projections. We then show that the cholinergic activity of the insular (gustatory) cortex is related to the taste novelty, and that the cholinergic signals initiated by novelty are crucial for taste memory formation. Then we present recent data indicating that cortical activation of muscarinic receptors is necessary for taste trace encoding, and also for its consolidation under certain circumstances. Finally, interactions between the cholinergic and other neuromodulatory systems inducing intracellular mechanisms related to plastic changes will be proposed as important processes underlying gustatory memory trace storage.     

Is Committed Desire Intentional? A Qualitative Exploration of Sexual Desire and Differentiation of Self in Couples

The question of what heightens or diminishes sexual desire has long been a passionate theme across cultures in literature, arts, media, and medicine. Yet, little research has been conducted to determine what affects level of desire within couples. The degree of differentiation of self has been suggested as an important variable in shaping partners' level of desire. Through a qualitative analysis of dyadic couple interviews, this study provides an account of characteristics, processes, and trajectories of sexual desire and differentiation in 33 heterosexual couples of varying ages and relationship duration. Factors associated with high desire were change and autonomy, whereas conflict and children were reported to be desire‐diminishing factors. Innovation, sharing, autonomy, and effort emerged as desire‐promoting strategies, while fostering personal interests, investing in a positive connection, and enhancing personal integrity were identified as couples' strategies to promote and preserve differentiation of self. The results also shed light on couples' perceptions of whether and how sexual desire changes over the course of the relationship and challenge common cultural assumptions about desire in committed relationships—namely the myth that the only authentic expression of desire is that which occurs spontaneously and without intention and planning. Implications for couple therapy are discussed.