Clinical and epidemiological data suggest that generalized anxiety disorder (GAD) is a chronic illness causing patients to suffer for many years leading to significant distress in daily life functioning. The literature suggests the several conclusions. GAD is a disorder in need of appropriate treatment and often has a chronic course with comorbid conditions, such as major depression and other anxiety disorders. Benzodiazepines, while effective anxiolytic agents acutely, when prescribed for >4 weeks cause rebound anxiety and following prolonged therapy may lead to withdrawal symptoms. Antidepressants cause significant anxiety relief compared with placebo and for psychosocial treatment cognitive-behavioral therapy is an efficacious psychosocial treatment. Many GAD patients are in need of long-term medication management. Furthermore, there is limited data for patients diagnosed with GAD the treatment outcome with the combination of medication and psychotherapy both acutely and long-term; how to best sequence these treatments; for those patients who do not meet remission criteria what is the ideal approach for augmentation; and for patients with treatment-refractory GAD the empirical evidence is lacking on medication switching and augmentation strategies. Research is needed in the area of developing treatment strategies for patients suffering from treatment-refractory GAD. There is still an urgent need to explore treatment combinations and duration strategies in the management of patients suffering with GAD. 相似文献
Rats were trained in Experiment 1 to find a submerged platform in 1 corner of either a rectangular or a kite-shaped pool. When the walls creating this corner were a different color than the opposite walls, then learning about the shape of the pool was potentiated in the kite but not in the rectangle. Experiments 2-4 revealed that learning about the rectangle can be overshadowed and blocked when information about the wall color indicates the location of the platform. The results mimic findings that have been obtained with Pavlovian conditioning, and they challenge the claim that learning about the shape of the environment takes places in a dedicated geometric module. 相似文献
In 3 experiments rats had to find a submerged platform that was located in a corner of a kite-shaped pool. The color of the walls creating this corner provided an additional cue for finding the platform in the shape + color condition but not the shape-only condition. During tests in a pool with walls of a uniform color but no platform, more time was spent in the corner where the platform was originally located after training in the shape + color than in the shape-only condition. The results challenge theories that assume either that learning about the shape of the environment takes place in a dedicated module or that cues compete for the control they acquire over behavior. 相似文献
Some critics have claimed that Spinoza's philosophy has nothing to offer aesthetics. I argue that within his conception of an ars vivendi one can discern a nascent theory of art (ars). I bring the figure of the prophet in relation to that of the artist and, alongside a consideration of Spinoza's views on goodness and beauty, show that the special talent of the artist should be understood in terms of the entirely natural expression of the conatus. 相似文献
Background: People living in poverty face multiple structural challenges to medication adherence including lack of transportation, inadequate housing and food insecurity. The degree to which individuals’ motivations to remain adherent may overcome structural barriers has received limited attention.
Purpose: To examine whether medication necessity and concerns beliefs predict antiretroviral therapy (ART) adherence over and above structural adherence barriers associated with poverty.
Methods: People living with HIV in a southern US city (N = 942) completed computerised interviews, an objective measure of adherence and HIV viral suppression obtained from medical records. Hierarchical logistic regression models were constructed to examine demographic and illness characteristics, structural barriers, mental health, substance use and medication necessity and concerns beliefs as predictors of ART adherence.
Results: In multivariable models, current drug use and medication necessity and concerns beliefs predicted treatment adherence over and above demographic, health, mental health and structural factors.
Conclusions: Medication beliefs are proximal and powerful motivating factors that predict adherence. Adherence interventions should directly address medication beliefs in developing strategies to manage barriers facing people with HIV living in poverty. 相似文献
Research on Child and Adolescent Psychopathology - Caregivers play a central role in promoting emotion regulation throughout infancy, childhood, and adolescence. However, there are no existing... 相似文献
Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology.
Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared
adolescent self injury with adolescent depression on biological, self-, and informant-report markers of vulnerability and
risk. Such a comparison may have important implications for treatment, prevention, and developmental models of self injury
and borderline personality disorder. We used a multi-method, multi-informant approach to examine how adolescent SII differs
from adolescent depression. Self-injuring, depressed, and typical adolescent females (n = 25 per group) and their mothers completed measures of psychopathology and emotion regulation, among others. In addition,
we assessed electrodermal responding (EDR), a peripheral biomarker of trait impulsivity. Participants in the SII group (a)
scored higher than depressed adolescents on measures of both externalizing psychopathology and emotion dysregulation, and
(b) exhibited attenuated EDR, similar to patterns observed among impulsive, externalizing males. Self-injuring adolescents
also scored higher on measures of borderline pathology. These findings reveal a coherent pattern of differences between self-injuring
and depressed adolescent girls, consistent with theories that SII differs from depression in etiology and developmental course. 相似文献