Predictors of Heart-Focused Anxiety in Patients Undergoing Genetic Investigation and Counseling of Long QT Syndrome or Hypertrophic Cardiomyopathy: A One Year Follow-up

Since Long QT syndrome and Hypertrophic cardiomyopathy are inherited cardiac disorders that may cause syncope, palpitations, serious arrhythmias, and sudden cardiac death, at-risk individuals may experience heart-focused anxiety. In a prospective multi-site study, 126 Norwegian patients attending genetic counseling were followed 1 year with multiple administration of questionnaires, including the Cardiac Anxiety Questionnaire, measuring three distinct symptoms of heart-focused anxiety- avoidance, attention, and fear—in mixed linear analyses. Overall, at 1-year follow-up, patients with clinical diagnosis as compared to patients at genetic risk had significantly higher scores of avoidance (p < .002), attention (p < .005), and fear (p < .007). Sudden cardiac death in close relatives, uncertainty whether other relatives previously had undergone genetic testing, patients’ perceived general health, self-efficacy expectations and procedural satisfaction with genetic counseling were influential in predicting the different symptoms of heart-focused anxiety over time.     

The dual-effects model of social control revisited: relationship satisfaction as a moderator

The dual-effects model of social control states that receiving social control leads to better health behavior, but also enhances distress in the control recipient. Associated findings, however, are inconsistent. In this study we investigated the role of relationship satisfaction as a moderator of associations of received spousal control with health behavior and affect. In a study with five waves of assessment spanning two weeks to one year following radical prostatectomy (RP), N=109 married or cohabiting prostate-cancer patients repeatedly reported on their pelvic-floor exercise (PFE) to control postsurgery urinary incontinence and affect as primary outcomes, on received PFE-specific spousal control, relationship satisfaction, and covariates. Findings from two-level hierarchical linear models with repeated assessments nested in individuals suggested significant interactions of received spousal control with relationship satisfaction predicting patients' concurrent PFE and positive affect. Patients who were happy with their relationships seemed to benefit from spousal control regarding regular PFE postsurgery while patients less satisfied with their relationships did not. In addition, the latter reported lower levels of positive affect when receiving much spousal control. Results indicate the utility of the inclusion of relationship satisfaction as a moderator of the dual-effects model of social control.     

The role of a lifetime history of oppositional defiant and conduct disorders in adults with ADHD: implications for clinical practice

IntroductionAttention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are frequently co-occurring disorders in children and adolescents. However, their clinical status among adults is still under discussion. This study analyzes how the current clinical presentation of adult ADHD might be influenced by a lifetime history of CD and ODD. METHODS: We compared three groups of patients: ADHD without history of CD/ODD (n = 178), ADHD + history of ODD (n = 184), and ADHD + history of CD (n = 96). RESULTS: A history of CD (and to a lower extent ODD) is associated with a more severe and externalizing profile.ConclusionPast CD and ODD entail a significant negative mental health impact on persistent ADHD, reinforcing the importance of actively assessing the developmental history of adult ADHD patients.     

Are head cues necessary for goats (Capra hircus) in recognising group members?

In this study, we investigated whether goats can distinguish a member of their own group from one belonging to a different group even when the head of the goat in question cannot be seen. In the experiment, a total of 45 adult female goats (walkers) were trained to walk along a passageway at the end of which they learnt to expect food (trial run). Walking down this corridor, they passed another adult female goat (stimulus goat) whose trunk and hind legs alone were visible. Using 19 individuals, ten pairs of stimulus goats consisting of one goat from the walker's group and one from a different group were matched in terms of body size, constitution, colour and coat length. In addition, the stimulus goat from the same group as the walker had to be higher ranking than the latter to avoid being attacked. The walkers completed two, four or six trial runs depending on the number of pairs suitable for a given walker. The walker's exploratory behaviour (observing and sniffing at the stimulus goat) was recorded. Data from 109 trial runs were analysed using generalised linear mixed-effects models with crossed random effects. On average, the walker spent a total of 8.7?s exploring the stimulus goat visually and olfactorily if the latter was from a different group and only about half as long (4.2?s) if it was from her own group. In particular, the time a walker spent observing a stimulus goat whilst approaching the latter was significantly longer if the stimulus goat belonged to a different group than to her own (2.5?s as opposed to 1.4?s). Moreover, a stimulus goat from a different group was sniffed at significantly longer (4.6?s) than one from the same group (1.9?s). Results suggest that goats can easily discriminate between members of their own group and those of a different group even when the latter's heads are hidden. Olfactory and visual cues are probably important for identifying group members.     

Attentional bias to negative information and 5-HTTLPR genotype interactively predict students' emotional reactivity to first university semester

People strongly differ in their emotional reactions to potentially stressing and challenging environmental circumstances. Two classes of individual differences have independently been reported to contribute to such emotional vulnerability: an attentional bias to negative information and a variation in the serotonin transporter gene (5-HTTLPR). The present study was conducted to investigate the possibility that these cognitive and genetic markers interact in their prospective prediction of emotional reactivity to an extended and mild potential stressor. Changes in dysphoria and anxiety across their first university semester were measured in 120 students. Results indicate that attentional bias toward negative information on Week 1 of the semester significantly predicted cross-semester changes in both anxiety and dysphoria. For the latter, this predictive capacity depended on the 5-HTTLPR genotype. Specifically, only in homozygous carriers of the 5-HTTLPR short allele did attentional bias to negative information on Week 1 significantly predict cross-semester change in dysphoria. These results carry important theoretical and practical implications concerning the ability to identify individuals vulnerable to experiencing elevated emotional reactivity to potentially stressing life-events.     

We’ve Come a Long Way,Baby!: Evolution and Revolution in CBT with Youth

As the gold standard in psychotherapy with children and adolescents, cognitive behavioral therapy (CBT) earned its stripes through the years. CBT evolved from treating individual disorders with single protocols to embracing a modular and transdiagnostic approach. Despite this impressive evolution, CBT initiated a revolution that continues to provide services to patients in this new era. CBT must maintain momentum to fuel progress and drive clinical reform. In this article, the need for training and dissemination are discussed. Revolutionary practices and delivery methods are suggested. CBT continues to push the envelope of revolution by partnering with neuroscience to bridge the gap between brain and body. Integrating findings from neuroscience with CBT-spectrum approaches and non-traditional treatment formats provides theoretical flexibility and additional treatment options for clinicians. Culturally-friendly applications to treat diverse youth and the use of common modules from third wave approaches are suggested. The use of technology such as smartphones, computers, and videogames is encouraged. Offering treatment in non-traditional settings and formats such as CBT-based camp programs is also addressed.     

Individuelle Therapiezielerreichung nach Gruppentherapie „SAVE“

Background

Adolescents with attention deficit hyperactivity disorder (ADHD) are severely impaired in routine daily activities in the same way as adults. Therapy programs focus on improving everyday behavior. Goal attainment scaling (GAS) has already proven to be a suitable instrument for assessing treatment success with adult ADHD patients.

Material and methods

Goal attainment scaling was used in addition to standardized self-evaluation of core symptoms of ADHD in 49 adolescents aged 12-18 years old with a mean age of 14.14 years (standard deviation SD±1.59 years) with ADHD to operationalize treatment success of the cognitive behavior group therapy program SAVE. Behavior-oriented aims and criteria for target achievement were set. To examine treatment success changes were assessed at different time points (10 weeks before treatment, process evaluation during treatment and after treatment).

Results

The adolescents in this study were able to define relevant goals together with the therapists. They focused on goals concerning organization of everyday life, attention, distraction and power of endurance. Goals were reached from the beginning of the study to post-evaluation, even before SAVE started, with great effects (d?=?1.85). Adolescents evaluated changes in symptoms during the course of the SAVE program in general (d?=?0.47) and attention deficits (d?=?0.45) as having significant effects. The reduction in symptoms (attention) was only moderately correlated with the target achievement.

Conclusion

The GAS method has been proven to be a practical instrument to assess treatment success for adolescents with ADHD. Further studies in a controlled design should focus on assessment of the influence of GAS as an intervention method.     

Some comments on “the silent cry” by mona serenius

Abstract

An unusual subjective account of war-time experience of the evacuation of Finnish children to Sweden. In retrospect, certain patterns of traumausation appear, especially in the psychological defences clearly related to separation, alienation, and frequently, the need to change language. I compare and contrast the Finnish experience with evacuations in the UK, which were overall less traumatic. Some psychoanalytic sources are supplied, relevant to the experiences, and to the characterological sequelae in the adults later. I criticise the majority of the post-war “scientific” reports on the data. Special reference is made to the value of the Finnish and Swedish War-Children's Societies.