Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: A pilot study

IntroductionChronic pain is difficult to treat and often precedes or exacerbates sleep disturbances such as insomnia. Insomnia, in turn, can amplify the pain experience. Both conditions are associated with inflammatory processes, which may be involved in the bi-directional relationship between pain and sleep. Cognitive behavioral therapy (CBT) for pain and CBT for insomnia are evidence based interventions for, respectively, chronic pain and insomnia. The study objectives were to determine the feasibility of combining CBT for pain and for insomnia and to assess the effects of the combined intervention and the stand alone interventions on pain, sleep, and mood outcomes compared to a control condition.MethodsTwenty-one adults with co-occurring chronic pain and chronic insomnia were randomized to either CBT for pain, CBT for insomnia, combined CBT for pain and insomnia, or a wait-list control condition.ResultsThe combined CBT intervention was feasible to deliver and produced significant improvements in sleep, disability from pain, depression and fatigue compared to the control condition. Overall, the combined intervention appeared to have a strong advantage over CBT for pain on most outcomes, modest advantage over both CBT for insomnia in reducing insomnia severity in chronic pain patients.DiscussionCBT for pain and CBT for insomnia may be combined with good results for patients with co-occurring chronic pain and insomnia.     

Exploring the Meaning of Spirituality and Spiritual Care in Chinese Contexts: A Scoping Review

Journal of Religion and Health - Spirituality is recognised as a fundamental aspect of health and nursing care. Yet, there are few studies exploring how this concept may be understood outside of...     

Transference,Catharsis, Insight and Reality Testing during Concomitant Individual and Group Psychotherapy

The authors argue that shame is a core issue for many men who assault their partners. Shame must therefore be addressed in treatment groups. This article outlines how one intervention, “the confession,” elicits shame and how that shame is negotiated through the various stages of group development.     

Posttraumatic Reactions among Firefighters after Critical Incidents: Cross-National Data

The presence of posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) following a critical incident were examined among firefighters from eight predominantly European countries. A sample of 1916 firefighters completed the Impact of Event Scale–Revised (IES–R) and the Posttraumatic Growth Inventory–Short Form (PTGI–SF) with reference to a critical incident they had experienced. Analyses indicated both negative and positive posttraumatic outcomes could derive from experiencing critical incidents in the line of duty. The analyses also showed country differences exist regarding firefighters’ PTSD symptoms and PTG. It is recommended that future researchers examine factors that could evoke such national differences.     

Uterine Transplant: A Risk to Life or a Chance for Life?

Science and Engineering Ethics - Being inherently different from any other lifesaving organ transplant, uterine transplantation does not aim at saving lives but supporting the possibility to...     

Music perception and octave generalization in rhesus monkeys

Two rhesus monkeys were tested for octave generalization in 8 experiments by transposing 6- and 7-note musical passages by an octave and requiring same or different judgments. The monkeys showed no octave generalization to random-synthetic melodies, atonal melodies, or individual notes. They did show complete octave generalization to childhood songs (e.g., "Happy Birthday") and tonal melodies (from a tonality algorithm). Octave generalization was equally strong for 2-octave transpositions but not for 0.5- or 1.5-octave transpositions of childhood songs. These results combine to show that tonal melodies form musical gestalts for monkeys, as they do for humans, and retain their identity when transposed with whole octaves so that chroma (key) is preserved. This conclusion implicates similar transduction, storage, processing, and relational memory of musical passages in monkeys and humans and has implications for nature-nurture origins of music perception.