Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study

Objective: Patients with eating disorders (ED) often suffer from co-morbid depression, which may complicate the ED treatment. Previous studies have found that ED interventions seem to have limited capacity to reduce depressive symptoms. Several studies of interpersonal psychotherapy (IPT), have found that when patients have been treated for depression, co-morbid symptoms have diminished. As depression and EDs are commonly co-occurring conditions, this pilot study aimed to examine the effect of an IPT treatment for these conditions, with the focus on the depressive symptoms.

Method: In this multi-centre study, 16 patients with EDs and co-occurring major depression received 16 weeks of depression-focused IPT.

Results: Significant improvements with substantial effect sizes were found for both depression (d = 1.48) and ED (d = .93). Symptom reduction in the two syndromes were strongly correlated (r = .625, p = .004). Patients with a restrictive ED did not improve on either depression or ED symptoms.

Conclusion: These findings point to the usefulness of IPT for concurrent depression and ED with a bingeing/purging symptomatology. Working with negative affect and problem-solving related to current interpersonal problems may alleviate general psychological distress among these patients.     

Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial

Objective

Feasibility, acceptability, and efficacy of a Dialectical Behavioral Therapy (DBT) -based method developed in Germany were evaluated in a Swedish outpatient psychiatric context.

Method

Fifty-one adults with ADHD on stable medical treatment or on no medication were randomized to the DBT-based skills training (n = 26) or a parallel loosely structured discussion group (n = 25). Self-rating scales were administered before randomization and after the treatment.

Results

Feasibility and participant satisfaction were good in both groups while skills training was perceived as more logical and effective for ADHD-related problems. The analyses of the individuals who completed the treatment and remained stable with regard to medication (n = 19 in skills training; n = 18 in control group) showed a significant reduction in ADHD symptoms in the skills training group, but not in the control group. No reduction of comorbidity was observed in any of the groups.

Conclusions

The treatment was feasible in an outpatient psychiatric context, well tolerated, and significantly reduced ADHD symptoms in on-treatment individuals who remained stable regarding medication status.     

Implicit and explicit adjustments to extrinsic visuo-motor transformations and their age-related changes

Humans have unique abilities in using tools. The skilled and goal-directed use of a tool implies that processes of motor control can be adjusted to the transformation of the movement of a part of the body into the movement of the effective part of the tool. A common example is the transformation of a hand movement in the motion of a cursor on a computer monitor. In part the adjustments to such transformations are implicit, that is, without conscious awareness of the novel transformation and the appropriate change of one’s own movements. However, the adjustments can also be explicit and intentional. We review a series of experiments which show that implicit and explicit adjustments to a novel visuo-motor gain are additive. This finding suggests that the processes which generate different types of adjustment are functionally independent. In a second series of experiments it turned out that at older adult age explicit adjustments to novel visuo-motor transformations are impaired, whereas implicit adjustments remain unaffected across working age.     

Biased attributions regarding the origins of preferences in a group decision situation

The current research investigated biases in attributions of the origins of others' preferences in a group decision situation. In two experiments, students indicated their preferred alternative in a decision on an important issue in their school, and then explained the bases for preferences of those agreeing and disagreeing with them. Results showed that participants saw preferences of those who agreed as more rationally and less externally based than of those who disagreed. This effect increased with perceived issue importance, when the decision was made by in‐group representatives, when the decision outcome was concordant with their own preference (Study 1), and, on the externality dimension, when their representatives were in the majority when deciding on an important issue (Study 2). Findings have important implications for our understanding of the tolerance of others and acceptance of group decisions, and ultimately, how group members behave and interact. Copyright © 2009 John Wiley & Sons, Ltd.     

Thinking Clearly about Violence

Philosophical Studies -     

Farewell to multiculturalism? sharing values and identities in societies of immigration

For critics of multiculturalism, societies of immigration need to strengthen cohesion based on shared democratic values and national identities. This article suggests that democratic values are not a sufficient basis for political cohesion, because they are universal and cannot identify a particular polity toward which one ought to be loyal. Immigrants are always asked to accept a package deal that includes not only democratic values, but also the hegemony of established national cultures. Shared democratic values may also not be strictly necessary for political cohesion. They must be embedded in political institutions and ought to be respected by office holders, democratic politicians, and parties, but democratic states must tolerate that most citizens appear to hold illiberal beliefs including illiberal attitudes toward immigrants. Immigrants are then often asked to profess a commitment to values that citizens do not widely share. If political loyalty, cannot be exclusively based on democratic values, must societies of immigration then ask newcomers to assimilate into a shared national identity? The article argues that this requires, first, a self-transformation of these identities in response to immigration. Instead of regarding shared identities as overriding all other affiliations, democratic states should see them as overarching and overlapping. Different attitudes toward dual nationality illustrate the implication of this suggestion. The article concludes by proposing a catalyst model of multiculturalism as an alternative to the metaphors of the melting pot, the salad bowl, and the mosaic.     

Effects of cold and mental stress on finger temperature in vasospastics and normal Ss

The present experiment studied the effects of mental and cold stress on finger temperature in 9 females suffering from peripheral vasospastic attacks (Raynaud's disease; RD group) and 9 female controls. Each S sat in a 0°C cold-storage room for 15 min, on 2 separate days. In one condition they were required to count backwards aloud under threat of electric shock to the hand. Finger temperature, pulse rate and subjective ratings of stress were recorded. A significant interaction with time and mental stress was observed only for the Control group with decreased finger temperature late in the session. Pulse rate was significantly elevated during the cold + mental-stress condition compared to the cold-only condition in the Control group, but not in the RD group. Subjective ratings of stress increased for both groups during the cold + mental-stress condition, with no significant difference between the groups.     

The integration of methods in residential psychotherapy]

The trend toward integration of psychotherapy into general medical practice has, especially in inpatient treatment of neurotic diseases, led to the development of psychotherapeutic systems, the differences of which are largely dependent upon both clinical conditions and therapeutical objectives. The author, in the light of ten years of practical experience with group psychotherapy of patients living in a hospital, gives a schematic outline of the Berlin system of integration of methods, discussing the system with reference to Kabanov's four basic principles, namely, the principle of the partnership of doctor and patient, the principle of the differences in efforts and effects, the principle of the unity of efficacy of methods, and the principle of the gradual transitions between methods and procedures. A detailed discussion is given of the gradual transition principle by reference to the phase-specific procedure of group psychotherapy and the methods of treatment coordinated therewith.