L’affaire Lambert

In the case Lambert, the Council of State (high court of the Public law) finished a long trial. The question concerned the power of medical decision: family? doctor? judge? The European Court of Human Rights disputes its solution.     

Physical activity does not provoke panic attacks in patients with panic disorder: A review of the evidence

Abstract

This paper summarizes the results of published studies in which physical activity has been performed by patients with panic disorder. Several case studies of apparent exercise-induced panic attacks were found. However, in field studies that involved ambulatory monitoring of panic disorder patients only 1 of 91 panic attacks that were monitored actually occurred while the test subject was engaged in moderately intense physical activity. Moreover, only five panic attacks occurred in association with 444 exercise bouts performed by 420 panic disorder patients in laboratory settings despite the fact that exercise induces somatic signs and symptoms of anxiety. Thus, the weight of the published evidence shows that acute physical activity does not provoke panic attacks in panic disorder patients.     

Öst's (2008) methodological comparison of clinical trials of acceptance and commitment therapy versus cognitive behavior therapy: Matching Apples with Oranges?

Öst (2008) recently compared the methodological rigor of studies of acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (CBT). He concluded that the ACT studies had more methodological deficiencies, and thus the treatment did not qualify as an “empirically supported treatment.” Although Öst noted several important limitations that should be carefully considered when evaluating early ACT research, his attempt to devise an empirical matching strategy by creating a comparison sample of CBT studies to bolster his conclusions was itself problematic. The samples were clearly mismatched in terms of the populations being treated, leading to differences in study design and methodology. Furthermore, reanalysis showed clear differences in grant support favoring CBT compared with ACT studies that were not reported in the original article. Given the actual mismatch between the samples, Öst's methodological ratings are difficult to interpret and provide little useful information beyond what could already be gathered by a qualitative review of ACT study limitations. Such limitations are characteristic of the earlier randomized controlled trials of any emerging psychotherapeutic approach.     

FACILITATING TRANSITION TIMES WITH HANDICAPPED PRESCHOOL CHILDREN: A COMPARISON BETWEEN PEER-MEDIATED AND ANTECEDENT PROMPT PROCEDURES

We examined the effects of a peer-mediated versus an antecedent prompt condition on the rate of independent movement and appropriate behavior of handicapped preschool children during three classroom transition times. Using an alternating treatments design, results showed that each treatment condition yielded increases in target behaviors; however, the antecedent prompt condition was superior during all three transition settings. In addition, teacher prompts to these children were significantly reduced during the intervention conditions, indicating that the children were making these transitions more independently.     

Effect of chevron design on driver behaviour when encountering and passing through a dangerous curve

Horizontal curves are locations on the road network with a high road accident risk. In order to provide drivers with timely and proper information about the upcoming curve, road authorities often use chevron signs. Although the main design of chevrons is similar in most countries (one colour for the background and another for the arrow), the combination of colours differs. The aim of this simulator study is to investigate how different colour combinations affect drivers when they encounter and drive through horizontal curves on rural roads at daytime. Overall, each of the tested chevrons reduced the driving speed (between 25 and 29 km/h), although not to the speed limit level (60 km/h). However, for curves marked with chevrons with fluorescent or white background the driving speed was the lowest at all measuring points, regardless of the curve direction. The observation of lateral movement shows that there are no significant differences in the way the vehicle is positioned when approaching and driving through curves marked with different chevrons. Based on the obtained results, practical recommendations and potential future research activities are presented.     

Effects of Interpretation Training on Hostile Attribution Bias and Reactivity to Interpersonal Insult

Research suggests that individuals high in anger have a bias for attributing hostile intentions to ambiguous situations. The current study tested whether this interpretation bias can be altered to influence anger reactivity to an interpersonal insult using a single-session cognitive bias modification program. One hundred thirty-five undergraduate students were randomized to receive positive training, negative training, or a control condition. Anger reactivity to insult was then assessed. Positive training led to significantly greater increases in positive interpretation bias relative to the negative group, though these increases were only marginally greater than the control group. Negative training led to increased negative interpretation bias relative to other groups. During the insult, participants in the positive condition reported less anger than those in the control condition. Observers rated participants in the positive condition as less irritated than those in the negative condition and more amused than the other two conditions. Though mediation of effects via bias modification was not demonstrated, among the positive condition posttraining interpretation bias was correlated with self-reported anger, suggesting that positive training reduced anger reactivity by influencing interpretation biases. Findings suggest that positive interpretation training may be a promising treatment for reducing anger. However, the current study was conducted with a non-treatment-seeking student sample; further research with a treatment-seeking sample with problematic anger is necessary.     

Selecting the Right Tool For the Job

There are competing ethical concerns when it comes to designing any clinical research study. Clinical trials of possible treatments for Ebola virus are no exception. If anything, the competing ethical concerns are exacerbated in trying to find answers to a deadly, rapidly spreading, infectious disease. The primary goal of current research is to identify experimental therapies that can cure Ebola or cure it with reasonable probability in infected individuals. Pursuit of that goal must be methodologically sound, practical and consistent with prevailing norms governing human subjects research. Some maintain that only randomized controlled trials (RCTs) with a placebo or standard-of-care arm can meet these conditions. We maintain that there are alternative trial designs that can do so as well and that sometimes these are preferable to RCTs.     

抑郁症计算机化治疗的效果及其影响因素：基于RCT的元分析与元回归分析

运用元分析和元回归分析的方法考察抑郁症计算机化治疗的效果及其影响因素。来源于50篇文献,42项RCT研究的67个样本满足了元分析标准（N=7920）。结果发现：（1）整体效果量为0.53,三个月追踪效果量为0.14;6个月追踪效果量为0.16;（2）在年龄段、抑郁严重程度、支持方式和测量量表四个亚组分析中,其效果量存在显著差异。干预方式、干预取向和分析方法对效果量的影响不显著;（3）出版年份显著影响治疗效果量,脱落率和干预单元数对整体效果量的影响不显著。结果表明：抑郁症的计算机化治疗具有中等的效果量;年龄段、抑郁严重程度、支持方式、测量量表和出版年份对其整体效果量有调节作用。将来抑郁症计算机化治疗的研究应重视上述调节变量对治疗效果的影响。     

BRIDGING THE DISCONNECTION BETWEEN APPLIED RESEARCH AND PRACTICE: A REVIEW OF TREATMENTS THAT WORK: EMPIRICALLY SUPPORTED STRATEGIES FOR MANAGING CHILD BEHAVIOR PROBLEMS BY ED CHRISTOPHERSEN AND SUSAN MORTWEET

In recent years, behavior analysts have lamented a disconnection between applied research and practice. In their book, Treatments That Work: Empirically Supported Strategies for Managing Child Behavior Problems, Christophersen and Mortweet (2001) have attempted to bridge this gap for medical and behavioral health providers alike by describing empirically supported treatments, derived from behavior therapy and its application, that are specifically designed for challenging problems commonly seen in typical children. The book is clearly intended for both primary care physicians and behavior therapists, and in this article, we review the extent to which the book meets the needs of each. Discussion centers on the extent to which the book can meet the need for both technical precision and conceptual breadth in training of behavior therapists. We conclude that, in making explicit the connections between research and practice, the authors have provided a useful clinical teaching tool and have also raised important questions about how best to establish collaborative relationships with physicians and promote the use of behavioral technology in primary care.