Anticipatory nausea and vomiting among cancer patients: A Review

Abstract

Anticipatory nausea and vomiting (ANV), as a side-effect of cancer chemotherapy, is a well recognized phenomenon. The literature is reviewed for data on: prevalence rates, factors contributing to onset and psychological treatments used to attempt a remission in the symptoms. From the available evidence it appears that ANV is a substantial problem with one major review indicating an average combined prevalence of 32%. Although explicable using a conditioning model it has a complex aetiology with emotional and cognitive elements, as well as specific pharmacological factors, playing a role in onset. ANV appears to be responsive to psychologically-based treatment methods, with a good outcome overall. However, more process evaluation is needed in order to understand aetiologic and treatment mechanisms and to determine how best to treat cases of ANV with different aetiologies. It is considered that procedures for identifying and referring patients with ANV should be routinely incorporated into the care of cancer patients receiving repeated cycles of chemotherapy.     

Together or Apart

Psychotherapists often mistake their theories for realities that they are not and thus may operate with an overly confident sense of "knowing" what is true about a particular couple relationship. Many schools of therapy tend to "pathologize" the dynamics of couple interaction and practitioners need to guard against being too inducted into any one world view. Facility with the theories and techniques of many different couples counseling strategies (psychodynamic, behavioral, structural and strategic approaches) can increase flexibility and the "working base" of therapists. Ultimately, however, the personhood of therapists, their awareness of their own biases (about levels of connection, emotional expressivity, feminism, or power relationships) and their ability to adopt a neutral, therapeutic stance are the essential ingredients for meaningful and curative couples counseling.     

Effects of Varying Levels of Treatment Integrity on Toddler Aggressive Behavior

Abstract

Effects of different levels of treatment integrity for a time-out intervention in relation to the aggressive behavior of an 18-month-old were investigated. The time-out intervention was composed of four steps and treatment integrity was systematically varied at 50%, 25%, 75%, and 100%. The results suggest that the 75% and 100% treatment integrity conditions were most effective for decreasing aggressive behavior. Further, there were only minor differences in aggressive behavior between the 25% and 50% treatment integrity conditions. Discussion focuses on the need for assessing optimal and minimum levels of treatment integrity for producing behavior change and the implications for classroom-based interventions.     

Couples

The author summarizes some of the views of the founder of the Contextual Family Therapy approach, Ivan Boszormenyi-Nagy, M.D., that lead to an integration of Object Relations Theories with the more recent Family Systems Theories. She then examines the relevance of some of the concepts decribed in Contextual Therapy for an understanding of the functioning of healthy couples.     

发挥中药在肿瘤症状处理中的作用——兼谈结直肠癌的中医“病证结合辨治”

改善症状是中医治疗晚期恶性肿瘤的优势,但简单的对症治疗显然体现不了中医的特色;辨证论治虽然是中医治疗的核心,但在对癌病本质的把握上缺乏理论和实践的支撑;单一的辨病论治强调以毒攻毒,却不能改善症状及预后。本文作者以对结直肠癌的治疗为例,认为抓主症,将病证与辨治相结合,有望较好地解决“症”“证”“病”三者的关系,在改善症状...     

肿瘤临床治疗中应关注肝脏

抗肿瘤细胞毒性药物有不同程度毒副作用,有些严重毒副反应是限制药物剂量或使用的直接原因。肝脏是药物代谢的主要器官,也是药物损伤的主要靶器官。随着临床肿瘤治疗关注治疗带来的副作用与关注疗效同等重要的发展,本文对抗肿瘤细胞毒性药物与肝损伤、发生机制、诊断、分型和临床治疗进展进行了阐述。     

下肢深静脉血栓形成的治疗进展

下肢深静脉血栓形成在欧美是一种比较常见的疾病,在我国随着临床医师意识的加强及诊疗水平的提高,其发病率也逐年上升。下肢深静脉血栓形成的危害是其并发症一肺栓塞和血栓形成后综合征,肺栓塞是临床上导致死亡的一个重要原因,而血栓形成后综合征严重影响患者的生活质量及工作能力,故其治疗成为一个热门话题。本文对下肢深静脉血栓形成的治疗...     

Cognitive-behavioural treatment of pathological gambling in individuals with chronic schizophrenia: a pilot study

The current study aimed to test the clinical effectiveness of a cognitive-behavioural program (CBT) specifically adapted for pathological gamblers with chronic schizophrenia, carried out in a naturalistic setting of community Mental Health Centres. Forty-four pathological gamblers with chronic schizophrenia were assigned either to a standard drug therapy for schizophrenia (control group) or to cognitive-behavioural therapy for pathological gambling plus a standard drug therapy for schizophrenia (experimental group). Psychological treatment comprised a 20-session program including psychoeducation, stimulus control, gradual exposure and relapse prevention. Therapeutic success was defined as abstinence or the occurrence of only 1 or 2 episodes of gambling during the follow-up period. While the patients treated in the experimental group showed a rate of success of 73.9%, only 19% of the participants belonging to the control group gave up gambling at the 3-month follow-up. The CBT group also did better than the control group in the number of gambling episodes and in the amount of money spent on gambling. However, the improvement of the experimental group was weaker at the 6- and 12-month follow-up. These findings support the beneficial effects of CBT as adjunctive therapy for patients with dual diagnoses (schizophrenia and pathological gambling).     

Thought suppression mediates the relationship between negative affect and borderline personality disorder symptoms

The purpose of this study was to examine the relationships among negative affect, childhood sexual abuse (CSA), thought suppression, and diagnostic symptoms of borderline personality disorder (BPD) in a community sample (n=127). Findings suggest that the temperamental variable negative affect intensity/reactivity was a stronger predictor of BPD symptoms than CSA. In addition, results indicated that higher thought suppression mediated the relationship between negative affective intensity/reactivity and BPD symptoms, after controlling for a history of CSA. Overall, findings suggest that (a) negative affectivity may be a better predictor of BPD symptoms than CSA, and (b) chronic efforts to suppress unpleasant thoughts may be a regulation strategy underlying the relationship between intense negative emotions and BPD symptoms.     

Coping style and memory specificity in adolescents and adults with histories of child sexual abuse

Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individual's general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.