Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

The Impact of PREP Training on Marital Conflicts Reduction: A Randomized Controlled Trial With Iranian Distressed Couples

The purpose of this study was to examine the efficacy of the Prevention and Relationship Education Program (PREP) training on marital conflict and marital satisfaction among a sample of distressed couples in Iran. The research procedure was experimental with a pretest, posttest, and follow-up design, including a control group. The sample included 76 volunteer couples among a sample of distressed couples who were randomly selected and assigned to the experimental or control group. They completed demographic questions, the Marital Conflicts questionnaire, and a revised Marital Satisfaction Inventory in pretest, posttest and at the 1-year follow-up. Results showed that PREP training effectively led to decreased marital conflict and improvement of marital satisfaction of couples at posttest and at the 1-year follow-up. The result of covariance analysis showed significant differences between the experimental and the control groups' marital conflict and marital satisfaction at posttest and at the 1-year follow-up.     

Sustained efficacy of dialectical behaviour therapy for borderline personality disorder

Dialectical Behaviour Therapy (DBT) is considered one of the most promising treatments for borderline personality disorder (BPD). Recently, we reported significantly positive effects of 12 months DBT on parasuicidal behaviour and impulsivity in a mixed group of female BPD patients with and without substance abuse. Fifty-eight women with BPD were randomly assigned to either 52 weeks of DBT or treatment as usual (TAU). Follow-up assessment took place at 78 weeks, i.e., 6 months after discontinuation of DBT. Participants were clinical referrals from addiction treatment and psychiatric services. Outcome measures included parasuicidal behaviour, impulsivity and substance abuse. Six months after treatment discontinuation, the benefits of DBT over TAU in terms of lower levels of parasuicidal and impulsive behaviours, and in alcohol use, sustained. No differences between the treatment conditions were found for drug abuse. In conclusion, DBT seems to have a sustained effect on some of the core symptoms of BPD and on alcohol problems in a mixed population of female borderline patients with and without substance abuse problems.     

艺术治疗的概念、发展及教育

综述了国内外近10年来关于艺术治疗的文献资料,回顾了艺术治疗的概念、学科范围界定、应用、发展,比较了中西方艺术文化差异,同时对于艺术治疗与健康和疾病的关系,及其机理等进行了探讨.也对国外艺术治疗在高等院校中的课程设置、讲解内容等进行了阐述.根据作者多年的研究和教育实践,试图探索出中国艺术治疗学科体系的构建框架.     

Tailoring Cognitive Behavioral Therapy for Individuals Diagnosed with Bulimia Nervosa

There is a wealth of data indicating the effectiveness of cognitive behavioral therapy in the treatment of bulimia nervosa. However, the best evidence indicates a treatment success rate of 50%. The purpose of this paper is to briefly describe cognitive behavioral treatment of bulimia nervosa and to offer suggestions on how this therapy approach may be tailored to best serve the needs of individual clients. Such tailoring should ultimately lead to even greater treatment success.     

干扰素治疗慢性乙型肝炎管理策略初探

在慢性乙肝抗病毒治疗中干扰素作为一线治疗取得了一定的疗效。在治疗过程中通过选择合适的慢性乙肝患者、监测疗效、确立个体化的疗程和剂量、及时监测不良反应和恰当的处理和最大限度的提高患者的依从性可使干扰素的疗效达到最大化。     

异维A酸组和维胺酯组治疗痤疮的比较

为了比较分析异维A酸组和维胺酯组治疗痤疮的临床疗效、费用和不良反应,于服药前后观察疗效、不良反应和相关费用。结果显示,异维A酸组治疗痤疮起效快。在治疗中度痤疮,两组总体疗效、医疗费用相当,但维胺酯组不良反应较轻。而在治疗重度痤疮方面,异维A酸组临床疗效较维胺酯组高,且医疗成本较低。     

注意缺陷多动障碍的研究与治疗

注意缺陷多动障碍（ADHD）的发病群体多为5岁以后的儿童,主要临床表现是多动、冲动,注意力无法集中,对一项任务不能够有规划进行下去,而且脾气暴躁、易怒。近年来,心理学界、神经科学界和教育学界等对ADHD的研究取得了很多进展。本文概括性地介绍了ADHD病症的基本特征,目前对于患者脑机制损害的研究,并从药理学和行为学等方面讨论了ADHD的治疗方法和手段。     

Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

Changes in Problematic Anger,Shame, and Disgust in Anxious and Depressed Adults Undergoing Treatment for Emotion Dysregulation

Emotion dysregulation, the pervasive difficulty managing negative emotions, is a core problem across mood and anxiety disorders. Anger, shame, and disgust are particularly problematic emotions, impacting both disorder severity and treatment outcome. We previously found that a 16-week dialectical behavior therapy skills training group (DBT-ST) was superior to an activities-based support group (ASG) in decreasing emotion dysregulation in 44 adults with high emotion dysregulation who met diagnostic criteria for an anxiety or depressive disorder. We presently examine these participants’ changes in anger, shame, disgust, and distress using self-reports collected over 6 months during and after treatment. Hierarchical linear modeling analyses show that DBT-ST was superior to ASG in decreasing anger suppression (d = 0.93) and distress (d = 1.04). Both conditions significantly reduced shame, disgust propensity, and disgust sensitivity, but neither was superior for these outcomes. The treatments did not significantly reduce anger expression. Mediation analyses suggest that condition indirectly influenced 4-month anger suppression, shame, and distress through its effect on 2-month emotion dysregulation. These findings suggest that DBT-ST is efficacious for certain problematic emotions and distress in depressed and anxious adults and that common factors may account for some, but not all, of its benefits.