Use of Internet Resources to Support Prolonged Exposure for Combat-Related PTSD

In vivo exposure as part of Prolonged Exposure (PE) requires the patient and therapist to generate a list of cues that are reminiscent of the trauma and generative of distress. In contrast to civilian trauma, it can be more challenging to build a robust in vivo hierarchy for a combat-related index trauma. Internet resources such as databases that list casualties from different wars, memorial pages of those who died in theater, and lists of unit association memberships and reunions are useful sources for in vivo hierarchies. These materials can provide opportunities for exposure to additional cues reminiscent of the traumatic event, provide information about the traumatic event that the veteran had been unable to recall, and create opportunities for veterans to reestablish relationships with veteran peers. Case illustrations are provided and reasons for caution are discussed.     

Implementation in a Changing Landscape: Provider Experiences During Rapid Scaling of Use of Evidence-Based Treatments

This study examined 133 service providers’ perspectives on a rapid shift to mandated evidence-based treatment delivery, utilizing an inductive coding process to capture themes present in their qualitative feedback. The majority of provider comments were negatively valenced, but attitudes varied considerably across response categories: comments regarding practice context and support were nearly uniformly negative, while comments regarding treatment fit and therapeutic consequences were more balanced. Treatment fit was the most commonly cited category; the fit to therapist (e.g., ease of use) subcategory was predominantly positive in contrast with the fit to client (e.g., flexibility) subcategory, which was predominantly negative. Results illustrate the intended and unintended consequences of large-scale implementation efforts on community providers, and may aid implementation researchers and system decision makers optimize the conditions under which community providers are asked to implement evidence-based treatment.     

Adapting Cognitive Processing Therapy to Treat Co-Occurring Posttraumatic Stress Disorder and Mild Traumatic Brain Injury: A Case Study

This case study aims to provide evidence for the effectiveness of adapting a particular manualized cognitive behavioral therapy intervention to treat co-occurring posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). This study presents the treatment of a woman who experienced co-occurring mTBI and PTSD following a motor vehicle accident, a dual diagnosis that was established through a flexible assessment approach involving interviews as well as standardized psychological, neuropsychological, and neurobehavioral testing. Treatment planning led to a-priori adaptation of Cognitive Processing Therapy (CPT) to treat both her PTSD symptoms and the sequelae associated with her mTBI. The therapist maintained fidelity to the manualized structure and content of CPT protocol, adapting portions of the treatment to add specific emphasis on issues of identity confusion and role loss in service of addressing these common functional impairments that can accompany mTBI. Discussion focuses on application of CPT for future treatment of comorbid PTSD and TBI amidst complicating factors, including role losses and medical and safety issues. This case study is especially relevant due to the prevalence of co-occurring PTSD and TBI across a variety of populations.     

Predictors of adherence to aerobic exercise in rectal cancer patients during and after neoadjuvant chemoradiotherapy

This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = ?.62; P = .30), married (d = .62; P = .42), with better mental health (r = .32; P = .21), fewer diarrhea symptoms (r = .48; P = .052), and higher anticipated enjoyment (r = .31; P = .23), support (r = .32; P = .22), and motivation (r = .31; P = .23). After NACRT, adherence was significantly better for patients who reported worse mental health (r = ?.56; P = .046) and meaningfully better for patients who were women (d = .54; P = .38), better educated (d = .77; P = .22), had no comorbidities (d = ?.63; P = .17), and exercised at baseline (d = 1.05; P = .12). Demographics, tumor side effects, and motivational variables may predict adherence to exercise during and after NACRT.     

精神科住院患者团体心理治疗准备性会谈与治疗后访谈初探

精神科住院患者团体心理治疗较门诊患者团体心理治疗存在临床情境的特殊性,本研究探索将准备性会谈与治疗后访谈纳入治疗计划,治疗前向患者普及住院治疗、心理治疗的知识,澄清团体心理治疗的形式、目标、内容,了解患者对团体心理治疗的疑问、期望,允许患者做出是否参加治疗的决定,并在治疗后的访谈中强化疗效因子。     

核辐射对消化系统损害的防治策略

消化系统中多个器官具有细胞代谢快、易受核射线损伤的特点,成为骨髓以外最容易遭受核辐射破坏的身体部位。日本核电站的泄露事故,使核辐射再度成为世界的焦点。随着人们对电离辐射认识的增加,核辐射对消化系统的损害也逐渐受到重视。本文通过对消化系统的损害机制的研究,论述了核辐射对消化系统的损害的防护和治疗策略。     

对T1G3膀胱癌治疗方法的探讨

T1G3膀胱癌有高复发和进展倾向,选择恰当的治疗方法成为难题。使用BCG治疗可促肿瘤进展和转移,但可保留膀胱。膀胱切除也许提供了最好的治疗方案,但膀胱切除仍会复发且具有手术风险,且被认为是过度治疗。此文从哲学角度来探讨T1G3膀胱癌的治疗方法,以便为临床实践和进一步的研究提供思路。     

基于机体反馈调控保护扭转肿瘤治疗思路

肿瘤的临床治疗经过漫长积极探索研究,中西医疗效均未取得成就性突破,本文穿越时空隧道,基于人类亿万年适应环境生存生物进化历程形成的精细反馈调控保护视角,循证机体实施反馈调控保护顽强延续生命依据,结合肿瘤病理生理机制,剖析肿瘤形成原因,追溯肿瘤临床治疗误区,扭转肿瘤治疗思路,引领肿瘤治疗新路径。     

Behavioral Activation Treatment for Depression in Older Adults Delivered via Videoconferencing: A Pilot Study

Depression affects up to 25% of older adults. Underdetection and subsequent undertreatment of depression in older adults has been attributed in part to difficulties in older adults being able to access treatment. This uncontrolled pilot study, N = 3, explored the acceptability and efficacy of a brief behavioral activation treatment delivered via videoconferencing to 3 participants, aged 64 to 73 years, diagnosed with major depressive disorder. The results indicate that a 5-session behavioral activation treatment delivered via videoconferencing produced clinically significant and reliable decreases in depression. The results also showed clinically significant and reliable decreases in negative affect and clinically significant and reliable increases in positive affect. Treatment gains were maintained at 1-month follow-up. Videoconferencing can be a valuable and effective tool in increasing accessibility to psychological treatment for older adults.     

A preliminary examination of the effect of massage on state body image

Evidence suggests positive effects of massage on psychological health; however, little is known about the effects of massage on body image. This research examined the effect of massage on state body image as well as relations between trait body image and attitudes toward massage. Forty-nine female university students were randomly assigned to either a massage condition or a control condition. It was hypothesized that participants in the massage condition would report improved state body image following the intervention when compared to participants in the control condition. As predicted, participants in the massage condition reported a more favorable state body image than participants in the control condition post-manipulation. Certain body image evaluations were moderately associated with views that massage is pleasurable, with the link between Body Areas Satisfaction and viewing massage as pleasurable reaching significance. Research is needed to determine the mechanism/s through which massage improves body image.