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.     

Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway

Refugees have often been exposed to multiple traumas making them prone to mental health problems later. The aim of this study is to describe the prevalence and symptom load of psychiatric disorders in refugees admitted to psychiatric outpatient clinics and to investigate the relationship between multiple exposure to traumatic events, the severity of traumatic symptoms and post-migration stressors. A clinical sample of 61 refugee outpatients from psychiatric clinics in Southern Norway was cross-sectionally examined using three structured clinical interviews (SCID-PTSD, SIDES and MINI) and self-report psychometric instruments (HSCL-25, IES-R). Post-traumatic Stress Disorder (PTSD) was diagnosed in 82% of the patients, while Disorders of Extreme Stress Not Otherwise Specified (DESNOS) was present in 16% of them. Comorbidity was considerable; 64% of the patients had both PTSD and major depression disorder (MDD) and 80% of those who had PTSD had three or more additional diagnoses. Multi-traumatized refugees in outpatient clinics have high prevalence of PTSD, DESNOS, comorbid depression and anxiety disorders. A more severe symptomatology was found in patients diagnosed with both PTSD and DESNOS, than in those diagnosed with only PTSD. Higher rates of unemployment, weak social network and weak social integration were also prevalent in these outpatients, and related to increased psychiatric comorbidity and severity of symptoms. Further research may clarify the existence of a cumulative relationship between pre-resettlement traumas and post-resettlement stressors in the mental health of refugees, which in turn may help to improve therapeutic interventions.     

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Intentions to participate in counselling among front-line,at-risk Irish government employees: an application of the theory of planned behaviour

ABSTRACT

The study set out to examine intentions to engage in counselling among at-risk Irish government employees and the differential utility of two alternative theory of planned behaviour (TPB) models of behaviour to explain intentions to participate in counselling. Individuals (N=259) employed in a front-line, at-risk occupation for the Irish government completed a TPB-based questionnaire. Quantitative analyses revealed that participants held positive to neutral intentions to participate in counselling, irrespective of gender. The original TPB model explained 49.9% of variance in intentions whereas an alternative TPB model, splitting the perceived behavioural control (PBC) construct between its internal and external control components, explained a further 8.9% of variance. Furthermore, self-efficacy was found to be the strongest predictor of intentions. This study therefore supports the use of the TPB in understanding counselling-seeking behaviour.     

惊反射在创伤后应激障碍研究中的应用:高唤醒与恐惧抑制

创伤后应激障碍(PTSD)是唯一在诊断标准中包含惊反射改变的精神疾病.相比自我报告法,对惊反射的实验室测量与总体症状关联更紧密,并已积累了较多神经机制研究成果,可作为连接前临床与临床研究的桥梁.在惊反射应用于PTSD研究的初期,它主要作为PTSD患者高唤醒症状的客观指标,但是尚未发现惊反射强度的变化与总体症状的明确关系.近年来,惊反射与情境性焦虑、恐惧抑制等新范式结合,发现特定情境下惊反射改变是PTSD患者特有的表现.惊反射在创伤应激障碍研究中所取得的新进展对PTSD病理机制的探索和临床诊断都有所启发和推进.     

The psychological neuroscience of depression: implications for understanding effects of deep brain stimulation

In this article it is suggested that current psychological theories of depression presuppose that this condition will develop as a result of a vicious circle involving negatively biased communication between systems of emotional stress-/alarm-signaling, executive functions and mood regulation. These systems may from a neuroanatomical point of view be located in the limbic system, the orbitofrontal and lateral prefrontal cortex and the hypothalamus-pituitary-adrenal (HPA-) axis respectively. The theoretical and practical implications of this model for the understanding of pharmacological treatments of depression are briefly discussed and this theory is related to the catecholamine hypothesis of depression. The model is furthermore discussed in relation to deep brain stimulation (DBS) of treatment resistant major depression. Similarities and differences between this perspective and the one advocated by the "homeostatic theory" of depression are discussed. It is concluded that a topographical psychological theory may offer a useful heuristic in thinking about depression and that it offers several testable predictions about treatments of the disorder.     

The Impact of Neighborhood Factors on the Well-Being of Survivors of Intimate Partner Violence Over Time

Intimate partner violence (IPV) is a pervasive social problem impacting the psychological well-being of millions of US women annually. The extant literature draws our attention to the devastating mental health effects of IPV, but largely overlooks how ecological factors may further explain survivors' well-being. This study examined how neighborhood disadvantage may contribute to survivors' compromised well-being, in addition to the abuse women experienced. Neighborhood disorder and fear of victimization significantly impacted survivors' well-being, over and above abuse. Although between-women effects of neighborhood disorder and fear were unrelated to change in women's depression or quality of life (QOL), significant within-woman effects were detected. Change in neighborhood disorder was negatively associated with change in QOL, and this relationship was fully mediated by fear. While no direct relationship between change in neighborhood disorder and depression was detected, an indirect effect through survivors' fear was revealed. Implications for future research and practice are discussed.     

Gender Role Traits Among Individuals with Social Anxiety Disorder

The present study investigated differences between individuals with and without social anxiety disorder (SAD) in instrumentality and expressiveness, personality traits traditionally linked to the male and female gender roles, respectively. Based on evolutionary and self-discrepancy theories, it was hypothesized that individuals with SAD would score lower on instrumentality and report a discrepancy between their perceived and ideal level of instrumentality compared to control participants. Sixty-four patients with SAD and 31 non-anxious control participants completed a battery of questionnaires, including ratings of their perceived and ideal gender role attributes and current psychosocial distress. Results supported the hypotheses, and provided initial evidence that a discrepancy between perceived and ideal instrumentality may be linked to social anxiety severity, depression and lower quality of life. No differences were detected between groups in expressiveness. The present findings suggest that individuals with SAD perceive themselves to be deficient in instrumentality. They also suggest that increasing instrumentality among individuals with SAD may be beneficial for treatment.     

心理资本对大学生就业成功率的影响

心理资本近年已成为研究大学生就业状况相关问题的热点之一.研究采用问卷调查法探讨了性别、生源地、专业、实习经验等因素对大学生心理资本的影响,以及两者对大学生就业成功率的影响.具体采用列联表分析、￡检验、方差分析以及二元logistic回归分析分析了心理资本各维度与各因素对大学生就业成功率的影响,发现专业和实习经历对心理资本有显著影响,心理资本中的乐观维度对大学生就业成功率有显著影响;建议为了提高大学生就业成功率,学校应努力为大学生提供更多的实践机会,重视大学生的人文教育,营造乐观的文化氛围.     

负性情绪在心理契约违背与反生产行为中的作用

为了探究反生产行为的产生机制,本研究采用问卷调查法,以“压力-情绪”模型为基础,使用相关分析以及线性回归分析等统计方法,考察了心理契约违背、负性情绪以及反生产行为之间的密切关系.结果发现,心理契约违背与负性情绪之间有显著的正相关,心理契约违背和负性情绪与反生产行为也具有显著的正相关关系,负性情绪在心理契约违背与反生产行为之间具有部分中介作用.