Cognitive and Behavioral Treatments for Anxiety and Depression in a Patient with an Implantable Cardioverter Defibrillator (ICD): A Case Report and Clinical Discussion

Implantable cardioverter-defibrillators (ICDs) are the treatment of choice for patients at risk for potentially life threatening arrhythmias. The associated stress of living with an implanted device and receiving ICD shock therapy has been noted to exert a psychological toll on the individual patient and family. Anxious and depressive symptomatology is frequently reported by these patients, thus creating a demand for tailored psychological interventions for this population. The current case report describes the components, delivery, and effectiveness of a targeted treatment approach for anxiety and depression in an individual with an ICD. Test results and interview data revealed significant improvements in multiple domains of cognitive, emotional, and behavioral functioning. Improvements in marital relations were also achieved. These treatment effects were maintained at follow-up and in the context of acute, medical stressors. Future clinical and research directions are also discussed.     

Development of a Substance Abuse Consultation and Referral Service in an Academic Medical Center: Challenges, Achievements and Dissemination

Approximately 25% of US hospital beds are occupied by individuals with active substance use disorders (SUD). Acute medical hospitalization provides an opportunity to address SUDs and provide patient-centered intervention and referral for treatment. Nationally, some hospitals have developed substance abuse consultation departments to improve the care of hospitalized substance users. In this paper we describe the Addiction Psychiatry Service (APS) in a large urban hospital which provides bed-side SUD consultation, screening, intervention and referral to treatment. APS utilizes the multiple disciplines of psychology, social work and medicine to integrate substance abuse services throughout the hospital and educate future generations of medical and psychology trainees. We conclude with how the APS service is informing the development of similar programs in other academic departments within our hospital and best practice recommendations to further disseminate this service model.     

Making the most of information‐gathering interviews with children

Because child abuse victims are often the only available sources of information about their experiences, extensive efforts have been made to understand how to maximize their informativeness. There is now broad international consensus regarding optimal interview practices, and broad awareness that children's informativeness increases when interviewers conduct developmentally appropriate interviews with children. In this paper, we (1) summarize current understanding of how children remember, retrieve, and communicate information and (2) discuss ways in which children's memory and reporting can be fostered using techniques designed to help children recount past experiences such as the Cognitive Interview, the Narrative Elaboration Technique, and the National Institute of Child Health and Human Development‐Protocol. Communicative success clearly depends on how well children understand their role and how effectively interviewers take advantage of children's competencies and abilities to help them maximize their informativeness. Unfortunately, agreement regarding ways in which interviews should be conducted has not been paralleled by changes in the way interviews are actually conducted in the field and more attention thus needs to be paid to training and implementation. Copyright © 2008 John Wiley & Sons, Ltd.     

Long-term outcome of Internet-delivered cognitive-behavioural therapy for social phobia: A 30-month follow-up

Internet-delivered guided cognitive behaviour therapy for social anxiety disorder has been found to generate promising short-term results, up to one year posttreatment. No study has however documented longer follow-up periods. In this 30-month follow-up we contacted 57 participants from the original study of which 77.2% (44/57) responded to the Internet-administered outcome measures and 66.7% (38/57) completed a telephone interview. Results showed large pretreatment to follow-up within-group effect sizes for the primary outcome measures (Cohen's d 1.10-1.71), and a majority (68.4%; 26/38) reported improvements in the interview. The findings suggest that the long-term effects seen in previous live treatment CBT trials can occur in Internet-delivered treatment as well.     

The Spiritual Trauma Experienced by Victims of Sexual Abuse by Catholic Clergy

Most of the published literature on clergy abuse of children has addressed the emotional and psychological effects of sexual abuse common to all victims. The literature published by Church-related sources has consistently addressed the impact of clergy abuse on the Church as an institution as well as the problems and treatment needs of the clergy abusers. Little has been written or even explored about the spiritual trauma suffered by clergy victims. This article examines some of the symptoms and possible recovery from the spiritual dimension of post abuse trauma.     

Traumatic stress and psychological adjustment in treatment-seeking women sexually abused in childhood: A follow-up

The objective of this study was to assess post-traumatic stress disorder (PTSD), psychological distress, and risk factors among women sexually abused in childhood (CSA) after six months in therapy. Thirty in-treatment CSA survivors reported their abuse history and filled out several questionnaires. Comparisons were made to a non-CSA in-treatment sample. Although, 50% of the CSA women still had PTSD, there was a remarkable decrease in PTSD symptoms (Cohen's d = 1.06). A considerable change in self-worth and in attachment styles was found. It was concluded that CSA survivors benefit much from 6 months of weekly treatment. However, it is recommended that treatment should continue for a still longer period.     

Similar Processes Despite Divergent Behavior in Two Commonly Used Measures of Risky Decision Making

Performance on complex decision-making tasks may depend on a multitude of processes. Two such tasks, the Iowa Gambling Task (IGT) and Balloon Analog Risk Task (BART), are of particular interest because they are associated with real world risky behavior, including illegal drug use. We used cognitive models to disentangle underlying processes in both tasks. Whereas behavioral measures from the IGT and BART were uncorrelated, cognitive models revealed two reliable cross-task associations. Results suggest that the tasks similarly measure loss aversion and decision-consistency processes, but not necessarily the same learning process. Additionally, substance-using individuals (and especially stimulant users) performed worse on the IGT than healthy controls did, and this pattern could be explained by reduced decision consistency.     

军事应激障碍的评估与防治

军事应激障碍是部队常见的心理障碍,也是严重影响部队战斗力的主要因素。探讨军事应激障碍的评估方法和防治措施是军事心理学研究的重要内容。本文系统地回顾了国内外军事应激障碍的评估原则和方法,并结合过去的研究成果,提出了军事应激障碍的防治措施。目的是为我军制定切实可行的军事应激防治措施提供科学依据,以维护部队官兵的心理健康,提高部队的战斗力     

超声引导下微创治疗子宫肌瘤

目前正式报道的超声引导下微创治疗子宫肌瘤的方法有两大类：（1）局部热消融治疗：在超声准确定位监视下或超声引导下将物理高温导入子宫肌瘤结节内,将肌瘤组织热凝固灭活,包括高强度聚焦超声、微波消融及射频消融。（2）在超声引导下向肌瘤内注入凝固剂或化疗药物灭活肌瘤组织。各种局部热消融治疗方法在消融范围内均可将肌瘤细胞有效灭活,疗效可靠,治疗后肌瘤可有效缩小、临床症状明显改善或消失,对正常生理功能影响很小或无明显影响。各种方法中,高强度聚焦超声无创伤,但治疗所需时间较长;微波或射频热效率高,治疗耗时短,但需肌瘤穿刺。肌瘤内注入凝固剂或药物操作方便,但由于药物弥散的因素适合3cm以下肌瘤的治疗。超声引导微创治疗子宫肌瘤创伤小、保留子宫,在有效使肌瘤缩小并控制临床症状的同时对患者的生理功能无影响或影响很小,并发症少,术后恢复快,有望成为治疗子宫肌瘤的主要方法之一。但治疗前应排除子宫恶性病变,并严格掌握适应证。