Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no recommended treatments for EDNOS. This article provides an overview of enhanced cognitive behavior therapy, a validated treatment for all forms of EDs.     

Cue effectiveness in communicatively efficient discourse production

Recent years have seen a surge in accounts motivated by information theory that consider language production to be partially driven by a preference for communicative efficiency. Evidence from discourse production (i.e., production beyond the sentence level) has been argued to suggest that speakers distribute information across discourse so as to hold the conditional per-word entropy associated with each word constant, which would facilitate efficient information transfer (Genzel & Charniak, 2002). This hypothesis implies that the conditional (contextualized) probabilities of linguistic units affect speakers' preferences during production. Here, we extend this work in two ways. First, we explore how preceding cues are integrated into contextualized probabilities, a question which so far has received little to no attention. Specifically, we investigate how a cue's maximal informativity about upcoming words (the cue's effectiveness) decays as a function of the cue's recency. Based on properties of linguistic discourses as well as properties of human memory, we analytically derive a model of cue effectiveness decay and evaluate it against cross-linguistic data from 12 languages. Second, we relate the information theoretic accounts of discourse production to well-established mechanistic (activation-based) accounts: We relate contextualized probability distributions over words to their relative activation in a lexical network given preceding discourse.     

Revisiting ‘What works for whom?’: A qualitative framework for evaluating clinical effectiveness in child psychotherapy

This paper describes a framework for evaluating the effectiveness of child psychotherapy used by child psychotherapists in an inner city Child and Adolescent Mental Health Service (CAMHS). The Hopes and Expectations for Treatment Approach (HETA) involves using the assessment for psychotherapy that normally precedes treatment to derive a baseline from which to generate a set of hopes/expectations as regards the effects of the treatment on the part of parents and the psychotherapist, to be revisited one year after the start of the psychotherapy and/or at its completion. The Strength and Difficulties Questionnaire, for parents and schools, was also administered before and after the treatment. The characteristics of the first 30 children referred for psychotherapy over a particular time period are described. Of the first 15 children in this group to complete one year of individual psychotherapy, all showed change or significant change in the areas concerning parents' and therapists' hopes at the end-of-year review, as rated by parents and psychotherapists. A case of a child with conduct disorder is used to describe how the assessment generated a psychoanalytic formulation, how the therapist's understanding was fed back to the parents, and how the parents' and therapist's hopes and expectations were derived and recorded. This case illustrates powerfully the impact of trauma in the parents' backgrounds on the internal world of the child, and how the method provides a useful bridge between parent and child work. Feedback from the psychotherapists, the parents and the referrers using the framework is reviewed, and in conclusion the paper argues for the framework's value in promoting good practice in the treatment and management of complex cases and in enhancing awareness of the nature and scope of the psychotherapy process.     

Transitioning from the Battlefield to Home: An Innovative Program for Israeli Soldiers

Soldiers moving from the army to civilian life encounter significant challenges during this time of transition, both in Israel and internationally. Identifying this period of time as a critical one, the Peace of Mind program is an innovative intervention designed specifically to address the issues occurring therein. This unique model focuses on mental health and normalization of responses, as well as on the processing of traumatic experiences. It is based on the considerable experience at the Israel Center for the Treatment of Psychotrauma in the fields of resilience building and trauma treatment. After reviewing the literature on returning soldiers, the model is described and several vignettes are presented.     

A comparison of two online cognitive‐behavioural interventions for symptoms of depression in a student population: The role of therapist responsiveness

Objectives: The study aimed to compare the efficacy of eight weekly sessions of a self‐administered online CBT treatment (cCBT; n=51) to a therapist‐assisted email CBT treatment (eCBT; n=50) in University students. Design: The design was a randomised parallel group trial. The study randomised participants with symptoms of depression to one of two available treatments. Method: Participants were offered eight weekly sessions of either cCBT or eCBT. Participants completed the Beck Depression Inventory‐II (BDI‐II) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) at pre‐and post‐treatment, at weeks 16 and 32 follow‐up. The Working Alliance Inventory‐Short Form (WAI‐SR) was completed at weeks 2, 4, and 6. Results: For both groups, pre‐post within group effect sizes reported were large for the BDI‐II and the CORE‐OM and these were maintained at follow‐up. Perceptions of working alliance were similar in each group, but Bond was significantly stronger for the eCBT condition. WAI scores correlated more positively with the outcome on BDI‐II for those in the eCBT condition than the cCBT condition, but not significantly. Conclusion: There were no significant differences between the two online treatments, both reduced depressive symptoms and improved general functioning. Similarly, at post‐treatment and follow‐up, clinical improvement and recovery was demonstrated for both groups equally. The study demonstrates the possibility for cCBT in a university setting that may contribute to addressing the shortcomings in meeting increasing demands that mental health services presently face.     

Anxiety,anticipation and contextual information: A test of attentional control theory

We tested the assumptions of Attentional Control Theory (ACT) by examining the impact of anxiety on anticipation using a dynamic, time-constrained task. Moreover, we examined the involvement of high- and low-level cognitive processes in anticipation and how their importance may interact with anxiety. Skilled and less-skilled tennis players anticipated the shots of opponents under low- and high-anxiety conditions. Participants viewed three types of video stimuli, each depicting different levels of contextual information. Performance effectiveness (response accuracy) and processing efficiency (response accuracy divided by corresponding mental effort) were measured. Skilled players recorded higher levels of response accuracy and processing efficiency compared to less-skilled counterparts. Processing efficiency significantly decreased under high- compared to low-anxiety conditions. No difference in response accuracy was observed. When reviewing directional errors, anxiety was most detrimental to performance in the condition conveying only contextual information, suggesting that anxiety may have a greater impact on high-level (top-down) cognitive processes, potentially due to a shift in attentional control. Our findings provide partial support for ACT; anxiety elicited greater decrements in processing efficiency than performance effectiveness, possibly due to predominance of the stimulus-driven attentional system.     

诊疗最优化原则的伦理学探析

讨论了诊疗最优化原则的伦理学意义:它充分体现了医学的宗旨、医学职业道德理想和对患者的无私关爱,有利于纠正医疗卫生行业的时弊,昭示着医疗卫生改革发展的方向。针对实践中遇到的阻力和困惑,作者提出了促进最优化原则实施的五点建议。     

结核病诊治进展与科技革命

现代科技革命极大地促进了结核病各方面的发展.微生物学和免疫学的发展,揭示了结核病的病因、发病机制、病理生理的本质,分子生物学技术使结核病的基础研究不仅停留在器官、细胞水平,而是深入到蛋白质、核酸、基因的水平;基因治疗的方法可望从根本上治疗结核病.高新技术的产物如X线照片、电子计算机断层扫描、纤维支气管镜检查和新药的出现等极大地提高了临床诊治的能力.借助于各种先进的医疗设备而进行精确的诊断,基因治疗将成为一种崭新的治疗手段.     

A review of recommendations for sequencing receptive and expressive language instruction

We review recommendations for sequencing instruction in receptive and expressive language objectives in early and intensive behavioral intervention (EIBI) programs. Several books recommend completing receptive protocols before introducing corresponding expressive protocols. However, this recommendation has little empirical support, and some evidence exists that the reverse sequence may be more efficient. Alternative recommendations include teaching receptive and expressive skills simultaneously (M. L. Sundberg & Partington, 1998) and building learning histories that lead to acquisition of receptive and expressive skills without direct instruction (Greer & Ross, 2008). Empirical support for these recommendations also is limited. Future research should assess the relative efficiency of receptive-before-expressive, expressive-before-receptive, and simultaneous training with children who have diagnoses of autism spectrum disorders. In addition, further evaluation is needed of the potential benefits of multiple-exemplar training and other variables that may influence the efficiency of receptive and expressive instruction.