Presence of PTSD is Associated with Clinical and Functional Impact in Veterans with Depression Treated in Community-Based Clinics

Journal of Clinical Psychology in Medical Settings - Providers in non-traditional mental health settings (e.g., primary care, community medical clinics) face challenges involving patients who often...     

Can Word Puzzles be Tailored to Improve Different Dimensions of Verbal Fluency? A Report of an Intervention Study

Verbal fluency is commonly used as a proxy measure of executive functioning, as it involves cognitive flexibility, working memory, and inhibitory control. Previous research has demonstrated that crosswords can be a useful means of improving verbal fluency, results consistent with the cognitive reserve hypothesis; the form of verbal fluency affected has, however, differed across studies. The present study sought to assess the extent to which it was possible to target phonemic (PVF) and semantic verbal fluency (SVF) separately through word puzzles designed to focus on semantic/thematic and structural clues respectively. Fifty-three university students were randomly assigned to one of three groups: semantic/thematic, structural, or a daily diary control group. They were assessed on PVF and SVF at baseline, and immediately following a four-week intervention. Age, sex, and depression scores were controlled for. A 2 × 3 mixed ANCOVA showed that the structural group improved significantly more in PVF during the intervention period than did the semantic/thematic or control groups, with the improvement linked to improved switching performance. The effect size was large. No significant difference in improvement in SVF emerged, although the effect size was moderate. The findings support the notion that it is possible to improve specific forms of verbal fluency through tailored brief word-puzzle interventions.     

Systematic Review of the Effects of Religion-Accommodative Psychotherapy for Depression and Anxiety

Integrating religion into psychotherapy may improve treatment for depression and anxiety. This review systematically examines clinical trials of religion-accommodative psychotherapy for depression or anxiety. Results indicate that integrating religion into psychotherapy does not lead to significantly more improvements in depression or anxiety than equivalent therapy without religious components. However, when compared with less stringent control groups, such as supportive psychotherapy, religion-accommodative therapy may be more effective, at least immediately post-treatment. Results from the 11 studies reviewed indicate that psychotherapy integrating religion is at least as effective for treating depression and anxiety as other forms of psychotherapy. Conclusions were limited by lack of power, comparable control groups, focus on anxiety, and treatment manuals.     

Depressed and Anxious COPD Patients: Predictors of Psychotherapy Engagement from a Clinical Trial

This study examined patient-level factors associated with engagement in mental health treatment in a sample of medically ill patients with clinically significant symptoms of depression and/or anxiety. A total of 248 patients was enlisted from a randomized controlled trial of cognitive-behavioral therapy for depression and anxiety in patients with chronic obstructive pulmonary disease (COPD). Logistic regression analysis was used to predict mental health engagement, defined as attending at least one intervention session. Results indicated that patient-perceived mastery over COPD was negatively related to mental health engagement. Further, mastery was the only significant predictor of mental health engagement after controlling for patient demographic characteristics, severity of COPD, depression, and anxiety. To improve engagement for medically ill patients with comorbid mental health difficulties, clinicians should explore patients’ attitudes about their mental health within the context of their perceived ability to cope with their medical disease.     

Cognitive-Behavioral Therapy: Innovations for Cardiopulmonary Patients With Depression and Anxiety

Medically ill patients face unique physical and emotional challenges that place them at increased risk for symptoms of depression and anxiety. Despite high prevalence and significant impact, depression and anxiety are infrequently treated in the medically ill because of a variety of patient, provider, and system factors. The current article describes the development of an innovative, modular-based cognitive-behavioral intervention (Adjusting to Chronic Conditions Using Education Support and Skills [ACCESS]) that integrates treatment for symptoms of anxiety and depression with medical disease self-management in patients with heart failure and chronic obstructive pulmonary disease. Data from 3 patients who participated in an ongoing open clinical trial are reviewed to illustrate the feasibility, acceptability, and potential strengths and limitations of this intervention.