The Effects On and Of Depression - An Exploratory Study of Rehabilitation and Secondary Prevention in Coronary Artery Disease

Forty consecutive participants in a comprehensive, behaviourally oriented coronary rehabilitation and secondary prevention program were followed for three years. Changes in depression (as measured with the Beck Depression Inventory) as well as the influence of baseline levels of depression on achieved changes in lifestyle behaviour and on rehabilitation and secondary prevention effects were analyzed. Subjects with moderate levels of baseline depression experienced short-term reductions of depression, which was maintained at the 12-month follow-up. Clinically depressed subjects experienced less positive results, with smaller immediate reductions as well as relapse to baseline levels after 12 months, specifically in non-physical, cognitive-affective depression symptoms. There were, however, no differences in lifestyle changes or in hospital treatment between groups with different pre-treatment depression levels. These results are discussed in relation to earlier research on the detrimental effects of depression on the prognosis of coronary artery disease.     

Self-Construing In Former Child Soldiers

This article presents a repertory grid study of young people who had experienced civil war in Sierra Leone, some as child soldiers and others as noncombatants. Unexpected findings included that the former combatants viewed themselves more favorably than did noncombatants. The findings are discussed in terms of individual and social construing processes, drawing on narratives and interview and focus group responses obtained from the participants in the larger investigation of which this study was part. Particular consideration is given to the role of forgiveness.     

Children in psychodynamic psychotherapy: changes in global functioning

This study was part of the Erica Process and Outcome Study. The aim was to investigate if children's global functioning improves after psychodynamic psychotherapy. Variables that may predict changes in global functioning were examined both statistically and qualitatively, for example, the child's age and gender; diagnosis and comorbidity; treatment variables. The sample consisted of 33 children (five to 10 years of age) who participated in psychodynamic psychotherapy with parallel work with parents. Twenty-nine children had at least one DSM-IV diagnosis, and 15 children had comorbid conditions. At the start of psychotherapy, the most frequent diagnoses were attention disorder and disruptive behaviour. Child psychotherapists rated the children's global functioning using CGAS and HCAM. Large effect sizes were obtained (d = 1.80 and d = 1.98). However, no statistical correlations were found between global functioning and the selected variables. In order to illuminate the complex connection between process and outcome the study was complemented with in-depth case studies where data were taken from questionnaires, completed by the child therapists every third month. Two child therapies were selected: one in which the therapist rated a large change and one in which a small change was rated (CGAS). The analysis showed that important individual change, for example, attainment of formulated goals, was not always reflected in the change rated using the CGAS. Findings suggest that psychodynamic child psychotherapy can be beneficial. However, further research is needed to identify factors that contribute to change in children's global functioning.     

Trainee therapists’ views on the alliance in psychotherapy and supervision: a longitudinal study

The shape of alliance in psychotherapy and supervision using growth curve modeling was examined for clinically inexperienced trainee therapists, who were engaged in long-term cognitive behavioral - or psychodynamic individual psychotherapy at a Psychology Clinic in Sweden. Trainee therapists rated their view of the alliance with their clients and their supervisors on the Working Alliance Inventory at five time points. The alliance to the client show a consistent, positive development throughout the therapy. The alliance to the supervisors show initially a decrease, followed by an increase, and then again, the rate of increase in the supervisory alliance ratings slowed down indicating a more complex view of the supervisory alliance compared to the view of the alliance in psychotherapy.     

Intensive cognitive behavioural group treatment for social phobia: a pilot study

The aim of this pilot study was to examine the effectiveness of an intensive form of cognitive behavioural group treatment practised routinely in a psychiatric clinic. A total of 27 outpatients with social phobia of long duration were assigned to a 41-hour treatment administered over 2 periods of 3.5 and 4.5 days, 1 week apart. Four groups, each comprising 6-8 patients, participated in the study. All except 1 patient (26/27) completed the treatment and 20 patients participated in all follow-up sessions after 3, 6 and 12 months. Treatment significantly reduced fear and avoidance of social interaction and performance, anticipatory anxiety and symptoms' influence on daily life. Follow-up assessments indicated maintained or increased improvement from post-test to 1 year and large sensitivity to treatment at both post-test and 1 year. Of the patients in the study, 85% were taking a prescribed drug, and 70% had taken medication for at least 1 year before they entered the treatment. At 1-year follow-up 52% had discontinued medication.     

THE OUTCOME OF SHORT‐TERM PSYCHODYNAMIC ART THERAPY COMPARED TO SHORT‐TERM PSYCHODYNAMIC VERBAL THERAPY FOR DEPRESSED WOMEN

The primary aim of this randomized controlled clinical trial was to compare the outcome from two types of short‐term psychodynamic psychotherapy. The participants were thirty‐nine women with depression. Half of the participants (n = 18) received art psychotherapy and the other half received verbal psychotherapy (n = 21). Data was collected before and after psychotherapy, and at a 3‐month follow‐up using self‐rating scales and interviewer‐based ratings. Results showed that art and verbal psychotherapies were comparable, and at follow‐up, the average participant in both groups had few depressive symptoms and stress‐related symptoms. The conclusion was that short‐term psychodynamic art therapy could be a valuable treatment for depressed women.     

Long-term effects of lifestyle behavior change in coronary artery disease: effects on recurrent coronary events after percutaneous coronary intervention.

This study evaluated the effects of a behaviorally oriented cardiac rehabilitation and secondary prevention program on lifestyle changes and on coronary recurrence rates. Patients recently treated with percutaneous coronary intervention (PCI) were randomized to an intervention with an aggressive focus on lifestyle changes (smoking, diet, exercise, and stress; n=46) or to a standard-care control group (n=42). Results showed that the intervention group had significantly larger overall lifestyle changes than the control group after 12, 24, 36, and 60 months. The intervention group had significantly lower rates of all coronary events (acute myocardial infarction, coronary artery bypass graft, PCI, cardiac death; 30.4% vs. 53.7%), and of cardiovascular mortality (2.2% vs. 14.6%). The need for future large-scale and long-term evaluations of lifestyle-oriented secondary prevention interventions of this kind is emphasized.