Coping strategies in obsessive-compulsive patients during Covid-19 lockdown

Background/ObjectiveThe main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.     

Generalization of theory-based predictions for improved nutrition to adults with morbid obesity: Implications of initiating exercise

Exercise is a robust predictor of long-term success with weight loss, and research based on social cognitive theory suggests that exercise program-induced changes in self-regulation, mood, and self-efficacy transfer to improved eating. These relationships were tested in adults with morbid obesity (overall M_age = 43 years; 86% female; M_{body mass index} = 45 kg/m²) participating in a 6-month treatment of cognitive-behaviorally supported exercise paired with either standard nutrition education (n = 87) or cognitive-behavioral methods for controlled eating (n = 89). Based on multiple mediation analyses, improvements in self-regulation and self-efficacy were significantly associated with increased fruit and vegetable intake and reduced body mass index (BMI). The cognitive-behavioral nutrition methods were associated with greater improvements in fruit and vegetable intake and BMI, however, within both models, complete mediation was found after simultaneous entry of changes in self-regulation, mood, and self-efficacy, and exercise volume as mediators. Only the indirect effect of change in self-regulation was a significant (or marginally significant) independent mediator. Generalization of previously identified relationships between exercise program-induced improvements in psychosocial variables and improvements in nutrition and BMI were supported for individuals with morbid obesity. Based on these relationships, implications for behavioral treatments were discussed.     

Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Background/Objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU). Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations. Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization. Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.     

Transcranial Direct Current Stimulation improves word production in Conduction Aphasia: Electroencephalographic and behavioral evidences

A Conduction Aphasic patient, RH, with many difficulties at the level of phonological output, was subjected to Transcranial Direct Current Stimulation (tDCS) therapy six months after suffering a stroke. Fifteen daily sessions were administered (five days per week). The treatment led to a better intra-hemispheric electrical coherence and inter-hemispheric balance, as shown by the quantitative EEG analysis. Transcranial Direct Current Stimulation therapy was shown to be effective in inhibiting irregular activation of the right hemisphere, offering the healthy areas of the left hemisphere the possibility of reassuming their linguistic processing abilities. Also, the number of errors in picture naming and repetition of words and pseudowords dropped considerably following treatment. The recovery was greater for long stimuli and was not affected by semantic or lexical variables such as familiarity. These results suggest that the Phonological Output Buffer, a mechanism dedicated to the maintenance, ordering and production of phoneme strings, was the processing stage modified by the treatment.     

Influence of weight loss therapy programs in body image self-perception in adults with intellectual disabilities

Some studies suggest that people with intellectual disabilities (ID) might show distortions regarding body image self-perception. The objectives of this study were to investigate whether people with ID could correctly identify their body image and to determine if participating in a weight loss therapy program (WLTP) influenced in any way that perception. For that purpose, an experiment was proposed and all along a weight loss therapy program, a comparison between a body image subjective measure, as the Stunkard scale, and an objective one, as body mass index, was performed. The results obtained showed that individuals with ID (n = 24) perceived in a wrong way their body image before any intervention program (58%). After applying the WLTP for ten weeks, an accentuation in this perception distortion (83%), mostly related with underestimation, was observed with respect to actual body mass index values. The strongest conclusion that can be drawn from this study is that people with ID do not correctly identify their body image. Furthermore, participating in WLTP influences their physical self-concept perception in the way that controlling two variables, as exercise and caloric restriction, causes greater disruption in that perception than controlling only one of them.     

Efficacy of stress management program for depressive patients with advanced head and neck cancer: A single-center pilot study

Background/ObjectivePatients with head and neck cancer (HNC) have some problems such as dysfunction of breathing, eating, and/or speaking. The aim of this study was to examine efficacy of the stress management program for HNC patients (SMAP-HNC) compared with usual care (UC).MethodWe conducted a pilot study of SMAP-HNC for depressive HNC patients between January 2016 and March 2018. The program contains psychoeducation, stress coping training, and operant reinforcement. The outcome measure was the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT), and Brief Coping Inventory (COPE).ResultsTwenty patients were randomly assigned to SMAP-HNC and UC group. Although a small sample sizes, there was no significant difference of depression score change between SMAP-HNC and UC group (Hedges’d g -0.83; 95% CI -1.80 to 0.13).ConclusionsIt was the first study to conduct stress management program for HNC patients. Unfortunately, our trial designed as a randomized controlled trial is underpowered to make conclusion as to the efficacy of SMAP-HNC. However, there are some valuable suggestions to modify the stress management program in future.     

Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial

Background/Objective Brief transdiagnostic psychotherapies are a possible treatment for emotional disorders. We aimed to determine their efficacy on mild/moderate emotional disorders compared with treatment as usual (TAU) based on pharmacological interventions. Method: This study was a single-blinded randomized controlled trial with parallel design of three groups. Patients (N = 102) were assigned to brief individual psychotherapy (n = 34), brief group psychotherapy (n = 34) or TAU (n = 34). Participants were assessed before and after the interventions with the following measures: PHQ-15, PHQ-9, PHQ-PD, GAD-7, STAI, BDI-II, BSI-18, and SCID. We conducted per protocol and intention-to-treat analyses. Results: Brief psychotherapies were more effective than TAU for the reduction of emotional disorders symptoms and diagnoses with moderate/high effect sizes. TAU was only effective in reducing depressive symptoms. Conclusions: Brief transdiagnostic psychotherapies might be the treatment of choice for mild/moderate emotional disorders and they seem suitable to be implemented within health care systems.     

Normal executive attention but abnormal orienting attention in individuals with sluggish cognitive tempo

Background/objective: Sluggish Cognitive Tempo (SCT) is an attentional disorder characterized by the symptoms of slowness in behavior or thinking, a lack of en.ergy, difficulty initiating and sustaining effort, daydreaming, and drowsiness. The aim of the present study was to investigate the distinctive attentional characteristics of SCT as compared to Attention-Deficit/Hyperactivity Disorder (ADHD). Method: A total of 110 adults were recruited and divided into four groups: SCT+ADHD, SCT, ADHD, and healthy controls. The Revised version of Attention Networks Test was used to investigate each group’s attentional profile. Results: The results revealed that the two SCT groups (SCT+ADHD and SCT) showed a significantly weaker orienting network due to the problems of engaging and disengaging attention than the other two groups. Additionally, the two ADHD groups (SCT+ADHD and ADHD) showed a significantly weaker executive control network than the other two groups. Conclusions: The findings demonstrate an attentional distinction between the SCT and the ADHD groups with a greater dysfunction in the orienting network in the SCT group as compared to the ADHD group. Furthermore, a greater executive control dysfunction was observed in the ADHD group as compared to the SCT group.