Pharmacological Management of Impulsivity and Compulsivity

2017 ◽  
Vol 41 (S1) ◽  
pp. S22-S22
Author(s):  
G. Dom
Keyword(s):  
Behavioral Interventions ◽  
Gambling Disorder ◽  
Behavioral Therapy ◽  
Point Of View ◽  
Cognitive Behavioral ◽  
Behavioral Addictions ◽  
Care Providers ◽  
Pharmacological Interventions ◽  
Pharmacological Management ◽  
Treatment As Usual

Increasingly patients present themselves to psychiatrists and other care providers with a specific request for treatment of one or more behavioral addictions. From a pathogenic point of view impulsivity and compulsivity are important drivers of these behavioral disorders, and as such may represent a target of pharmacological and broader neurobiological, e.g. Neuro-stimulation, treatment. Although currently treatment as usual has a focus on psychosocial and cognitive behavioral interventions, interest is growing toward the pharmacological interventions. In the presentation a state of the art will be presented regarding the pharmacological treatment of behavioral addictions, with a focus on Gambling Disorder and Gaming Disorder.Disclosure of interestMember Advisory Board Lundbeck - Belgium.Received funding from Belgian LOTTO for research into Cognitive Behavioral Therapy for Gambling Disorder.

scholarly journals Feasibility and acceptability of cognitive behavioral therapy for insomnia (CBT-I) or acupuncture for insomnia and related distress among cancer caregivers

2020 ◽  
Vol 18 (6) ◽  
pp. 644-647
Author(s):  
Allison J. Applebaum ◽  
Kara Buda ◽  
Michael A. Hoyt ◽  
Kelly Shaffer ◽  
Sheila Garland ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Treatment Modality ◽  
Behavioral Therapy ◽  
Informal Caregivers ◽  
Cognitive Behavioral ◽  
Pharmacological Interventions ◽  
Psychological Outcome ◽  
Patients With Cancer ◽  
The Impact ◽  
Preliminary Support

AbstractObjectiveInsomnia is a common, distressing, and impairing psychological outcome experienced by informal caregivers (ICs) of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) and acupuncture both have known benefits for patients with cancer, but such benefits have yet to be evaluated among ICs. The purpose of the present study was to evaluate the feasibility, acceptability and preliminary effects of CBT-I and acupuncture among ICs with moderate or greater levels of insomnia.MethodParticipants were randomized to eight sessions of CBT-I or ten sessions of acupuncture.ResultsResults highlighted challenges of identifying interested and eligible ICs and the impact of perception of intervention on retention and likely ultimately outcome.Significance of the resultsFindings suggest preliminary support for non-pharmacological interventions to treat insomnia in ICs and emphasize the importance of matching treatment modality to the preferences and needs of ICs.

scholarly journals Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Tomas Nygren ◽  
Matilda Berg ◽  
Ali Sarkohi ◽  
Gerhard Andersson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Focus Groups ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Cognitive Behavioral ◽  
Care Providers ◽  
Self Help ◽  
Arabic Speaking

BACKGROUND Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers. OBJECTIVE This study aims to describe the process of developing a transdiagnostic internet-based cognitive behavioral therapy self-help program in Arabic for mild to moderate symptoms of common psychological problems such as anxiety, depression, and insomnia. METHODS The iterative development process, including feedback from 105 pilot users as well as 2 focus groups, is described. RESULTS Overall, the modules were rated as acceptable by the pilot users, with overall ratings ranging from 3 to 4 points on average for the respective modules on a 5-point Likert scale. Feedback from the 2 focus groups was overall positive with regard to the content and structure of the program but also included suggestions for improving the Arabic translation as well as the usability of the material. CONCLUSIONS An internet-based self-help program that is deemed acceptable by an Arabic-speaking audience can be successfully developed, thus providing increased access to psychological help for an at-risk population. However, further research regarding the efficacy of this type of intervention is warranted.

Beyond basic communication: The role of the mother tongue in cognitive-behavioral therapy (CBT)

2020 ◽  
Vol 24 (4) ◽  
pp. 881-892
Author(s):  
Michal Tannenbaum ◽  
Eden Har
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Minority Groups ◽  
Mother Tongue ◽  
Behavioral Therapy ◽  
Therapeutic Process ◽  
Point Of View ◽  
Cognitive Behavioral ◽  
Theoretical Understanding ◽  
Complex Process ◽  
Understanding Emotions

Immigration is a crisis-prone, complex process, often involving the need to acquire a new language, frequently at the expense of the mother tongue. Thus, the phenomenon of immigrants requiring various forms of mental health assistance while having limited fluency in the therapist’s language is widespread. Cognitive behavioral therapy (CBT) has become a widely prevalent therapeutic approach in many countries, including countries absorbing immigrants. This article reviews case studies that relate to the use of CBT with immigrants, both in individual and group sessions, focusing on the position of the patient’s mother tongue in the process. Research has persistently shown that the mother tongue is emotionally significant—using it, being exposed to it, expressing emotions and understanding emotions expressed in it, having access to it and to memories encoded in it, and the like. Given these dimensions, it plays a potentially important role in the therapeutic process. The pivotal question, then, is whether a therapeutic process that is essentially emotional can be effective if the mother tongue is not an inherent part of it. This article addresses this issue while examining the mother tongue’s position in CBT, the therapists’ awareness of these issues, the accommodations, if any, made in this regard, the therapists’ point of view, and suggestions for improving the use of CBT with immigrants. It is written to be of relevance to a diverse audience including researchers from varied disciplinary backgrounds, therapists who work with multilingual patients (especially immigrants or members of other minority groups) or are multilingual themselves. Our aims, therefore, are to contribute to the theoretical understanding of the mother tongue’s centrality in emotional processes and to offer some practical recommendations for therapists and training institutions.

scholarly journals Meta-analysis and Meta-regression of Cognitive Behavioral Therapy for Psychosis (CBTp) Across Time: The Effectiveness of CBTp has Improved for Delusions

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Katarzyna Sitko ◽  
Bridgette M Bewick ◽  
David Owens ◽  
Ciara Masterson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Medium Effects ◽  
Treatment As Usual ◽  
Meta Analyses

Abstract Published research shows small-to-medium effects of Cognitive Behavioral Therapy for Psychosis (CBTp) on reducing psychotic symptoms. Given the on-going development of CBTp interventions, the aim of this systematic review is to examine whether the effectiveness of CBTp has changed across time. MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for randomized controlled trials examining CBTp interventions targeting positive and/or negative symptoms vs treatment as usual. Four meta-analyses were carried out to examine the effectiveness of CBTp for: positive symptoms; delusions; hallucinations; and negative symptoms. Four meta-regressions examined whether the effectiveness of CBTp changed across time for these groups of symptoms. A total of 28 studies (n = 2698) yielded a pooled g of −0.24 (95% confidence interval [CI] −0.32, −0.16, P < .001) favoring CBTp for positive symptoms, with nonsignificant heterogeneity (Q = 26.87, P = .47; I2 =0%); 13 studies (n = 890) yielded a pooled g of −0.36 (95% CI −0.59, −0.13, P = .002) for delusions, with substantial heterogeneity (Q = 31.99, P = .001; I2 =62%); 16 studies (n = 849) yielded a pooled g of −0.26 (95% CI −0.42, −0.11, P < .001) for hallucinations, with nonsignificant heterogeneity (Q = 18.10, P = .26; I2 =17%); 19 studies (n = 1761) yielded a pooled g of −0.22 (95% CI −0.33, −0.12, P < .001) for negative symptoms, with nonsignificant heterogeneity (Q = 20.32, P = .32, I2 =11%). Meta-regressions indicated a significant effect of year on the effectiveness of CBTp only for delusions (F[1, 11] = 5.99, P = .032; R2 = 0.594); methodological quality did not effect this finding. Findings indicate small-to-medium effects of CBTp for psychotic symptoms, with increasing effectiveness across time for delusions.

Cognitive Therapy for Delusions in Schizophrenia: Models, Benefits, and New Approaches

2004 ◽  
Vol 18 (3) ◽  
pp. 207-221 ◽  
Author(s):  
Corinne Cather ◽  
David Penn ◽  
Michael Otto ◽  
Donald C. Goff
Keyword(s):  
Behavioral Interventions ◽  
Behavioral Therapy ◽  
Data Gathering ◽  
Skills Training ◽  
Problem Formulation ◽  
Cognitive Behavioral ◽  
Psychotic Symptoms ◽  
Behavioral Experiments ◽  
Cognitive Therapies ◽  
And Coping

The main purpose of the review is to demonstrate how cognitive models of psychosis translate into cognitive-behavioral approaches for intervening with psychotic symptoms in schizophrenia. Several cognitive-behavioral factors which play a role in the maintenance and possibly formation of delusional beliefs are discussed, including attentional bias to threat, “data gathering” deficits, dysfunctional metacognition, and safety behaviors. Strategies for engagement, problem formulation, and psychoeducation with deluded patients are described. Cognitive-behavioral interventions are presented, specifically, cognitive restructuring, behavioral experiments, and coping skills training. Challenges to conducting cognitive-behavioral therapy (CBT) with delusions in schizophrenia are reviewed. Novel cognitive therapies, which address these challenges, are presented.

scholarly journals Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia

2019 ◽  
Vol 13 (6) ◽  
pp. 544-547 ◽  
Author(s):  
Jeffrey Rossman
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Health Care Providers ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Chronic Insomnia ◽  
Relaxation Techniques ◽  
Care Providers ◽  
Medical Problems ◽  
Sleep Medication ◽  
Falling Asleep

Sleep difficulties are an extremely prevalent health problem, with about 33% to 50% of adults reporting regular difficulty falling asleep or staying asleep. About 7% to 18% of adults meet the criteria for an insomnia disorder.1,2 Sleep disruptions contribute to a variety of medical problems, including cognitive impairment, reduced immune function, metabolic imbalance, and exacerbation of psychiatric conditions.3 The most effective nonpharmacological treatment for chronic insomnia is cognitive-behavioral therapy for insomnia (CBT-i). CBT-i produces results that are equivalent to sleep medication, with no side effects, fewer episodes of relapse, and a tendency for sleep to continue to improve long past the end of treatment. The long-term improvements seem to result from the patient learning how to support and promote the body’s natural sleep mechanism. The five key components of CBT-i are sleep consolidation, stimulus control, cognitive restructuring, sleep hygiene, and relaxation techniques. Although CBT-i is a safe and highly effective treatment for insomnia, unfortunately, it is underutilized, primarily because of two reasons: (1) There is currently a shortage of trained CBT-i practitioners. (2) Patient are much more likely to learn about sleep medication as a treatment for their insomnia (via drug advertisements and prescribing physicians) than CBT-i. Physicians and health care providers can play an important role in educating their patients about CBT-i and recommending it as a first-line treatment for chronic insomnia.

scholarly journals Effects of Internet-Based Cognitive Behavioral Therapy in Routine Care for Adults in Treatment for Depression and Anxiety: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Anne Etzelmueller ◽  
Christiaan Vis ◽  
Eirini Karyotaki ◽  
Harald Baumeister ◽  
Nickolai Titov ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Cognitive Behavioral ◽  
Effect Sizes ◽  
Depression And Anxiety ◽  
Care Providers ◽  
Treatment Of Depression

BACKGROUND Although there is evidence for the efficacy of internet-based cognitive behavioral therapy (iCBT), the generalizability of results to routine care is limited. OBJECTIVE This study systematically reviews effectiveness studies of guided iCBT interventions for the treatment of depression or anxiety. METHODS The acceptability (uptake, participants’ characteristics, adherence, and satisfaction), effectiveness, and negative effects (deterioration) of nonrandomized pre-post designs conducted under routine care conditions were synthesized using systematic review and meta-analytic approaches. RESULTS A total of 19 studies including 30 groups were included in the analysis. Despite high heterogeneity, individual effect sizes of investigated studies indicate clinically relevant changes, with effect sizes ranging from Hedges’ g=0.42-1.88, with a pooled effect of 1.78 for depression and 0.94 for anxiety studies. Uptake, participants’ characteristics, adherence, and satisfaction indicate a moderate to high acceptability of the interventions. The average deterioration across studies was 2.9%. CONCLUSIONS This study provides evidence supporting the acceptability and effectiveness of guided iCBT for the treatment of depression and anxiety in routine care. Given the high heterogeneity between interventions and contexts, health care providers should select interventions that have been proven in randomized controlled clinical trials. The successful application of iCBT may be an effective way of increasing health care in multiple contexts.

Using Cognitive and Behavioral Methods to Support Bereaved Students

2017 ◽  
pp. 130-148
Author(s):  
Rosemary Flanagan
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Group Treatment ◽  
Behavioral Interventions ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Treatment Package ◽  
Behavioral Methods

This chapter addresses cognitive and behavioral interventions for students experiencing grief and bereavement. The evidence-based treatment package called Trauma-Focused Cognitive-Behavioral Therapy is covered in detail. The components of this treatment package for bereaved students are discussed. Other group treatment options are also mentioned. Practical considerations and implementation issues for this treatment package are reviewed.

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