The clinical application of the stress concept

2002 ◽  
Vol 14 (4) ◽  
pp. 192-195
Author(s):  
F. Koerselman
Keyword(s):  
Clinical Practice ◽  
Clinical Application ◽  
Clinical Psychiatry ◽  
Life Stress ◽  
Daily Life ◽  
Biological Approach ◽  
Research Findings ◽  
Dsm Iv ◽  
The Impact ◽  
The Way

Background:Knowledge on fundamental aspects of the influence of ‘stress’ on animal and human organisms is accumulating. In clinical situations, however, psychiatrists still do not use apropriate instruments to recognize and handle the impact of daily life stress. DSM-IV is insufficient in this respect.Objective:A different approach is sketched for clinicians to be able to integrate knowledge from research more effectively.Method:Application of a ‘broad’ biological view may reveal the significance of interpretation, emotion, impulse and reaction as stages of a ‘mental tract’, which is involved in processing the input of stressful situations.Result:This may lead to a more rational ‘targeting’ of pharmacological and psychotherapeutic strategies in clinical practice.Conclusion:A re-orientation of clinical psychiatry from mere classification towards a ‘broad’ biological approach may pave the way for a more rational and purposeful application of research findings to therapy.

scholarly journals Citation bias and selective focus on positive findings in the literature on the serotonin transporter gene (5-HTTLPR), life stress and depression

2016 ◽  
Vol 46 (14) ◽  
pp. 2971-2979 ◽  
Author(s):  
Y. A. de Vries ◽  
A. M. Roest ◽  
M. Franzen ◽  
M. R. Munafò ◽  
J. A. Bastiaansen
Keyword(s):  
Serotonin Transporter ◽  
Life Stress ◽  
Web Of Science ◽  
Evidence Base ◽  
Transporter Gene ◽  
Negative Results ◽  
Research Findings ◽  
Citation Bias ◽  
The Impact ◽  
Positive Focus

BackgroundCaspi et al.'s 2003 report that 5-HTTLPR genotype moderates the influence of life stress on depression has been highly influential but remains contentious. We examined whether the evidence base for the 5-HTTLPR–stress interaction has been distorted by citation bias and a selective focus on positive findings.MethodA total of 73 primary studies were coded for study outcomes and focus on positive findings in the abstract. Citation rates were compared between studies with positive and negative results, both within this network of primary studies and in Web of Science. In addition, the impact of focus on citation rates was examined.ResultsIn all, 24 (33%) studies were coded as positive, but these received 48% of within-network and 68% of Web of Science citations. The 38 (52%) negative studies received 42 and 23% of citations, respectively, while the 11 (15%) unclear studies received 10 and 9%. Of the negative studies, the 16 studies without a positive focus (42%) received 47% of within-network citations and 32% of Web of Science citations, while the 13 (34%) studies with a positive focus received 39 and 51%, respectively, and the nine (24%) studies with a partially positive focus received 14 and 17%.ConclusionsNegative studies received fewer citations than positive studies. Furthermore, over half of the negative studies had a (partially) positive focus, and Web of Science citation rates were higher for these studies. Thus, discussion of the 5-HTTLPR–stress interaction is more positive than warranted. This study exemplifies how evidence-base-distorting mechanisms undermine the authenticity of research findings.

Reflections on the Clinical Utility of the ICD-10 and DSM-IV Classifications and their Diagnostic Criteria

1999 ◽  
Vol 33 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Aksel Bertelsen
Keyword(s):  
Clinical Practice ◽  
Clinical Psychiatry ◽  
Clinical Utility ◽  
The Other ◽  
Diagnostic Classification ◽  
Full Understanding ◽  
Clinical Diagnoses ◽  
Icd 10 ◽  
Dsm Iv ◽  
Quality And Reliability

Objective: The change to non-theoretical, criteria-based diagnostic classification in ICD-10 and DSM-III/IV has presented a major innovation in clinical psychiatry. The aim of the present paper is to provide a provisional evaluation of their utility in clinical practice. Method: The method involved a close scrutiny of ICD-10 and DSM-IV with a view to identifying difficulties and problems in their use. Results and Conclusions: The criteria-based classifications are no longer just coding conventions, but have become part of the conceptual framework of the discipline itself. The advantages, particularly as to the quality and reliability of clinical diagnoses, outweigh the disadvantages with temptations to mechanistic and reductionistic applications of criteria and incomplete nosological evaluation. Comprehensive clinical evaluation, however, should work at two separate levels: one, the initial, syndromatical diagnostic level, followed by the other, the nosological level, with evaluation of factors possibly influencing course and outcome of the psychiatric disorders. Only when both the syndromatical diagnosis and nosological factors are taken into consideration, is it possible to get a full understanding of the disorder necessary for optimal treatment. In this way, clinical psychiatry can be kept as it was intended: a healing discipline.

Clinic risk associated with comorbidity of (subclinical) psychosis, anxiety and depressive symptoms: A case for stratified medicine in psychiatry

2016 ◽  
Vol 33 (S1) ◽  
pp. S49-S49 ◽  
Author(s):  
M. van Nierop ◽  
I. Myin-Germeys ◽  
R. van Winkel
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Childhood Trauma ◽  
Life Stress ◽  
Stress Reactivity ◽  
Daily Life ◽  
Clinical Severity ◽  
Psychotic Symptoms ◽  
The Impact

BackgroundMeta-analyses link childhood trauma to depression, mania, anxiety, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life.AimTo investigate the impact of trauma on psychopathological phenotype, functional outcome, and daily life stress reactivity.MethodsWe used data from a representative general population sample (NEMESIS-2; n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP; n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture. Additionally, we examined these groups in terms of social functioning, clinical severity, and quality of life. In a separate sample (n = 621), daily life (emotional and cortisol) stress reactivity was assessed, using ambulatory assessment.ResultsIn all samples, childhood trauma was considerably more strongly associated with an admixture of symptoms of depression, anxiety, psychosis, and mania, rather than with these symptoms in isolation. Individuals exposed to childhood trauma, who also had an admixture of symptoms, had a lower quality of life, more help-seeking behaviour, higher prevalence of substance use disorders, and lower social functioning, compared with individuals not exposed to trauma, without an admixture of symptoms, or neither. Furthermore, trauma-exposed individuals with an admixed psychopathological phenotype show a higher daily emotional stress reactivity.ConclusionChildhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries. Stratifying according to childhood trauma exposure thus identifies an admixed phenotype, possibly induced by continuous daily life stress reactivity, that has important clinical relevance. Identification of functionally meaningful aetiological subgroups may aid clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Role of Personality in the Initiation of Communication Situations

2014 ◽  
Vol 35 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Sofie Frederickx ◽  
Joeri Hofmans
Keyword(s):  
Individual Differences ◽  
Negative Binomial ◽  
Daily Life ◽  
Negative Binomial Regression ◽  
Big Five Personality ◽  
Binomial Regression ◽  
Communication Situations ◽  
The Impact ◽  
The Way

Whereas a small number of studies have focused on the impact of extraversion, agreeableness, and neuroticism on the way people communicate, little is known about how the big five personality traits relate to individual differences in the specific types of communication-related situations selected in daily life. For a period of five days, people were asked to report on the types of conversations they initiated earlier that day (N = 168). Multilevel negative binomial regression analysis showed that the specific types of conversations initiated in daily life can be predicted by individual differences in extraversion, agreeableness, and neuroticism. As such, the results show that individual differences in personality are not only reflected in the way people behave once they communicate, but also in the situations that people report to select in daily life.

scholarly journals Restrictions’ acceptance and risk perception by young generations in a COVID-19 context

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Claudia Seabra ◽  
Miral AlAshry ◽  
Kevser Çınar ◽  
Irfan Raja ◽  
Manuel Reis ◽  
...  
Keyword(s):  
Daily Life ◽  
Tourism Industry ◽  
Daily Lives ◽  
Content Type ◽  
Safety Perceptions ◽  
The Future ◽  
National Governments ◽  
The Impact ◽  
Future Plans ◽  
The Way

Purpose The purpose of this study is to analyze the impact of the acceptance of national governments’ restrictions imposed due to the COVID-19 pandemic on the citizens’ safety perceptions of daily life and future plans. In particular, the aim is to examine the relationship among the citizens who belong to Generations Y and Z and who represent the future of tourism markets, as tourists and as host communities, in three important receiving countries, namely, Egypt, Portugal and Turkey. Design/methodology/approach This pilot project gathers data from three important receiving countries located on two continents involving 348 residents from Generations Y and Z. To identify the factors underlying the “acceptance of restrictions and measures” and the “Impacts of the COVID-19 threat on safety perceptions” a factor analysis was carried out. Notably, Pearson's correlation coefficient and a multiple linear regression analysis allowed to analyze the relationships between the two factors and a Kruskal–Wallis test was used to assess the influence of individuals’ country of residence. Findings The results reveal that in general, young generations accepted the measures and restrictions imposed by the respective governments. In addition, the present pandemic has a strong impact on their safety perception in daily lives and future plans to travel. Moreover, results prove that between the three countries there are dissimilarities showing that the countries' situation regarding COVID-19 influences those two dimensions. Research limitations/implications This study adds to the development of studies on the impacts of health risks in tourism activity, specifically on the safety measures adopted and their impacts on local receiving communities. It shows that the current pandemic is severely affecting the daily lives and plans for the future of citizens and tourists, which is in accordance with previous studies. Practical implications The outcome of this study paves the way for policy-makers in the tourism industry because it presents experiences from Generations Y and Z members, future customers and tourist products consumers, but also from receiving communities. Social implications The results of this study bring some light on how local communities, specifically, the younger generations, are facing this pandemic period and on the impact it has on the way they face daily life, future plans and on their level of acceptance of a sector as important as tourism. Originality/value To the knowledge, besides the relevant studies already conducted on the impact of the COVID-19 crisis on the tourism field, no study has yet been carried out to analyze how residents have reacted and accepted the restrictions and security measures imposed by their national governments and their impact on residents’ feelings and perceptions, daily lives and travel plans. Furthermore, the specific impacts of this crisis will have on the younger generations are yet to be analyzed.

scholarly journals THE POSSIBILITIES OF THE NEW PUBLIC SPACE THROUGH CHANGING DYNAMICS DURING THE COVID 19

2021 ◽  
Vol 11 (2) ◽  
pp. 360-377
Author(s):  
Arife KOCA ◽  
Osman TUTAL
Keyword(s):  
Public Space ◽  
Daily Life ◽  
Global Scale ◽  
Urban Environments ◽  
Public And Private ◽  
New Normal ◽  
Epidemic Process ◽  
New Public ◽  
The Impact ◽  
The Way

The epidemic process experienced on a global scale, together with the health field in which it emerged, directly affected daily life from education to tourism, from production to consumption. This effect has been so great. Even the process of returning to normal starting from the first half of 2020 has been defined as the new normal. The new normal has changed the individual’s daily life space and boundaries and imposed restrictions on the use of public exteriors from residential interiors. The change in the use of the space has also changed the relations, communication style, and interaction with space and those who use the space. Relationships and interactions established in daily life have started to be realized almost through residences due to the limitations on public space. Education, work, entertainment, commerce has been started distance and digital environment. This situation causes to changes in behaviors and the way they socialize. The change in the way people socialize and lifestyle with the epidemic causes transform in the use of public and private spaces. As the dynamics of the city change, these areas need to rethink the designs and develop creative solutions. Spatial studies on the Covid 19 pandemic process are approached from different aspects and it is seen that the studies are multidimensional. In the study, these different views are analyzed and the paper is focused from a different framework. It is aimed to contribute to the epidemic process by developing suggestions for public space approaches and possibilities. The method of the study is determined as the evaluation of physical and virtual public space through examples in accordance with literature researches and discussions. It is important to develop new perspectives on the impact of the epidemic on urban environments and to understand what the long-term impacts could have on the public sphere. And then, it is aimed to conduct research on the socio-spatial impacts to be developed according to the results of Covid 19 measures. Therefore, within the scope of the study, the effects of the epidemic in urban spaces are tried to be understood. It is discussed how the possibilities of new public spaces occurring in the built environment and virtual environment will change the nature and definition of this concept.

scholarly journals Clinical relevance of discoveries in psychopharmacogenetics1

2004 ◽  
Vol 10 (6) ◽  
pp. 455-465 ◽  
Author(s):  
Evangelia M. Tsapakis ◽  
Amlan Basu ◽  
Katherine J. Aitchison
Keyword(s):  
Genetic Variation ◽  
Clinical Practice ◽  
Adverse Effects ◽  
Clinical Response ◽  
Clinical Psychiatry ◽  
Mechanism Of Action ◽  
Clinical Relevance ◽  
Therapeutic Efficacy ◽  
Research Findings ◽  
Methodological Problems

Individual genetic variation accounts for some of the variability in response to drugs used routinely in clinical psychiatry. Psychopharmacogenetics focuses on how polymorphisms in genes affecting the mechanism of action of a drug's effect and/or metabolism (both peripheral and central) can influence an individual's clinical response to the drug, in terms of both therapeutic efficacy and adverse effects. Pharmacogenetics promises to be of substantial help in the field of psychiatric pharmacotherapy, but before research findings can be applied to clinical practice, ethical and methodological problems have to be addressed and overcome. This review summarises the most robust findings in the field and outlines how psychopharmacogenetic studies could lead to treatment individualisation.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Translating Principles of Speech Science to Clinical Practice: Current and Future Trends in Craniofacial Disorders

2008 ◽  
Vol 18 (1) ◽  
pp. 31-40 ◽  
Author(s):  
David J. Zajac
Keyword(s):  
Clinical Practice ◽  
Speech Intelligibility ◽  
Current Practice ◽  
Computer Assisted ◽  
Behavioral Management ◽  
Single Word ◽  
Future Directions ◽  
Speech Science ◽  
The Impact ◽  
Opinion Article

Abstract The purpose of this opinion article is to review the impact of the principles and technology of speech science on clinical practice in the area of craniofacial disorders. Current practice relative to (a) speech aerodynamic assessment, (b) computer-assisted single-word speech intelligibility testing, and (c) behavioral management of hypernasal resonance are reviewed. Future directions and/or refinement of each area are also identified. It is suggested that both challenging and rewarding times are in store for clinical researchers in craniofacial disorders.

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