Psychological Treatments for Anhedonia

2019 ◽  
pp. 574-595
Author(s):  
Halina J. Dour ◽  
Richard T. LeBeau ◽  
Michelle G. Craske
Keyword(s):  
Positive Affect ◽  
Affective Disorders ◽  
Anxiety And Depression ◽  
Future Research ◽  
Long Term Outcomes ◽  
Psychological Treatments ◽  
Core Symptom ◽  
Poor Treatment ◽  
Poor Treatment Response

Anhedonia is defined as the reduced ability to anticipate or expect future rewards, recognize or appreciate present rewards, and learn methods of obtaining rewards. It is a core symptom of depression and a correlate of many anxiety disorders. Anhedonia is a unique and significant predictor of negative long-term outcomes and poor treatment response. Despite the apparent link between diminished positive affect and affective disorders, current psychotherapies for anxiety and depression primarily focus on minimizing negative affect (e.g., sadness, thoughts of death) with little focus on addressing deficits in positive affect (anhedonia). This chapter reviews current and emerging interventions that target anhedonia, including a discussion of possible mechanisms (i.e., factors that explain change) of these treatments. It concludes with directions for future research in this important area.

scholarly journals Long-term outcomes of psychological treatment for posttraumatic stress disorder: a systematic review and meta-analysis

2021 ◽  
pp. 1-11
Author(s):  
Maxi Weber ◽  
Sarah Schumacher ◽  
Wiebke Hannig ◽  
Jürgen Barth ◽  
Annett Lotzin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Stress Disorder ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Long Term Outcomes ◽  
Psychological Treatments

Abstract Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, PsycINFO, PSYNDEX, and related articles were searched for randomized controlled trials with at least 12 months of follow-up. Twenty-two studies (N = 2638) met inclusion criteria, and 43 comparisons of cognitive behavioral therapy (CBT) were available at follow-up. Active treatments for PTSD yielded large effect sizes from pretest to follow-up and a small controlled effect size compared with non-directive control groups at follow-up. Trauma-focused treatment (TFT) and non-TFT showed large improvements from pretest to follow-up, and effect sizes did not significantly differ from each other. Active treatments for comorbid depressive symptoms revealed small to medium effect sizes at follow-up, and improved PTSD and depressive symptoms remained stable from treatment end to follow-up. Military personnel, low proportion of female patients, and self-rated PTSD measures were associated with decreased effect sizes for PTSD at follow-up. The findings suggest that CBT for PTSD is efficacious in the long term. Future studies are needed to determine the lasting efficacy of other psychological treatments and to confirm benefits beyond 12-month follow-up.

Physiotherapy management of patients with major chest trauma: Results from a global survey

Trauma ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Heleen van Aswegen ◽  
Julie Reeve ◽  
Lisa Beach ◽  
Romy Parker ◽  
Monika Fagevik Olsèn
Keyword(s):  
Online Survey ◽  
Chest Trauma ◽  
Trauma Team ◽  
Future Research ◽  
Long Term Outcomes ◽  
Breathing Exercises ◽  
Surgical Fixation ◽  
Short And Long Term ◽  
Ventilatory Management

Aim Major chest trauma is associated with significant morbidity and mortality. Management of patients with major chest trauma includes pain relief, ventilatory management, surgical fixation and early rehabilitation to improve both short- and long-term outcomes. Physiotherapy is widely considered an integral component of the multidisciplinary trauma team and aims to improve respiratory status and reduce the sequelae associated with immobility and reduced physical function. Despite this there is scarce evidence describing or investigating physiotherapy interventions and how these practices vary worldwide. The aim of this study was to ascertain the current physiotherapy management of patients having sustained major chest trauma and to investigate how such practices varied internationally. Methods A purpose designed online survey was administered to a group of experienced physiotherapists who work in the field of trauma. Results Response rate was 51% ( n = 49) and respondents represented all five continents. Respondents reported focussing on active coughing ( n = 46, 96%, r = 0.5, p = 0.98), body positioning ( n = 43, 94%, r = 0.7, p = 0.41), deep breathing exercises ( n = 44, 94%, r = 0.8, p = 0.66) and early mobilisation ( n = 47, 98%, r = 1, p = 0.64). Ambulation in hospital was reported to be common ( n = 46, 98%, r = 0.2, p = 0.99) but rehabilitation to address longer term sequelae following hospital discharge was reported to be rare ( n = 4, 8%). Conclusion This survey has highlighted those practices used by physiotherapists worldwide which aim to address the complications associated with major chest trauma. Having established global practice, the study provides a platform for future research investigating the efficacy of such interventions in improving both short- and long-term outcomes for patients following major chest injury.

Long-Term Outcomes in Pockets of Effectiveness

2020 ◽  
pp. 187-201
Author(s):  
Erin Metz McDonnell
Keyword(s):  
Scale Up ◽  
The State ◽  
Future Research ◽  
Long Term Outcomes ◽  
Organizational Reform ◽  
Future Outcomes

This chapter describes what happened to the positive cases in this study over the longer term. By examining the outcomes observed in the selected cases, the chapter sheds some speculative light on whether the bureaucratic ethos can survive the departure of the niche founder, and sketches a range of possible outcomes for whether niches can scale up or possibly even diffuse more broadly. However, because the cases studied so far in this work have been selected instead of being randomly sampled, they cannot definitively show what will happen or even what is likely to happen as pockets of effectiveness within the state mature. They do however, sketch a range of future outcomes that are possible, laying a foundation for future research to analyze the conditions under which particular long-term outcomes do or do not emerge. The cases collectively illuminate some of the promise and pitfalls of interstitiality as a force for organizational reform more broadly throughout the state.

scholarly journals The Effects of Hypertension on Cognitive Function in Children and Adolescents

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Stephen D. Cha ◽  
Hiren P. Patel ◽  
David S. Hains ◽  
John D. Mahan
Keyword(s):  
Children And Adolescents ◽  
Pediatric Population ◽  
Organ Damage ◽  
Future Research ◽  
Cognitive Effects ◽  
Long Term Outcomes ◽  
Future Studies ◽  
End Organ Damage ◽  
Anxiety Depression

Hypertension (HTN) is found in about 3-4% of the pediatric population with long-term risks of end organ damage if untreated or poorly controlled. Although children with HTN are being more frequently screened for end organ damage (i.e., LVH), the cognitive effects of HTN and methods to screen for cognitive dysfunction have not been extensively explored. In recent years, there have been a small number of studies that have provided important insights that can guide future research in this area. These studies show that HTN can be associated with headaches, restlessness, sleep disturbance, anxiety, depression, decreased attention, and also poor executive functioning. By increasing the utilization of cognitive tests in hypertensive children and adolescents, important cognitive defects secondary to HTN may be detected. More research is needed in the area, and the results of future studies could have far reaching implications for long-term outcomes in hypertensive children and adolescents.

Long-Term Effects of Sports Concussions: Bridging the Neurocognitive Repercussions of the Injury with the Newest Neuroimaging Data

2016 ◽  
Vol 23 (5) ◽  
pp. 567-578 ◽  
Author(s):  
Luke C. Henry ◽  
Sebastien Tremblay ◽  
Louis De Beaumont
Keyword(s):  
Scientific Literature ◽  
Chronic Traumatic Encephalopathy ◽  
Future Research ◽  
Long Term Effects ◽  
Long Term Outcomes ◽  
Research Directions ◽  
Neuroimaging Data ◽  
Future Research Directions ◽  
Sports Concussions

Little is known of the long-term effects of sports-related concussion. Within the scientific literature, conclusions vary substantially where some work suggests there are no long-term consequences at all and other studies show rampant neurodegeneration thought to be caused by sometimes even a single concussive blow to the head. There is growing evidence that supports multiple long-term outcomes, showing both subclinical and clinically relevant changes in the brains of athletes, young and old alike. This article reviews the pathohistology of cerebral concussions and examines the extant literature with a focus on electrophysiological and neuroimaging findings. Neurobehavioral and neurocognitive changes are also reviewed, particularly as they are related to chronic traumatic encephalopathy. Lacunae within the literature are explored, and future research directions are proposed.

scholarly journals Sex-Specific Clinical Characteristics and Long-Term Outcomes in Patients With Myocardial Infarction With Non-obstructive Coronary Arteries

2021 ◽  
Vol 8 ◽  
Author(s):  
Side Gao ◽  
Wenjian Ma ◽  
Sizhuang Huang ◽  
Xuze Lin ◽  
Mengyue Yu
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Cox Regression ◽  
Older Age ◽  
Major Adverse Cardiovascular Events ◽  
Future Research ◽  
Long Term Outcomes ◽  
Men And Women ◽  
Kaplan Meier

Background: Sex differences in clinical profiles and prognosis after acute myocardial infarction have been addressed for decades. However, the sex-based disparities among patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) remain largely unreported. Here, we investigated sex-specific characteristics and long-term outcomes in MINOCA population.Methods: A total of 1,179 MINOCA patients were enrolled, including 867 men and 312 women. The mean follow-up was 41.7 months. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including all-cause death, non-fatal reinfarction, revascularization, non-fatal stroke, and hospitalization for unstable angina or heart failure. Baseline data and outcomes were compared. Kaplan-Meier curves and Cox regression analyses were used to identify association between sex and prognosis.Results: Female patients with MINOCA had more risk profiles with regard to older age and higher prevalence of hypertension and diabetes compared with men. The evidence-based medical treatment was similar in men and women. The incidence of MACE (men vs. women: 13.8 vs. 15.3%, p = 0.504) did not differ significantly between the sexes. The Kaplan-Meier analysis also indicated that women had a similar incidence of MACE compared to men (log rank p = 0.385). After multivariate adjustment, female sex was not associated with the risk of MACE in overall (adjusted hazard ratio 1.02, 95% confidence interval: 0.72–1.44, p = 0.916) and in subgroups of MINOCA patients.Conclusion: The long-term outcomes were similar for men and women presenting with MINOCA despite older age and more comorbidities in women. Future research should aim to improve in-hospital and post-discharge care for both sexes with MINOCA.

Comorbidity of Depression and Conduct Disorder

2014 ◽  
Author(s):  
Deborah M. Capaldi ◽  
Hyoun K. Kim
Keyword(s):  
Conduct Disorder ◽  
Problem Behaviors ◽  
Depressive Disorders ◽  
Conduct Disorders ◽  
Future Research ◽  
Long Term Outcomes ◽  
The Past ◽  
Gender Similarities ◽  
The Individual

Both depression and conduct disorders are relatively prevalent and are related to poor long-term outcomes. Despite being characterized by very different symptoms, it is well established that these two disorders co-occur at higher rates than expected by chance, resulting in poorer adjustment for the individual than would result from either problem alone. The termcomorbidityis usually reserved to refer to the association of diagnosed disorders, whereasco-occurrencerefers more broadly to the association of levels of symptoms of conduct problems and depression, which are usually calculated with means or possibly symptoms counts. In the past two decades, researchers have focused particularly on the following issues regarding the comorbidity of depression and conduct disorder: (1) possible causal associations of the two problem behaviors (i.e., do depressive disorders tend to onset after conduct disorders or vice versa); (2) theory regarding causes of the association (i.e., common versus unique risk factors for these two problem behaviors); (3) changes across development (i.e., with age); (4) risks from diagnosed disorders versus symptoms that do not reach diagnostic criteria; (5) outcomes or prognosis (e.g., are outcomes more severe for co-occurring problems than for either problem alone, are there distinct patterns of outcomes associated with co-occurring problems). Within each of these areas there is considerable interest in moderation of effects by gender or gender similarities and differences. This chapter reviews findings pertaining to these issues and presents suggestions for future research. In addition, assessment approaches and clinical implications are discussed.

Why Is There No Statement Regarding Partial Intracapsular Tonsillectomy (Tonsillotomy) in the New Guidelines?

2019 ◽  
Vol 160 (2) ◽  
pp. 213-214 ◽  
Author(s):  
Sanjay R. Parikh ◽  
Sanford Archer ◽  
Stacey L. Ishman ◽  
Ron B. Mitchell
Keyword(s):  
Neck Surgery ◽  
Perioperative Outcomes ◽  
Future Research ◽  
Tonsillar Hypertrophy ◽  
Long Term Outcomes ◽  
Advantages And Disadvantages ◽  
New Guidelines ◽  
Few Data ◽  
Intracapsular Tonsillectomy

Partial intracapsular tonsillectomy (PIT) was revisited in 2003 as an alternate surgical option to total tonsillectomy for the treatment of tonsillar hypertrophy. However, evaluation of the existing literature on PIT reveals that it is largely focused on comparing perioperative outcomes after PIT and total tonsillectomy, with few data regarding long-term outcomes. The goal of this commentary is to explain why PIT was not incorporated into the 2019 American Academy of Otolaryngology–Head and Neck Surgery Foundation clinical practice guideline for tonsillectomy, while acknowledging its use and potential advantages and disadvantages and outlining future research opportunities.

scholarly journals Defining and measuring adherence to cancer screening

2016 ◽  
Vol 23 (4) ◽  
pp. 179-185 ◽  
Author(s):  
Jessica Chubak ◽  
Rebecca Hubbard
Keyword(s):  
Cancer Screening ◽  
Data Sources ◽  
Future Research ◽  
Inclusion Criteria ◽  
Long Term Outcomes ◽  
Screening Guidelines ◽  
Screening Adherence ◽  
Using Data ◽  
Study Inclusion

Background The importance of cancer screening is well-recognized, yet there is great variation in how adherence is defined and measured. This manuscript identifies measures of screening adherence and discusses how to estimate them. Discussion We begin by describing why screening adherence is of interest: to anticipate long-term outcomes, to understand differences in outcomes across settings, and to identify areas for improvement. We outline questions of interest related to adherence, including questions about uptake, currency or being up-to-date, and longitudinal adherence, and then identify which measures are most appropriate for each question. Our discussion of how to select measures focuses on study inclusion criteria and outcome definitions. Finally, we describe how to estimate different measures using data from two common data sources: survey studies and surveillance studies. Estimation requires consideration of data sources, inclusion criteria, and outcome definitions. Censoring often will be present and must be accounted for. Conclusion We conclude that consistent definitions and estimation of adherence to cancer screening guidelines will facilitate comparison across studies, tests, and settings, and help to elucidate areas for future research and intervention.

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