scholarly journals Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress

2018 ◽  
Vol 10 (2) ◽  
pp. 413-422 ◽  
Author(s):  
Allison J Applebaum ◽  
Aliza A Panjwani ◽  
Kara Buda ◽  
Mia S O’Toole ◽  
Michael A Hoyt ◽  
...  

Abstract Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient’s illness—notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge’s g range: 0.36–0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs.

2008 ◽  
Vol 22 (3) ◽  
pp. 271-288 ◽  
Author(s):  
Megan E. Hughes ◽  
Lauren B. Alloy ◽  
Alex Cogswell

The relation between repetitive thought and depression and anxiety symptoms was examined in an undergraduate sample. Individuals completed self-report measures of rumination, worry, depression, and anxiety as well as other related constructs including private self-consciousness, looming maladaptive style, cognitive style, cognitive content, and future outlook. Regression analyses and tests for significant differences between partial correlations were utilized to assess the study hypotheses. The results indicated that rumination and worry overlap in their association with depression and anxiety symptoms, and that rumination may be an especially important component of this overlap. Secondary analyses demonstrated that rumination and worry are two distinct constructs, as their patterns of associations with related constructs were different.


2021 ◽  
pp. 1-14
Author(s):  
Daniel E. Gustavson ◽  
Amy J. Jak ◽  
Jeremy A. Elman ◽  
Matthew S. Panizzon ◽  
Carol E. Franz ◽  
...  

Background: Although not strongly correlated with current objective cognitive ability, subjective cognitive decline (SCD) is a risk factor for Alzheimer’s disease. Most studies focus on SCD in relation to future decline rather than objective prior decline that it purportedly measures. Objective: We evaluated whether self-report of cognitive decline—as a continuous measure—corresponds to objectively-assessed episodic memory and executive function decline across the same period. Methods: 1,170 men completed the Everyday Cognition Questionnaire (ECog) at mean age 68 assessing subjective changes in cognitive ability relative to 10 years prior. A subset had mild cognitive impairment (MCI), but MCI was diagnosed without regard to subjective decline. Participants completed up to 3 objective assessments of memory and executive function (M = 56, 62, and 68 years). Informant-reported ECogs were completed for 1,045 individuals. Analyses controlled for depression and anxiety symptoms assessed at mean age 68. Results: Participant-reported ECog scores were modestly associated with objective decline for memory (β= –0.23, 95%CI [–0.37, –0.10]) and executive function (β= –0.19, 95%CI [–0.33, –0.05]) over the same time period. However, these associations were nonsignificant after excluding MCI cases. Results were similar for informant ratings. Participant-rated ECog scores were more strongly associated with concurrent depression and anxiety symptoms, (β= 0.44, 95%CI [0.36, 0.53]). Conclusion: Continuous SCD scores are correlated with prior objective cognitive changes in non-demented individuals, though this association appears driven by individuals with current MCI. However, participants’ current depression and anxiety ratings tend to be strongly associated with their SCD ratings. Thus, what primarily drives SCD ratings remains unclear.


2019 ◽  
Vol 8 (12) ◽  
pp. 2099 ◽  
Author(s):  
Almudena Carneiro-Barrera ◽  
Francisco J. Amaro-Gahete ◽  
Germán Sáez-Roca ◽  
Carlos Martín-Carrasco ◽  
Jonatan R. Ruiz ◽  
...  

The prevalence and treatment response of depression and anxiety symptoms in obstructive sleep apnoea (OSA), although widely addressed in research and clinical settings, still remain unclear due to overlapping symptoms. The ADIPOSA study sought to elucidate the presence of non-overlapping symptoms of depression and anxiety in patients with moderate to severe OSA before and after continuous positive airway pressure (CPAP) treatment. Forty-eight adults aged 18–80 (68.75% men) with moderate to severe OSA were enrolled in this twelve-week longitudinal single-arm trial and completed a full-night ambulatory sleep diagnostic test and an assessment of cognitive-affective depression and anxiety symptoms using the Beck-Depression Inventory-Fast Screen (BDI-FS), the State-Trait Depression Inventory (IDER) and the State-Trait Anxiety Inventory (STAI). We found no cognitive-affective depression or anxiety symptoms of clinical relevance at baseline. The amelioration of depression and anxiety symptoms after CPAP use was only statistically significant when considering anxiety-trait (p < 0.01; d = 0.296) and euthymia (p < 0.05; d = 0.402), the distinctive component of depression. Although dysthymia or high negative affect remained unchanged, CPAP may be effective at reducing the lack of positive affect, a well-established health-protective factor. However, not until depression and anxiety disorders related to OSA are accurately measured in clinical and research settings will it be possible to obtain robust conclusions on the occurrence and amelioration of these symptoms after treatment.


2018 ◽  
Vol 49 (2) ◽  
pp. 314-324 ◽  
Author(s):  
Kathryn E. Smith ◽  
Tyler B. Mason ◽  
Ross D. Crosby ◽  
Li Cao ◽  
Rachel C. Leonard ◽  
...  

AbstractBackgroundNetwork analysis is an emerging approach in the study of psychopathology, yet few applications have been seen in eating disorders (EDs). Furthermore, little research exists regarding changes in network strength after interventions. Therefore the present study examined the network structures of ED and co-occurring depression and anxiety symptoms before and after treatment for EDs.MethodParticipants from residential or partial hospital ED treatment programs (N = 446) completed assessments upon admission and discharge. Networks were estimated using regularized Graphical Gaussian Models using 38 items from the Eating Disorders Examination-Questionnaire, Quick Inventory of Depressive Symptomatology, and State-Trait Anxiety Inventory.ResultsED symptoms with high centrality indices included a desire to lose weight, guilt about eating, shape overvaluation, and wanting an empty stomach, while restlessness, self-esteem, lack of energy, and feeling overwhelmed bridged ED to depression and anxiety symptoms. Comparisons between admission and discharge networks indicated the global network strength did not change significantly, though symptom severity decreased. Participants with denser networks at admission evidenced less change in ED symptomatology during treatment.ConclusionsFindings suggest that symptoms related to shape and weight concerns and guilt are central ED symptoms, while physical symptoms, self-esteem, and feeling overwhelmed are links that may underlie comorbidities in EDs. Results provided some support for the validity of network approaches, in that admission networks conveyed prognostic information. However, the lack of correspondence between symptom reduction and change in network strength indicates that future research is needed to examine network dynamics in the context of intervention and relapse prevention.


2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Daniel E. Gustavson ◽  
Alta du Pont ◽  
Mark A. Whisman ◽  
Akira Miyake

Recent theoretical advances have emphasized the commonality between rumination and worry, often referred to as repetitive negative thinking. Although not studied extensively, repetitive negative thinking may not only account for a substantial overlap between depression and anxiety symptoms but also encapsulate other constructs including one’s tendency to experience unwanted intrusive thoughts or have low levels of mindfulness. In this study, 643 college students completed self-report questionnaire measures of repetitive negative thinking (the Habit Index of Negative Thinking) and other relevant constructs including rumination, worry, depression and anxiety symptoms, intrusive thoughts, and mindfulness. To analyze the data, we conducted systematic commonality analyses, which algebraically decomposed shared variances among these measures into various unique components. Results in Study 1 indicated that individual differences in repetitive negative thinking were explained largely by the overlap between rumination and worry, but also by some rumination-specific and worry-specific variance. Moreover, the shared variation in rumination and worry explained the frequencies of depression and anxiety symptoms and their overlap. We also found in Study 2 that repetitive negative thinking was positively related to intrusive thoughts and negatively related to mindfulness. These associations were mostly explained by shared variance with rumination and worry, but there was also some mindfulness-specific variance. These results suggest that repetitive negative thinking may indeed lie at the core of the comorbidity between depression and anxiety symptoms, but that it is also a broader construct that encompasses intrusive thoughts and low levels of mindfulness.


2019 ◽  
Author(s):  
Alexandra C Pike ◽  
Frida Printzlau ◽  
Alexander H. von Lautz ◽  
catherine harmer ◽  
Mark G. Stokes ◽  
...  

Mood and anxiety disorders are associated with deficits in attentional control involving emotive and non-emotive stimuli. Current theories focus on impaired attentional inhibition of distracting stimuli in producing these deficits. However, standard attention tasks struggle to separate distractor inhibition from target facilitation. Here, we investigate whether distractor inhibition underlies these deficits using neutral stimuli in a behavioural task specifically designed to tease apart these two attentional processes. Healthy participants performed a validated four-location Posner cueing paradigm and completed self-report questionnaires measuring depressive symptoms and trait anxiety. Using regression analyses, we found no relationship between distractor inhibition and mood or anxiety symptoms. However, we find a relationship between target facilitation and both depression and anxiety. Specifically, higher depressive symptoms were associated with reduced target facilitation, and higher anxiety symptoms were associated with enhanced target facilitation in a task-version in which the target location repeated over a block of trials. By contrast, we find the opposite direction of relationships in a task-version in which the location of the forthcoming target was cued on a trial-wise basis. This dissociation may point to separate mechanisms underlying the relationships between depressive and anxiety symptoms and attention and warrants further investigation in clinical populations.


2019 ◽  
Author(s):  
Belinda Parker ◽  
Melinda Rose Achilles ◽  
Mirjana Subotic-Kerry ◽  
Bridianne O'Dea

Abstract Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.


2019 ◽  
Author(s):  
Belinda Parker ◽  
Melinda Rose Achilles ◽  
Mirjana Subotic-Kerry ◽  
Bridianne O'Dea

Abstract Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented, and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.


1994 ◽  
Vol 28 (4) ◽  
pp. 667-674 ◽  
Author(s):  
J. J. Manning ◽  
G. R. Hooke ◽  
D. A. Tannenbaum ◽  
T. H. Blythe ◽  
T. M. Clarke

This uncontrolled study evaluates the efficacy of a combined treatment of medications (for the majority of patients) and a closed group, intensive (two-week) cognitive-behaviour therapy programme for heterogeneous groups of psychiatric patients. Five hundred and thirty-one patients at a private psychiatric clinic were included in the study. Self-report measures of depression, anxiety, self-esteem and “locus of control’ were administered before and after treatment and at intervals up to one year later. Statistically and clinically significant improvements were found in all measures and these improvements were maintained up to one year. The results provide support for the efficacy of the treatment.


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