scholarly journals D-Cycloserine as Adjunct to Brief Computerised CBT for Spider Fear: Effects on Fear, Behaviour, and Cognitive Biases

2019 ◽  
Author(s):  
Nils Kappelmann ◽  
Mareike Suesse ◽  
Susann Steudte-Schmiedgen ◽  
Reinoud Kaldewaij ◽  
Michael Browning ◽  
...  
Keyword(s):  
Information Processing ◽  
Cognitive Biases ◽  
Behavioural Therapy ◽  
Self Report ◽  
Avoidance Task ◽  
Spider Fear ◽  
Information Processing Biases ◽  
Cognitive Behavioural ◽  
Fear Effects ◽  
Computerised Cbt

AbstractIn anxiety disorders, cognitive behavioural therapy (CBT) improves information-processing biases such as implicit fear evaluations and avoidance tendencies, which predicts treatment response, so they might constitute important treatment targets. This study investigated (i) whether information-processing biases changed following single-session computerised CBT for spider fear, and (ii) whether this effect could be augmented by administration of D-cycloserine (DCS). Spider-fearful individuals were randomized to receiving 250mg of DCS (n=21) or placebo (n=17) and spider fear was assessed using self-report, behavioural, and information-processing (Extrinsic Affective Simon Task & Approach Avoidance Task) measures. Linear mixed-effects analyses indicated improvements on self-report and behavioural spider fear following CBT, but not on cognitive bias measures. There was no evidence of an augmentation effect of DCS on any outcome. Cognitive biases at 1-day were not predictive of 1-month follow-up spider fear. These findings provide no evidence for information-processing biases relating to CBT response or augmentation with DCS.

scholarly journals Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement

2021 ◽  
pp. 026988112110010
Author(s):  
Susann Steudte-Schmiedgen ◽  
Emily Fay ◽  
Liliana Capitao ◽  
Clemens Kirschbaum ◽  
Andrea Reinecke
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Self Report ◽  
Symptom Improvement ◽  
Threat Bias ◽  
Spider Fear ◽  
Threat Processing ◽  
Cognitive Behavioural ◽  
Specific Fear

Background: Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised endogenous GCs and reductions in information-processing biases to threat. Aims: To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response. Methods: Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone ( n = 17) or placebo ( n = 16) one hour prior to single-session predominantly computerised exposure-based CBT. Spider fear was assessed using self-report and behavioural approach measures at baseline, 1-day and 1-month follow-up. Threat processing was assessed at baseline and 1-day follow-up. Cortisol and cortisone were analysed from hair and saliva samples at baseline. Results/outcomes: Self-report, behavioural and threat processing indices improved following CBT. Hydrocortisone augmentation resulted in greater improvement of self-report spider fear and stronger increase in speed when approaching a spider, but not on threat bias. Neither threat bias nor endogenous GCs predicted symptom change, and no interactive effects with hydrocortisone emerged. Preliminary evidence indicated higher hair cortisone as predictor of a stronger threat bias reduction. Conclusions/interpretation: Our data extend earlier findings by suggesting that GC administration boosts the success of exposure therapy for specific fear even with a low-level therapist involvement. Future studies corroborating our result of a predictive hair GC relationship with threat bias change in larger clinical samples are needed.

scholarly journals D-cycloserine as adjunct to brief computerised CBT for spider fear: Effects on fear, behaviour, and cognitive biases

2020 ◽  
Vol 68 ◽  
pp. 101546 ◽  
Author(s):  
Nils Kappelmann ◽  
Mareike Suesse ◽  
Susann Steudte-Schmiedgen ◽  
Reinoud Kaldewaij ◽  
Michael Browning ◽  
...  
Keyword(s):  
Cognitive Biases ◽  
Spider Fear ◽  
Fear Effects ◽  
Computerised Cbt

The effectiveness, feasibility and acceptability of a school-based intervention to improve sleep and psychological wellbeing in adolescents.

2021 ◽  
Author(s):  
Stephanie McCrory ◽  
Astrid McLellan ◽  
Karolina Kiper ◽  
Clare Munro ◽  
Christopher-James Harvey ◽  
...  
Keyword(s):  
Behavioural Therapy ◽  
Self Report ◽  
Psychological Wellbeing ◽  
Future Research ◽  
Convenience Sample ◽  
School Based ◽  
Cognitive Behavioural ◽  
Physical Health Problems ◽  
Improvement Interventions ◽  
Measure Change

Introduction: Adolescents are vulnerable to experiencing insufficient sleep which can increase the risk of developing insomnia, mental/physical health problems and mood regulation. School-based sleep improvement interventions (SBSII) have been developed utilising Cognitive Behavioural Therapy for Insomnia techniques and found improvements in sleep knowledge and behaviour. This study aimed to evaluate the effectiveness, feasibility and acceptability of a school-based sleep improvement intervention (iSLEEP) for improving sleep and psychological wellbeing in adolescents.Methods: A mixed-methods approach was adopted. The participants (115, aged 12-15) were recruited from secondary schools in Scotland. iSLEEP comprised of three lessons, combining formal sleep education and CBT-I, and were delivered over three consecutive weeks. Baseline (1 week before lesson 1) and follow-up (1 week following lesson 3) assessments comprised of self-report questionnaires to measure change in sleep, depression, anxiety and stress. Two weeks following the final lesson, a convenience sample of 19 pupils (14 females) were recruited to participate in focus groups.Results: There were significant improvements in overall sleep and marginal differences between those who were categorised with ‘probable insomnia’ at baseline and likewise for ‘good sleepers’. There were no significant improvements in symptoms of depression, anxiety or stress. Two themes and two sub-themes were generated. Participants reported that iSLEEP was acceptable and improved their sleep.Conclusions: These findings indicate that iSLEEP is an effective, feasible and acceptable SBSII. Future research should aim to utilise a controlled design to further investigate the efficacy of iSLEEP.

scholarly journals ‘Message to Dentist’: Facilitating Communication with Dentally Anxious Children

2019 ◽  
Vol 7 (3) ◽  
pp. 69
Author(s):  
Helen Rodd ◽  
Laura Timms ◽  
Fiona Noble ◽  
Sarah Bux ◽  
Jenny Porritt ◽  
...  
Keyword(s):  
Dental Anxiety ◽  
Effective Means ◽  
Young Patients ◽  
Behavioural Therapy ◽  
Self Report ◽  
Dental Practice ◽  
Negative Consequences ◽  
Communication Aid ◽  
Cognitive Behavioural ◽  
Hospital Clinic

Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally anxious children, aged 9–16 years, were invited to complete the MTD proforma, before and following their course of treatment. They scored how worried they were and their anticipated pain levels on a scale of 1–10 (10 being the worst outcome). They also wrote down their coping plans and post-treatment reflections. One hundred and five children, from a UK general dental practice and a hospital clinic, were included. They had a mean age of 11.6 years, and 65% were female. There was a significant reduction in self-report worry (from 4.9 to 2.1) and anticipated pain (from 5.1 to 2.0) scores (p < 0.05, paired t-test). Many children (30%) used listening to music/audiobook as a coping strategy. Thematic analysis revealed concerns around pain, uncertainty, errors and specific procedures. The MTD proforma proved an effective means of facilitating communication between anxious children and the dental team, allowing them to identify their worries and make personalised coping plans.

scholarly journals Cognitive-behavioural therapy (CBT) for renal fatigue (BReF): a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020842 ◽  
Author(s):  
Federica Picariello ◽  
Rona Moss-Morris ◽  
Iain C Macdougall ◽  
Sam Norton ◽  
Maria Da Silva-Gane ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Self Report ◽  
Behavioural Responses ◽  
Feasibility Randomised Controlled Trial ◽  
Cognitive Behavioural ◽  
Potential Benefits ◽  
Randomised Controlled

IntroductionFatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients.MethodsWe aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue. Patients will be randomised individually (using a 1:1 ratio) to either a 4–6 weeks’ CBT-based intervention (intervention arm) or to a waiting-list control (control arm). The primary feasibility outcomes include descriptive data on numbers within each recruiting centre meeting eligibility criteria, rates of recruitment, numbers retained postrandomisation and treatment adherence. To assess the potential benefits of the cognitive-behavioural therapy for renal fatigue intervention, secondary self-report outcomes include measures of fatigue severity (Chalder Fatigue Questionnaire), fatigue-related functional impairment (Work and Social Adjustment Scale), sleep quality (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Changes in fatigue perceptions (Brief Illness Perception Questionnaire), cognitive and behavioural responses to fatigue (Cognitive and Behavioural Responses to Symptoms Questionnaire), sleep hygiene behaviours (Sleep Hygiene Index) and physical activity (International Physical Activity Questionnaire–short form) will also be explored. These self-report measures will be collected at baseline and 3 months postrandomisation. Nested qualitative interviews will be conducted postintervention to explore the acceptability of the intervention and identify any areas in need of improvement. The statistician and assessor will be blinded to treatment allocation.Ethics and disseminationA National Health Service (NHS) Research Ethics Committee approved the study. Any amendments to the protocol will be submitted to the NHS Committee and study sponsor.Trial registration numberISRCTN91238019;Pre-results.

Psychological interventions for cognitive dysfunction in MDD

2021 ◽  
pp. 65-78
Author(s):  
Bernhard T. Baune
Keyword(s):  
Cognitive Training ◽  
Cognitive Biases ◽  
Therapeutic Option ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Attentional Allocation ◽  
Cognitive Interventions ◽  
Training Interventions ◽  
Cognitive Behavioural ◽  
Positive Stimuli

The chapter psychological interventions for cognitive function in MDD outlines promising cognitive training interventions that may yield neuropsychological, cognitive, emotional, and functional benefits for patients diagnosed with major depressive disorder (MDD). The chapter reviews how psychological interventions such as cognitive behavioural therapy are aimed to address cognitive biases, which include distorted information appraisal or attentional allocation towards negative and away from positive stimuli. It emphasizes that specific cognitive interventions target cognitive deficits and that the use of cognitive training represents a promising and novel therapeutic option which may yield neuropsychological, affective, functional, and behavioural improvements in patients with MDD.

Cognition and behaviour

2019 ◽  
pp. 89-104
Author(s):  
Manoj Sivan ◽  
Margaret Phillips ◽  
Ian Baguley ◽  
Melissa Nott
Keyword(s):  
Decision Making ◽  
Information Processing ◽  
Rehabilitation Medicine ◽  
Behavioural Therapy ◽  
Pharmaceutical Management ◽  
Perceptual Disorders ◽  
General Overview ◽  
Cognitive Behavioural ◽  
High Level ◽  
Behaviour Learning

This chapter provides a general overview of cognition, and relevant models of information processing to facilitate decision-making and acting with regard to rehabilitation medicine. Perceptual disorders are discussed, and factors that may cause them to arise are covered. Attention is also described, including key terminology, and memory structure and forms are covered. High-level cognitive processes are described, and then applied to rehabilitation approaches (both remedial and compensatory). General background to behaviour, learning theory, management, and treatment approaches are all discussed, including cognitive behavioural therapy. Finally, pharmaceutical management to modify behaviour is covered.

scholarly journals An improved competence rating scale for CBT Supervision: Short-SAGE

2018 ◽  
Vol 11 ◽  
Author(s):  
Robert P. Reiser ◽  
Tom Cliffe ◽  
Derek L. Milne
Keyword(s):  
Clinical Supervision ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Self Report ◽  
Internal Reliability ◽  
Cognitive Behavioural ◽  
Health Practitioners ◽  
Recent Developments ◽  
The Uk

AbstractRecent developments have led the UK government to deem clinical supervision ‘essential’ to a safe and effective national health service. Cognitive behavioural therapy (CBT) supervision has been increasingly operationalized and manualized, but there are few psychometrically sound observational instruments with which to measure CBT supervision. This paper reports the factor analysis of a promising 23-item instrument for observing competence in CBT supervision (Supervision: Adherence and Guidance Evaluation: SAGE). N =115 qualified mental health practitioners (supervisors and their supervisees) rated the same supervision session by completing SAGE. A principal components analysis indicated that a two-factor solution, identified as the ‘Supervision Cycle’ and the ‘Supervisee Cycle’ components, accounted for 52.8% of the scale variance and also demonstrated high internal reliability (α = .91 and α = .81, respectively). These findings provide the basis for a shorter, 14-item version of SAGE, clarify the factor structure of SAGE, ease implementation, and afford more succinct feedback. Short-SAGE also improves implementation yield, taking half the time to complete as the original 23-item scale. These conceptual and practical improvements strengthen the role of SAGE as a promising observational instrument for evaluating CBT supervision, complementing self-report assessments of competent CBT supervision with an instrument that can fulfil the distinctive functions that are provided through direct observation.

A prospective investigation of postconcussional symptoms after mild traumatic brain injury

2011 ◽  
Vol 26 (S2) ◽  
pp. 419-419
Author(s):  
R. Hou
Keyword(s):  
Traumatic Brain Injury ◽  
Information Processing ◽  
Brain Injury ◽  
Attentional Bias ◽  
Mild Traumatic Brain Injury ◽  
Illness Perception ◽  
Behavioral Model ◽  
Self Report ◽  
Cognitive Behavioural ◽  
Threat Avoidance

ObjectiveThe aim of this study was to investigate the contributions of cognitive, emotional and behavioural factors to the development of Post Concussional Syndrome (PCS) after mild traumatic brain injury (MTBI), particularly the role of attentional bias (AB).Methods80 MTBI patients completed baseline questionnaire assessments and 39 completed computer tasks. 42 patients completed the follow-up assessments. A series of self-report measures were used to assess cognitive, behavioural and emotional responses, and the visual probe task was adopt to measure reaction time (RT) and assess attentional bias (AB). The main outcomes were measured by the Rivermead Postconcussion Symptoms Questionnaire (RPQ).ResultsPCS symptoms at 3 months were positively correlated with measures of stress response (r = 0.397, p = 0.011), particularly stress avoidance (r = 0.497, p = 0.001), anxiety (r = 0.33, p = 0.035), illness perception (r = 0.528, p = 0.000), and all or nothing behaviour (r = 0.422, p = 0.006). There were also significant correlations between PCS symptoms and Mean RT (r = 0.507, p = 0.012) and total AB (r = −0.425, p = 0.039). The positive correlations between PCS and RT indicates that PCS symptoms may be associated with slow information processing, whereas the negative correlation between AB and PCS symptoms may reflect that PCS symptoms are associated with threat avoidance.ConclusionsThere were significant correlations between PCS symptoms and a number of cognitive, emotional and behavioral factors, which is consistent with the proposed cognitive behavioral model. The significant findings from RT/AB reflect that PCS symptoms may be associated with slow information processing and trauma-related threat avoidance. This study provides a cognitive behavioural approach to a better understanding of PCS.

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