scholarly journals Psychotherapy for patients with complex disorders and chronic symptoms

2000 ◽  
Vol 177 (2) ◽  
pp. 131-137 ◽  
Author(s):  
E. Guthrie
Keyword(s):  
External Validity ◽  
Psychological Treatment ◽  
Internal Validity ◽  
Psychological Interventions ◽  
Outcome Study ◽  
Psychological Treatments ◽  
Complex Disorders ◽  
Efficacy Trials ◽  
Methods Of Evaluation ◽  
To Receive

BackgroundA clear distinction has been made between efficacy and effectiveness in relation to the methods of evaluation of new psychological treatments in psychiatry. Efficacy trials target patients with relatively pure conditions, who may not be representative of the patients who are usually referred for psychological treatment in a clinical setting. Few studies have explored the benefits of psychotherapy in patients with complex disorders and enduring symptoms.AimsTo explore the rationale for the distinction between efficacy and effectiveness, particularly in relation to outcome studies of patients with complex and enduring disorders.MethodA narrative review with examples drawn from the literature, and an illustration of a recent naturalistic outcome study which combines features of both efficacy and effectiveness.ResultsStudies of patients with complex and mixed disorders can be designed so that they retain internal validity, but also have external validity and are relevant to clinical practice.ConclusionStudies which evaluate psychological interventions should be carried out in populations of patients clinically representative of those who are likely to receive the intervention, should it be shown to be of benefit.

Psychological treatment of depression in children and adolescents

1998 ◽  
Vol 173 (4) ◽  
pp. 291-298 ◽  
Author(s):  
Richard Harrington ◽  
Jane Whittaker ◽  
Philp Shoebridge
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Preventive Intervention ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Psychological Treatments ◽  
Literature Searches ◽  
Cognitive Behavioural ◽  
Treatment Of Depression

BackgroundThis paper reviews research on the psychological treatment of depression in children.MethodManual and computer literature searches were performed.ResultsThe most promising psychological interventions for depression in children are individual rather than family therapies. Cognitive – behavioural therapy seems to be an effective treatment for depressive symptoms and mild depressive disorders. It may also be a useful preventive intervention, though this remains to be conclusively demonstrated. There have been no systematic studies comparing psychological treatments with medication.ConclusionsStudies comparing psychological treatments and medication are now required.

scholarly journals The effects of psychological treatment of perinatal depression: an overview

2021 ◽  
Author(s):  
Pim Cuijpers ◽  
Eirini Karyotaki
Keyword(s):  
Parental Stress ◽  
Perinatal Depression ◽  
Psychological Treatment ◽  
Public Health Problem ◽  
Psychological Interventions ◽  
Important Public Health Problem ◽  
Psychological Treatments ◽  
Treatment Of Depression ◽  
Moderate Effect Size ◽  
Meta Analyses

Abstract Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.

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.

scholarly journals Human perceptual learning is delayed by the N-methyl-D-aspartate receptor partial agonist D-cycloserine

2021 ◽  
pp. 026988112098634
Author(s):  
Harriet Dempsey-Jones ◽  
Susann Steudte-Schmiedgen ◽  
Michael Browning ◽  
Tamar R Makin ◽  
Marcella L Woud ◽  
...  
Keyword(s):  
Perceptual Learning ◽  
Psychological Treatment ◽  
Longitudinal Design ◽  
Partial Agonist ◽  
Tactile Perception ◽  
Simple Explanation ◽  
Tactile Learning ◽  
Before And After ◽  
Learning And Cognition ◽  
To Receive

Background: The optimisation of learning has long been a focus of scientific research, particularly in relation to improving psychological treatment and recovery of brain function. Previously, partial N-methyl-D-aspartate agonists have been shown to augment reward learning, procedural learning and psychological therapy, but many studies also report no impact of these compounds on the same processes. Aims: Here we investigate whether administration of an N-methyl-D-aspartate partial agonist (D-cycloserine) modulates a previously unexplored process – tactile perceptual learning. Further, we use a longitudinal design to investigate whether N-methyl-D-aspartate-related learning effects vary with time, thereby providing a potentially simple explanation for apparent mixed effects in previous research. Methods: Thirty-four volunteers were randomised to receive one dose of 250 mg D-cycloserine or placebo 2 h before tactile sensitivity training. Tactile perception was measured using psychophysical methods before and after training, and 24/48 h later. Results: The placebo group showed immediate within-day tactile perception gains, but no further improvements between-days. In contrast, tactile perception remained at baseline on day one in the D-cycloserine group (no within-day learning), but showed significant overnight gains on day two. Both groups were equivalent in tactile perception by the final testing – indicating N-methyl-D-aspartate effects changed the timing, but not the overall amount of tactile learning. Conclusions: In sum, we provide first evidence for modulation of perceptual learning by administration of a partial N-methyl-D-aspartate agonist. Resolving how the effects of such compounds become apparent over time will assist the optimisation of testing schedules, and may help resolve discrepancies across the learning and cognition domains.

scholarly journals A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Samina Ali ◽  
◽  
Gareth Hopkin ◽  
Naveen Poonai ◽  
Lawrence Richer ◽  
...  
Keyword(s):  
External Validity ◽  
Treatment Options ◽  
Internal Validity ◽  
Clinical Effectiveness ◽  
Drop Out ◽  
Innovative Design ◽  
Clinical Trial Research ◽  
Research Questions ◽  
Internal And External Validity ◽  
Treatment Population

Abstract Background Patients and their families often have preferences for medical care that relate to wider considerations beyond the clinical effectiveness of the proposed interventions. Traditionally, these preferences have not been adequately considered in research. Research questions where patients and families have strong preferences may not be appropriate for traditional randomized controlled trials (RCTs) due to threats to internal and external validity, as there may be high levels of drop-out and non-adherence or recruitment of a sample that is not representative of the treatment population. Several preference-informed designs have been developed to address problems with traditional RCTs, but these designs have their own limitations and may not be suitable for many research questions where strong preferences and opinions are present. Methods In this paper, we propose a novel and innovative preference-informed complementary trial (PICT) design which addresses key weaknesses with both traditional RCTs and available preference-informed designs. In the PICT design, complementary trials would be operated within a single study, and patients and/or families would be given the opportunity to choose between a trial with all treatment options available and a trial with treatment options that exclude the option which is subject to strong preferences. This approach would allow those with strong preferences to take part in research and would improve external validity through recruiting more representative populations and internal validity. Here we discuss the strengths and limitations of the PICT design and considerations for analysis and present a motivating example for the design based on the use of opioids for pain management for children with musculoskeletal injuries. Conclusions PICTs provide a novel and innovative design for clinical trials with more than two arms, which can address problems with existing preference-informed trial designs and enhance the ability of researchers to reflect shared decision-making in research as well as improving the validity of trials of topics with strong preferences.

Investigating the Youth Physical Activity Promotion Model: Internal Structure and External Validity Evidence for a Potential Measurement Model

2007 ◽  
Vol 19 (4) ◽  
pp. 420-435 ◽  
Author(s):  
David A. Rowe ◽  
Thomas D. Raedeke ◽  
Lenny D. Wiersma ◽  
Matthew T. Mahar
Keyword(s):  
Physical Activity ◽  
External Validity ◽  
Internal Validity ◽  
Physical Activity Promotion ◽  
Measurement Model ◽  
Measurement Properties ◽  
Validity Evidence ◽  
Potential Measurement ◽  
Activity Promotion ◽  
Youth Physical Activity

The purpose of the study was to investigate the measurement properties of questionnaires associated with the Youth Physical Activity Promotion (YPAP) model. Data were collected from 296 children in Grades 5–8 using several existing questionnaires corresponding to YPAP model components, a physical activity questionnaire, and 6 consecutive days of pedometer data. Internal validity of the questionnaires was tested using confirmatory factor analyses, and external validity was investigated via correlations with physical activity and body composition. Initial model fit of the questionnaires ranged from poor to very good. After item removal, all scales demonstrated good fit. Correlations with percentage body fat and objectively measured physical activity were low but in the theoretically predicted direction. The current study provides good internal validity evidence and acceptable external validity evidence for a brief set of questionnaire items to investigate the theoretical basis for the YPAP model.

scholarly journals Toward Experimental International Business

2015 ◽  
Vol 22 (4) ◽  
pp. 530-544 ◽  
Author(s):  
Arjen van Witteloostuijn
Keyword(s):  
International Business ◽  
External Validity ◽  
Design Methodology ◽  
Internal Validity ◽  
Cross Cultural ◽  
Web Based ◽  
Content Type ◽  
Experimental Laboratory ◽  
Experimental Management ◽  
Missed Opportunity

Purpose – The purpose of this paper is to argue that the time is ripe to establish a powerful tradition in Experimental International Business (IB). Probably due to what the Arjen van Witteloostuijn refers to as the external validity myth, experimental laboratory designs are underutilized in IB, which implies that the internal validity miracle of randomized experimentation goes largely unnoticed in this domain of the broader management discipline. Design/methodology/approach – In the following pages, the author explains why the author believes this implies a missed opportunity, providing arguments and examples along the way. Findings – Although an Experimental Management tradition has never really gained momentum, to the author, the lab experimental design has a very bright future in IB (and management at large). To facilitate the development of an Experimental IB tradition, initiating web-based tools would be highly instrumental. This will not only boost further progress in IB research, but will also increase the effectiveness and playfulness of IB teaching. Originality/value – Given the high potential of an Experimental IB, the Cross-Cultural and Strategic Management journal will offer a platform for such exciting and intriguing laboratory work, cumulatively contributing to the establishment of an Experimental IB tradition.

scholarly journals Protocol for a systematic review of psychological treatment for methamphetamine use: an analysis of methamphetamine use and mental health symptom outcomes

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015383 ◽  
Author(s):  
Alexandra Stuart ◽  
Amanda L Baker ◽  
Jenny Bowman ◽  
Kristen McCarter ◽  
Alexandra Mary Janice Denham ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Ethical Issues ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Critical Evaluation ◽  
Comprehensive Overview ◽  
Psychological Treatments ◽  
Methamphetamine Use ◽  
Research Reporting ◽  
Quantitative Synthesis

IntroductionPeople who use methamphetamine (MA) regularly, often experience symptoms of mental ill health associated with the use of the drug. These include symptoms of psychosis, depression, anxiety and also cognitive deficits. Accordingly, psychological treatments aim to reduce MA use and related problems, including symptoms of mental ill health. Although there has been a substantial body of research reporting on the evidence of effectiveness of psychological treatments for MA use, there is a paucity of research addressing the effectiveness of these treatments for coexisting symptoms of mental ill health. We aim to address this gap by providing a comprehensive overview of the evidence for psychological treatments for MA use and associated symptoms of mental ill health in experimental/controlled clinical studies. In addition, a critical evaluation of study methods and the outcomes of psychological interventions on MA use and symptoms of mental ill health will be conducted.Methods and analysisThe Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement will be used to inform the methods of this review. Eight electronic peer-reviewed databases will be searched. Pilot searches have been conducted for MA literature considering controlled clinical trials only. Eligible articles will be independently assessed against inclusion criteria. Before final analyses are completed, searches will be rerun and if eligible, additional studies will be retrieved for inclusion. A quantitative synthesis of the findings will be reported where possible, and ‘summary of findings’ tables will be generated for each comparison. Risk ratios and 95% CI (dichotomous outcomes) will be calculated and/or effect size according to Cohen’s formula (continuous outcomes) for the primary outcome of each trial.Ethics and disseminationNo ethical issues are foreseen. Findings will be disseminated widely to clinicians and researchers via journal publication and conference presentation(s).Trial registration numberCRD42016043657.

scholarly journals Designing Research With Qualitative Comparative Analysis (QCA): Approaches, Challenges, and Tools

2017 ◽  
Vol 49 (2) ◽  
pp. 356-386 ◽  
Author(s):  
Eva Thomann ◽  
Martino Maggetti
Keyword(s):  
Comparative Analysis ◽  
External Validity ◽  
Qualitative Comparative Analysis ◽  
Internal Validity ◽  
Specific Research ◽  
Extant Literature ◽  
Specific Mode ◽  
Research Context ◽  
Trade Offs ◽  
Conducting Research

Recent years have witnessed a host of innovations for conducting research with qualitative comparative analysis (QCA). Concurrently, important issues surrounding its uses have been highlighted. In this article, we seek to help users design QCA studies. We argue that establishing inference with QCA involves three intertwined design components: first, clarifying the question of external validity; second, ensuring internal validity; and third, explicitly adopting a specific mode of reasoning. We identify several emerging approaches to QCA rather than just one. Some approaches emphasize case knowledge, while others are condition oriented. Approaches emphasize either substantively interpretable or redundancy-free explanations, and some designs apply an inductive/explorative mode of reasoning, while others integrate deductive elements. Based on extant literature, we discuss issues surrounding inference with QCA and the tools available under different approaches to address these issues. We specify trade-offs and the importance of doing justice to the nature and goals of QCA in a specific research context.

scholarly journals High Fidelity Microsurgical Simulation: The Thiel Model and Evaluation Instrument

2018 ◽  
Vol 27 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Andrei Odobescu ◽  
Isak Goodwin ◽  
Djamal Berbiche ◽  
Joseph BouMerhi ◽  
Patrick G. Harris ◽  
...  
Keyword(s):  
External Validity ◽  
Internal Validity ◽  
High Fidelity ◽  
Evaluation Instrument ◽  
Intra Class Correlation ◽  
Validity Measures ◽  
The Difference ◽  
Fidelity Model ◽  
Junior Residents ◽  
Internal And External Validity

Background: The Thiel embalmment method has recently been used in a number of medical simulation fields. The authors investigate the use of Thiel vessels as a high fidelity model for microvascular simulation and propose a new checklist-based evaluation instrument for microsurgical training. Methods: Thirteen residents and 2 attending microsurgeons performed video recorded microvascular anastomoses on Thiel embalmed arteries that were evaluated using a new evaluation instrument (Microvascular Evaluation Scale) by 4 fellowship trained microsurgeons. The internal validity was assessed using the Cronbach coefficient. The external validity was verified using regression models. Results: The reliability assessment revealed an excellent intra-class correlation of 0.89. When comparing scores obtained by participants from different levels of training, attending surgeons and senior residents (Post Graduate Year [PGY] 4-5) scored significantly better than junior residents (PGY 1-3). The difference between senior residents and attending surgeons was not significant. When considering microsurgical experience, the differences were significant between the advanced group and the minimal and moderate experience groups. The differences between minimal and moderate experience groups were not significant. Based on the data obtained, a score of 8 would translate into a level of microsurgical competence appropriate for clinical microsurgery. Conclusions: Thiel cadaveric vessels are a high fidelity model for microsurgical simulation. Excellent internal and external validity measures were obtained using the Microvascular Evaluation Scale (MVES).

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