Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: A Case Study in Iceland (Preprint)

2021 ◽  
Author(s):  
Kristjana Thorarinsdottir ◽  
Emily Holmes ◽  
Johann Palmar Hardarson ◽  
Unnur Hedinsdottir ◽  
Marie Kanstrup ◽  
...  
Keyword(s):  
Traumatic Event ◽  
Single Case ◽  
Psychological Trauma ◽  
Cognitive Intervention ◽  
Clinical Psychologist ◽  
Post Intervention ◽  
Intrusive Memories ◽  
Intervention Phase

BACKGROUND Additional interventions are needed for survivors of psychological trauma. Case studies can help treatment innovation with an intervention designed to disrupt memory reconsolidation, taking a single symptom approach by focusing on intrusive memories of a traumatic event. OBJECTIVE We aimed to examine a novel brief cognitive intervention to reduce the number of intrusive memories of trauma, in an Icelandic setting and extending previous studies by examining longer-term effects up to 3 months. The intervention comprised a brief memory reminder, then Tetris gameplay with mental rotation, targeting one memory at a time in each session. The intervention was guided by a clinical psychologist and adapted to the Icelandic setting. METHODS This was a single case study in Iceland with a woman in her fifties, with 4 different intrusive memories from childhood. The primary outcome was the change in number of intrusive memories from baseline to intervention phase, and to follow-ups. The number of intrusions was monitored in a daily diary for: 4 weeks preintervention; 8 weeks during intervention; 1 week at 1-month and 3-month follow-ups. Intrusions were targeted one-by-one over 6 intervention sessions, creating 4 repetitions of an AB design (i.e., length of baseline ‘A’ and intervention phase ‘B’ varied for each memory). We examined change in both total number of intrusions (summed across all 4 memories) and individually for each memory. RESULTS The number of total intrusions per week was 12.6 at baseline; 6.1 over the intervention phase (a 52% reduction from baseline); 3.0 at the 1-month follow-up (76% reduction); and 1.0 at the 3-month follow-up (92% reduction). Reductions in symptoms of posttraumatic stress and depression were observed post-intervention. Sleep, concentration, stress and functioning improved. The participant considered the gameplay intervention acceptable, and helpful in that she found the memories disappeared while playing. CONCLUSIONS This guided brief cognitive intervention reduced the number intrusive memories from over the intervention phase and follow-ups. The brief memory reminder was well-tolerated, removing the need to discuss trauma in detail. Next steps require extension to more cases and exploring remote delivery of the intervention. CLINICALTRIAL VSNb2017110046/03.01

Amavat in pediatric age group (multidisciplinary Ayurvedic approach): a single case study

2020 ◽  
Vol 8 (03) ◽  
Author(s):  
Mayuri Pawar
Keyword(s):  
Clinical Symptoms ◽  
Single Case ◽  
Treatment Protocol ◽  
Oral Intake ◽  
External Application ◽  
Pediatric Age Group ◽  
Patient Reported ◽  
Ayurvedic Treatment

Amavata is a chronic, progressive and crippling disorder caused due to generation of ama and its association with vitiated vata dosha and deposition in shleshma sthana (joints). Clinically resembling with Rheumatoid Arthirtis, it poses a challenge for the physician owing to its chronicity, morbidity and complications. The treasure of Ayurveda therapeutics has laid out detailed treatment line for amavata. A 13years old male patient reported to this hospital with pain and stiffness of metacarpophalangeal joints of right hand followed by pain in corresponding joints of other hand 1 year back. This was succeeded by pain and mild swelling on bilateral wrist, ankle and elbow joints. Based on clinical examination and blood investigations, diagnosis of amavata was made and Ayurvedic treatment protocol was advised with baluka sweda (sudation) as external application, rasnasaptak kashayam and dashmoolharitaki avaleha for oral intake for 30 days. The patient was asked for follow up every 15 days up to total of 45 days. Assessment was done subjectively based on clinical symptoms and blood investigations as objective parameters. There was substantially significant improvement and the patient felt relieved of the pain and inflammation of the joints after the treatment. This case study reveals the potential of Ayurvedic treatment protocol in management of amavata and may form a basis for further detailed study of the subject.

scholarly journals Geographic Information Systems and COVID-19: The Johns Hopkins University Dashboard

2020 ◽  
Author(s):  
BELMIRO N JOAO
Keyword(s):  
Information Systems ◽  
Single Case ◽  
Single Case Study ◽  
Epidemic Outbreak ◽  
Global Epidemic ◽  
Johns Hopkins University ◽  
Successful Case ◽  
Other Information

Abstract Background: This article presents a single case study on the development of a GIS for global monitoring of coronavirus (COVID-19). For such concepts presented about GIS, its use and evolution in epidemic events and a presentation of the context of the current coronavirus outbreak and the meaningless results of consolidating a panel with reliable data.Methods: A single case study of a GIS in continuous development with data sharing and comments from the scientific community was carried out. Because it is not a post-mortem analysis, or a follow-up to a successful case, it was not possible to use more rigorous and systematic approaches such as those used by Lee (1989) and Onsrud, Pinto and Azad (1992) for case studies in GIS.Results: The case study presents the results of the development of a control dashboard, as well as the availability of consolidated data made by researchers at Johns Hopkins University and who showed a reliable platform and a world reference for health comunity.Conclusions: Efforts to develop a dashboard and provide data on the coronavirus outbreak resulted in the immediate replication of several other information systems with different approaches (Power BI, R, Tableau), becoming a reference for any new global epidemic outbreak events.

scholarly journals Interoceptive Axes Dissociation in Anorexia Nervosa: A Single Case Study With Follow Up Post-recovery Assessment

2019 ◽  
Vol 9 ◽  
Author(s):  
Daniele Di Lernia ◽  
Silvia Serino ◽  
Nicoletta Polli ◽  
Chiara Cacciatore ◽  
Luca Persani ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Single Case ◽  
Single Case Study ◽  
Recovery Assessment

MANAGING CHALLENGING BEHAVIOUR IN AN ADULT WITH LEARNING DISABILITIES: THE USE OF LOW AROUSAL APPROACH

1998 ◽  
Vol 26 (2) ◽  
pp. 163-171 ◽  
Author(s):  
Andrew McDonnell ◽  
Simon Reeves ◽  
Amanda Johnson ◽  
Alan Lane
Keyword(s):  
Learning Disabilities ◽  
Behaviour Change ◽  
Single Case ◽  
Challenging Behaviour ◽  
Single Case Study ◽  
Short Term ◽  
One Year ◽  
Challenging Behaviours

Behaviour change is often a desired outcome for carers and professionals who work with people with learning disabilities and challenging behaviours. Managing these behaviours in the short term is an important step towards this goal. This single case study presents the use of a low arousal approach in managing challenging behaviours in a young man labelled with severe challenging behaviour. This strategy focuses on the interaction of the carers with the client and how their approach has an important impact on the behaviour of the client. The study documents the incidents of challenging behaviour and shows a decline in their frequency from baseline over a one-year period. These gains were maintained at five-month follow-up. The implications for services of these findings are discussed.

scholarly journals Efficacy of an Early Cognitive-Behavioral Intervention for Acute Stress Disorder in Mexican Earthquake Victims

2020 ◽  
Vol 23 ◽  
Author(s):  
Raúl Durón-Figueroa ◽  
Georgina Cárdenas-López ◽  
Soledad Quero
Keyword(s):  
Early Intervention ◽  
Stress Disorder ◽  
Acute Stress ◽  
Traumatic Event ◽  
Single Case ◽  
Theoretical Models ◽  
Acute Stress Disorder ◽  
Significant Clinical Improvement ◽  
Quasi Experimental

Abstract Acute stress disorder (ASD) refers to the symptoms associated with posttraumatic stress disorder (PTSD) within the first four weeks following the traumatic event. Recent theoretical models suggest that early detection of ASD provides an opportunity to implement early interventions to prevent the development of PTSD or ameliorate its symptomatology. The aim of the present study was the evaluation of the efficacy of an ASD treatment for earthquake victims, which would serve as an early intervention for PTSD. A single-case (n = 1) quasi-experimental design was used, with pre and post-assessments, as well as one, three and six-month follow-ups, with direct treatment replications. Fourteen participants completed the treatment and the follow-up measurements. The results obtained using a single-case analysis showed significant clinical improvement and clinically significant change when employing a clinical significance analysis and the reliable index of change. Statistical analyses of the dataset displayed statistically significant differences between the pre and post-assessments and the follow-up measures, as well as large effect sizes in all clinical measures. These results suggest that the treatment was an efficacious early intervention for PTSD during the months following the traumatic event, although some relevant study limitations are discussed in the text.

ATTENTIONAL FOCUS AND FEAR OF BLUSHING: A CASE STUDY

1999 ◽  
Vol 27 (2) ◽  
pp. 153-164 ◽  
Author(s):  
Sandra Mulkens ◽  
Susan M. Bögelts ◽  
Peter J. de Jong
Keyword(s):  
Single Case ◽  
Attentional Focus ◽  
Single Case Study ◽  
Fear Avoidance ◽  
Differential Effects ◽  
Before And After ◽  
Fear Of Blushing

By means of a single case study, the effects of redirecting attention above exposure only on fear of blushing, avoidance, and idiosyncratic dysfunctional beliefs were tested. A social phobic patient with fear of blushing as the predominant complaint received sessions of Task Concentration Training (TCT) and Exposure in Vivo (EXP) alternately, after a steady baseline had been established. The treatment consisted of 14 individual sessions. Assessments were held before and after baseline, after treatment, after 4 weeks follow-up, and after 1-year follow-up. Continuous measurements were held throughout the treatment in order to measure the differential effects of TCT and EXP on fear, avoidance and beliefs. TCT and EXP together, turned out to be an effective treatment for fear of blushing: large effects were observed on all three outcome measurements. When differential effects are closely looked at, EXP seemed more effective in decreasing fear of blushing. However, the patient appeared to have used TCT strategies as well during the EXP weeks, which may have contributed to the favourable effects of EXP.

scholarly journals A Pilot Study of Concentrated EMDR: A Brief Report

2011 ◽  
Vol 5 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Earl Grey
Keyword(s):  
Pilot Study ◽  
Panic Disorder ◽  
Single Case ◽  
Single Case Study ◽  
Major Depressive ◽  
Treatment Frequency ◽  
Case Study Design ◽  
Psychotic Features

The current research used a quantitative single-case study design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) treatment for a participant diagnosed with comorbid major depressive disorder (MDD), severe without psychotic features, and panic disorder with agoraphobia. Treatment frequency was three sessions per week, with twelve 90-minute reprocessing sessions provided over a period of 1 month; the study also evaluated this application of “concentrated EMDR.” At baseline, mean scores on the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) were 49 and 38, and at 3-month follow-up, the scores had decreased to 8 and 7 respectively. The results of this pilot study indicate that concentrated EMDR may be effective in treating comorbid MDD and panic disorder with agoraphobia. The study also evaluated the application of concentrated EMDR, with treatment frequency increased from one session to three sessions per week. Twelve 90-minute reprocessing sessions were provided over a period of 1 month. Results show the apparent effectiveness of concentrated EMDR.

Case Study of Clinical Behavior Analysis for a 20-Year-Old Client With Emetophobia

2019 ◽  
Vol 18 (3) ◽  
pp. 163-174
Author(s):  
Takashi Mitamura
Keyword(s):  
Behavior Analysis ◽  
Single Case ◽  
Intervention Strategies ◽  
Single Case Design ◽  
Clinical Behavior Analysis ◽  
Clinical Behavior ◽  
Empirically Supported ◽  
Clinically Significant

This case study illustrates a clinical behavior analytic intervention for a female client with emetophobia, the fear of vomiting. Clinical behavior analysis is a recently developing branch of empirically supported psychotherapy, derived from behavior analysis. This case study presents modified case formulations and changed intervention strategies according to the results of repeated measuring. The intervention was six sessions and three gradual follow-up sessions; the effect of the intervention was monitored by a single-case design. The intervention strategies were changed from symptom-focused interventions, which are based on exposure, to value-focused gradual follow-up sessions. The client’s phobia and depression were alleviated through the intervention and gradual follow-up phases. Moreover, her value-based activities increased through the gradual follow-up phase. The Reliable Change Indexes (RCIs) were calculated to evaluate changes between the intervention and follow-up phases. There were large and clinically significant decreases on measures. The results highlight the utility of repeated measuring and importance of a value-focused approach.

scholarly journals Early Detection of t(8;21) Chromosomal Translocations during Treatment of PML-RARA Positive Acute Promyelocytic Leukemia: A Case Study

2010 ◽  
Vol 4 ◽  
pp. CMO.S6446 ◽  
Author(s):  
Walter Kleine Neto ◽  
Mariana Serpa ◽  
Sabri Saeed Sanabani ◽  
Patricia Torres Bueno ◽  
Elvira Deolinda Rodrigues Pereira Velloso ◽  
...  
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Genetic Screening ◽  
Treatment Initiation ◽  
Single Case ◽  
Promyelocytic Leukemia ◽  
Chromosomal Translocations ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid

Here we describe a female patient who developed acute promyelocytic leukemia (APL) characterized by t(l5;17) translocation at diagnosis. The patient began treatment with all-trans retinoic acid (ATRA) + chemotherapy. During follow up, the patient was found to be negative for the t(15;17) transcript after 3 months of therapy which remained undetectable, thereafter. However, the emergence of a small clone with a t(8;21) abnormality was observed in the bone marrow and peripheral blood (PB) cells between 3 and 18 months following treatment initiation. The abnormal translocation observed in PB cells obtained at 3 months was detected after the second cycle of consolidation therapy and reappeared at 15 months during maintenance treatment, a period without ATRA. Although based on a single case, we conclude that genetic screening of multiple translocations in AML patients should be requested to allow early identification of other emerging clones during therapy that may manifest clinically following treatment.

scholarly journals P.047 Successful management of Parkinsonism in a schizophrenic patient

2016 ◽  
Vol 43 (S2) ◽  
pp. S32-S32 ◽  
Author(s):  
GB Young ◽  
B Mulroy ◽  
R Rafiq
Keyword(s):  
Single Case ◽  
D2 Receptor ◽  
Receptor Subtypes ◽  
Antipsychotic Therapy ◽  
Dopaminergic Drugs ◽  
D3 Receptors ◽  
Receptor Profile ◽  
Schizophrenic Patients

Background: D2 receptor antagonists have been a mainstay in treating schizophrenia. Dopamine agonists used in the treatment of Parkinsonism can aggravate psychosis. Dopaminergic drugs with emphasis on other receptor subtypes with less D2 activation could reduce Parkinsonism in schizophrenic patients without seriously aggravating Parkinsonism. Rotigitine acts primarily on D3 receptors, while activity on other dopamine receptors is 8-20 times less. We report the successful treatment of a schizophenic patient with rotigitine and contend that its effectiveness relates to rotigitine’s receptor profile. Methods: Single case study with follow-up. Results: A 67 year old woman with longstanding schizophrenia developed severe, progressive Parkinsonian features over 2 years despite stable antipsychotic therapy. More than one tablet of levodopa-carbidopa 100/25 precipitated psychosis. Risperidone was changed to cloazapine without benefit in Parkinsonism. The rotigitine patch was introduced and increased to 8 mg/24 hours without aggravating her mental status and produced considerable improvement in Parkinsonian features. Conclusions: Rotigitine is worth exploring as a treatment for severe Parkinsonism in patients with schizophrenia.

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