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Treatment options for social cognition and negative symptoms in schizophrenia spectrum disorders (SSD) remain limited. Oxytocin could be a promising augmentation approach, but the social context influences the effect in humans. This pilot study hypothesized that oxytocin in a positive social setting through mindfulness-based group therapy (MBGT) would positively affect empathy and negative symptoms as well as affect and stress in an exploratory approach in SSD. An experimental, randomized, double-blinded (participants, psychotherapists), placebo-controlled pilot study with 41 individuals with SSD was conducted at the Charité - Universitätsmedizin Berlin. Oxytocin or placebo (24 I.U.) was administered intranasally 45 min before two sessions of MBGT each. A 2 × 2 mixed model ANCOVA design was calculated to assess empathy by the Interpersonal Reactivity Index and the Multifaceted Empathy Test and negative symptoms by the Self-Evaluation of Negative Symptoms. No benefit of oxytocin compared to placebo on empathy was observed, but significant between-group differences favoring oxytocin were found regarding the negative symptoms Diminished emotional range and Avolition. Negative affect and stress were significantly reduced compared to baseline. Mindfulness increased in both groups. Results indicated protocol adherence and retention rate of 91.1%, a drop-out rate of 8.9 % and a completion of 96 % of all sessions by the participants. No severe adverse events or side effects were reported. Our findings indicate proof-of-concept and suggest a potential role of oxytocin on negative symptoms and related variables in SSD in combination with MBGT. Future research should examine the stability of these effects with larger sample sizes.
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Atenção Plena , Psicoterapia de Grupo , Esquizofrenia , Humanos , Empatia , Ocitocina/farmacologia , Projetos Piloto , Esquizofrenia/tratamento farmacológico , Método Duplo-CegoRESUMO
Background: Depression is highly prevalent in people living with HIV (PLWH) but remains under treated in Sub-Saharan Africa. In this context, we conducted the first study of Group Interpersonal Therapy (IPT) to treat depression in PLWH in Senegal. We assessed the perceptions and experiences of patients and group facilitators, as well as barriers to implementation. Methods: This study was conducted at the Fann National University Hospital Center in Dakar, the urban capital of Senegal. Qualitative data were collected during the implementation phase (February to June 2020 and then from January to February 2021), with a 6-month pause due to the COVID-19 pandemic. Twenty-five patients and three group facilitators were individually interviewed by a socio-anthropologist. Qualitative data were analyzed thematically. Results: Group IPT was perceived as successful and beneficial by patients and facilitators. Patients reported positive experiences with group IPT and sustained outcomes. Beyond improving depressive symptoms, patients reported improvements in their social and professional lives, and the development of skills to prevent relapse. Group facilitators noted the benefits of therapy for their patients and for their professional skills, reporting greater clinical competence and improved supportive skills. Challenges to intervention implementation included confidentiality and patient privacy concerns, healthcare accessibility issues, and time demands. Conclusion: In this first qualitative study of group IPT for depression in PLWH in Senegal, participants described both positive experiences with the intervention and challenges to its implementation. Future studies, conducted in suburban and rural communities outside of Dakar, would further inform the implementation of IPT in Senegal.
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Infecções por HIV , Psicoterapia de Grupo , Humanos , Depressão/terapia , Pandemias , Senegal , Infecções por HIV/epidemiologiaRESUMO
This study investigated the effectiveness of brief individual experiential schema therapy (ST) in 12 adult outpatients with cluster C personality disorders (PD) using randomised multiple baseline design. Waitlist period was followed by five explorative sessions, 18 experiential ST sessions, two treatment follow-up (FU) booster sessions and a 6-month FU assessment. Overall well-being (ORS), behavioural treatment goals and negative core beliefs were assessed 60-91 times, global symptomatic distress (BSI) six times. PD severity (SCID-5-PD) was pre-post-analysed. Randomisation and non-parametric tests showed large significant effects (d = 1.08-2.38, r = .53-.66) on all outcomes at treatment-FU and 6-month FU assessment. This is the first study providing preliminary evidence of effectiveness of brief individual experiential ST for patients with cluster C PD, tentatively challenging the common tenet that long treatment duration is required. Due to limitations, replication is recommended.
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Terapia Cognitivo-Comportamental , Psicoterapia de Grupo , Adulto , Humanos , Pacientes Ambulatoriais , Terapia do Esquema , Transtornos da Personalidade/terapia , Resultado do TratamentoRESUMO
BACKGROUND: The present study explored the acceptability of psilocybin-assisted group therapy from the perspective of patients with cancer and depression who participated in a clinical trial assessing the safety and efficacy of this novel intervention. METHODS: Guided by the conceptual framework of acceptability, the authors conducted semi-structured interviews with participants of the psilocybin trial. Data were analyzed using template and thematic analyses. RESULTS: Participants' (n = 28) perspectives on the acceptability of the group and simultaneous sessions was generally positive, both in terms of safety and efficacy: first, the groups contributed to increase participants' sense of safety and preparedness as they were engaging in the therapy; and second, the groups fostered a sense of connection and of belonging, which served to enrich and deepen the meaning of participants' experience, ultimately opening a dimension of self-transcendence and compassion. Other subthemes related to factors influencing the acceptability of the group approach included: 1) the importance of the therapeutic framework, 2) the complementary value of individual sessions, 3) disruptive factors related to the group and/or simultaneous setting, and 4) opportunities and challenges related to group size and how to structure interactions. CONCLUSIONS: This study enhances understanding of what promotes acceptability of the psilocybin-assisted therapy group model for the treatment of MDD in cancer patients. PLAIN LANGUAGE SUMMARY: We conducted exit interviews with participants of a phase 2 trial of psilocybin-assisted therapy (PAT) conducted in a community cancer center, to assess the acceptability of a novel psilocybin delivery model combining simultaneous individual therapy and group sessions. Our findings support the acceptability of this intervention and suggest that in addition to being feasible, it might also enhance participants' perceived safety and efficacy compared to uniquely individual or group delivery models of PAT. Our analysis highlights critical factors conditioning acceptability and suggests new ways PAT may be scaled and integrated into cancer care.
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Transtorno Depressivo Maior , Neoplasias , Psicoterapia de Grupo , Humanos , Psilocibina/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Psicoterapia , Neoplasias/tratamento farmacológico , Neoplasias/induzido quimicamenteRESUMO
BACKGROUND: Depression is common in patients with cancer and is associated with lower treatment adherence and reduced quality of life. Antidepressants and psychotherapy have limited success in improving depression among patients with cancer. This study explored the safety, feasibility, and efficacy of psilocybin-assisted therapy in patients with cancer and major depressive disorder. METHODS: This phase 2, open-label trial enrolled patients with curable and noncurable cancer and major depressive disorder at a single community oncology practice site. A single 25-mg dose of psilocybin was administered simultaneously to cohorts of three to four participants with individual (4.25 hours in 1:1 therapist-to-patient ratio) and group therapeutic support (3.75 hours) before, during, and after psilocybin administration. Outcomes included depression severity, anxiety, pain, demoralization, and disability. RESULTS: Thirty participants completed the study. No psilocybin-related serious adverse events occurred; treatment-related adverse events (e.g., nausea, headache) were generally mild and expected. There were no laboratory or electrocardiogram abnormalities. No suicidality was reported. Efficacy was suggested with a robust reduction in depression severity scores from baseline to posttreatment of 19.1 points (95% CI, 22.3 to -16.0; p < .0001) by week 8. Eighty percent of participants demonstrated a sustained response to psilocybin treatment; 50% showed full remission of depressive symptoms at week 1, which was sustained for 8 weeks. CONCLUSIONS: Psilocybin-assisted therapy in group cohort administration was safe and feasible in patients with cancer and depression. Efficacy was suggested based on clinically meaningful reductions in depressive symptoms. The novel, group-oriented format, compact delivery time, community cancer center setting, and one-to-one therapist-to-patient ratio could also add to therapeutic gains and efficiency of administration. TRIAL REGISTRATION: NCT04593563. PLAIN LANGUAGE SUMMARY: Depression is common in patients with cancer and associated with lower treatment adherence, reduced quality of life, and limited response to antidepressants and psychotherapy. We conducted a phase 2 trial to study a single dose of psilocybin administered in a group therapy setting with one-to-one therapist-to-participant psychological support to patients with curable and noncurable cancer and major depressive disorder. Findings of the study showed safety (no treatment-related serious adverse events or suicidality) with psilocybin and suggested efficacy, with a significant reduction in depression severity scores from baseline to posttreatment. Further investigation is warranted.
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Transtorno Depressivo Maior , Neoplasias , Psicoterapia de Grupo , Humanos , Psilocibina/efeitos adversos , Transtorno Depressivo Maior/tratamento farmacológico , Qualidade de Vida , Antidepressivos/efeitos adversos , Neoplasias/complicações , Neoplasias/tratamento farmacológicoRESUMO
OBJECTIVES: Depression is often accompanied by various degrees of cognitive decline, with a high incidence. Guidelines recommend medication combined with psychological therapy. Solution focused group therapy (SFGT) is a newer group psychotherapy technique. This study aims to explore the difference between SFGT combined with escitalopram and only use escitalopram in treating depression. METHODS: A total of 84 patients who met the diagnostic criteria of international classification of diseases-10 (ICD-10) were enrolled into the combined group (SFGT combined with escitalopram, n=42) and the control group (only escitalopram, n=42) for an 8-week treatment. Patients were measured with the 24-item Hamilton Depression Scale (HAMD-24) and the Cognitive Flexibility Inventory (CFI) at baseline (T0), week 4 (T1), and week 8 (T2), respectively. Differences in depressive symptoms and cognitive flexibility between the 2 groups were compared and analyzed. RESULTS: At T2, 8 patients were dislodged in the combined group and 10 in the control group. There was no difference in the subscales and total scores of HAMD-24 and CFI between the 2 groups at T0 (all P>0.05). At T1 and T2, compared with the control group, the total scores and anxiety somatization, cognitive impairment, delay, and a sense of despair subscales scores of HAMD-24 were lower, and the total scores and subscales scores of CFI in the combined group were higher (all P<0.05). CONCLUSIONS: SFGT combined with escitalopram is more effective than monotherapy for improving the anxiety somatization symptoms, cognitive impairment, retardation symptoms and despair symptoms, and increasing the cognitive flexibility.
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Transtorno Depressivo , Psicoterapia de Grupo , Humanos , Citalopram/uso terapêutico , Citalopram/efeitos adversos , Depressão/terapia , Escitalopram , Transtorno Depressivo/complicações , Transtorno Depressivo/terapia , Cognição , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the efficacy and feasibility of utilizing Traditional Chinese Medicine (TCM) combined group psychotherapy intervention on psychological distress management and gut micro-biome regulation for colorectal (CRC) survivors. METHODS: A single-arm phase I clinical trial was conducted between December 2020 and December 2021 in Xiyuan Hospital and Beijing Cancer Hospital in China. Inclusion criteria included stage I-III CRC survivors after radical surgery with age between 18 and 75. The intervention was a 6-week online TCM combined group psychotherapy intervention including 90-min communication, TCM lifestyle coaching, self-acupressure guidance, and mindfulness practice led by TCM oncologist and psychiatrist each week. Outcomes were measured by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Fear of Cancer Recurrence Inventor (FCRI), and Quality of Life Questionnaire (QLQ-C30). Fecal samples before and after intervention were collected for 16Sr RNA analysis. RESULTS: We recruited 40 CRC survivors and 38 of them finally completed all interventions with average age of 58±13 years' old. Paired t-test showed that SAS at week 2(35.4±5.8), week 4 (37.9±10.5) and week 6 (31.3±6.4) during the intervention was significantly lower than baseline (42.1±8.3, p<0.05 respectively). SDS score also declined substantially from baseline (38.8±10.7) to week 2 (28.3±8.8, p<0.001) and week 6 (25.4±7.7, p<0.001). FCRI decreased from 19.4±7.2 at baseline to 17.5±7.1 at week 4 (p=0.038) and 16.3±5.8 at week 6 (p=0.008). Although changes of QLQ-C30 were not statistically prominent, symptom burden of insomnia and fatigue significantly alleviated. The abundances of gut microbiota Intestinibacter, Terrisporobacter, Coprobacter, and Gordonibacter were all significantly elevated after intervention. CONCLUSIONS: TCM combined group psychotherapy intervention is feasible and effective to reduce CRC survivors' psychological distress and modulate certain gut bacteria which might be associated with brain-gut axis effect. It is necessary to carry out with phase II randomized controlled clinical trial.
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Neoplasias Colorretais , Psicoterapia de Grupo , Humanos , Pessoa de Meia-Idade , Idoso , Adolescente , Adulto Jovem , Adulto , Medicina Tradicional Chinesa , Qualidade de Vida/psicologia , Sobreviventes/psicologia , Neoplasias Colorretais/terapia , Neoplasias Colorretais/psicologiaRESUMO
Welcoming migrant families into an early childhood unit forces professionals to reflect on their clinical practices. When faced with parents with whom the therapeutic alliance is hard to establish and with children with developmental delays, a psychologist and a childcare assistant turn to transcultural psychology to find adapted tools. This text presents the reflections, the set up and the beginning of a parent-child therapeutic group.
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Psicoterapia de Grupo , Migrantes , Humanos , Pré-Escolar , Pais/psicologia , Relações Pais-FilhoRESUMO
Recent evidence supported the notion that add-on group therapy should be provided to individuals with borderline personality disorder (BPD) who already undergo individual psychotherapy. The present 20 week-study was aimed to evaluate the efficacy of the adjunction of group interpersonal psychotherapy (IPT-G) to individual interpersonal psychotherapy adapted for BPD - revised (IPT-BPD-R) in comparison with individual IPT-BPD-R alone in a group of BPD patients. In addition, demographical and clinical characteristics that can be considered predictors of response to add-on group therapy were investigated. Forty-six patients were randomly assigned to 1) IPT-BPD-R plus IPT-G or to 2) IPT-BPD-R in the waiting list for IPT-G. Patients were assessed at baseline and after 20 weeks with: the Clinical Global Impression Scale, Severity item (CGI-S); the Social Occupational Functioning Assessment Scale (SOFAS); the Satisfaction Profile (SAT-P); the Borderline Personality Disorder Severity Index (BPDSI); the Modified Overt Aggression Scale (MOAS); the Childhood Trauma Questionnaire - Short Form (CTQ-SF); the Inventory of Interpersonal Problems (IIP-32); and the Reading the Mind in the Eyes Test (RMET). Statistical analyses included: ANOVA for repeated measures to compare score changes of the rating scales within groups (trial duration) and between groups (treatment modalities), and multiple regression analysis to identify which clinical factors are significantly and independently related to the difference of BPDSI score between baseline and week 20 (Δ BPDSI). The significance level was P ≤ 0.05. Both significant within-subjects effects (duration) and between-subjects effects (treatment modalities) were found for the following rating scales: MOAS; BPDSI items "feelings of emptiness", "outbursts of anger," and "affective instability"; RMET; SAT-P items "work" and "sleep, food, free time"; and IIP-32 scale "domineering/controlling". At the multiple regression analysis BPDSI item "impulsivity", RMET, and the subscale "socially inhibited" of the IIP-32 were significantly and independently related to Δ BPDSI score. In conclusion, the add-on of IPT-G produced higher improvement in core BPD symptoms, social cognition, a dysfunctional interpersonal style, and subjective quality of life. Subjects who were less impulsive, less socially inhibited, and with higher abilities in social cognition obtained greater benefits from the adjunction of group therapy. CLINICAL TRIALS REGISTRATION NUMBER: ACTRN12623000002684, Australian New Zealand Clinical Trials Registry (ANZCTR).
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Transtorno da Personalidade Borderline , Psicoterapia Interpessoal , Psicoterapia de Grupo , Humanos , Transtorno da Personalidade Borderline/psicologia , Qualidade de Vida/psicologia , Resultado do Tratamento , Austrália , PsicoterapiaRESUMO
INTRODUCTION: Panic disorder is one of the most commonly occurring emotional disorder, showing increased prevalence rates since the COVID-19 pandemic. The ever-growing number of patients in need of treatment is a heavy burden on the healthcare system, which draws attention to the importance of low-intensity, short and effective psychological interventions in the treatment of mental disorders, especially in the field of primary care. According to international guidelines, the recommended evidence-based treatment of panic disorder is cognitive behavioral therapy, which is based on the cognitive model of panic disorder. According to the model, a panic attack develops in those who catastrophize the symptoms of the normal stress reaction, i.e., consider them a sign of a serious physical illness such as heart-attack and react to this with intense anxiety. OBJECTIVE: Based on Salkovskis and Clark (1986), we developed a 5 session, intensive cognitive behavioral group therapy protocol for panic patients. METHOD: Effectiveness of the short group therapy was assessed with questionnaires (Spielberger's State-Trait Anxiety Inventory, Beck Depression Inventory) and an additional subjective scale. Paired sample t-tests were conducted. RESULTS: Our results suggest that the intensity of anxiety and depressive symptoms (t(36) = 5.497, p<0.0001; Z = -4.871, p<0.0001) as well as the frequency of panic attacks (Z= -5.190, p<0.0001) decreased significantly after the 5 session group therapy. DISCUSSION AND CONCLUSION: Our clinical study provides further evidence by the effectiveness of low-intensity psychological interventions, offering an evidence-based protocol for professionals working in primary as well as mental health care. Orv Hetil. 2023; 164(42): 1665-1672.
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Terapia Cognitivo-Comportamental , Transtorno de Pânico , Psicoterapia de Grupo , Humanos , Transtorno de Pânico/terapia , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Pandemias , Terapia Cognitivo-Comportamental/métodos , Cognição , Resultado do TratamentoRESUMO
BACKGROUND: Depression, a common mental problem frequently detected in people with epilepsy (PWE), is a major factor that decreases the quality of life of PWE. The cognitive behavioral therapy (CBT) is the most commonly used non-pharmacological treatment for depressive disorders. The CBT for PWE with depression has not yet been studied in Korea. This study aimed to evaluate the effects of the CBT on depression in PWE in Korea. METHOD: This study included 16 PWE with depression who received CBT and 30 control PWE with depression who did not receive CBT. The mean number of CBT sessions per patient was 7.2 in the CBT group. The Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire-9 (PHQ-9) were administered before and after CBT sessions in the CBT group, whereas PHQ-9 was performed at baseline and follow-up in the control group. The difference in PHQ-9 and BDI-II scores were analyzed between the pre- and post-CBT periods in the CBT group. The difference between baseline and follow-up PHQ-9 scores was compared in the control group. RESULTS: There was no significant difference in baseline variables between the CBT and control groups. The PHQ-9 score significantly decreased after the CBT sessions in the CBT group (pre-CBT PHQ-9 = 13.56 vs. post-CBT PHQ-9 = 8.56) but it did not change in the control group (Baseline PHQ-9 = 13.83 vs. follow-up PHQ-9 = 14.67). Twelve PWE had undergone four or more CBT sessions with pre-CBT and post-CBT BDI-II. The BDI-II score significantly decreased after CBT sessions (pre-CBT BDI-II = 30.75 vs. post-CBT BDI-II = 21.5). The CBT decreased the sub-field scores of cognitive and physical-emotional factors as well as suicidal ideation, but the score of sleep problems did not significantly improve. The CBT did not significantly change the seizure frequency. CONCLUSION: The CBT significantly improved depression in Korean PWE. Therefore, it can be considered a treatment tool for depression in PWE. However, a study with more patients and a fixed number of CBT sessions is recommended to generalize this effect.
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Terapia Cognitivo-Comportamental , Epilepsia , Psicoterapia de Grupo , Humanos , Qualidade de Vida , Questionário de Saúde do Paciente , Epilepsia/complicações , Epilepsia/terapia , Resultado do TratamentoRESUMO
AIM: The aim of the present research is to assess the satisfaction levels of participants in a multifamily psychoanalysis group conducted within a territorial mental health service, following the model developed by Argentine psychoanalyst Jorge García Badaracco. METHODS: To evaluate participant satisfaction in the therapeutic group, an anonymous satisfaction questionnaire was adopted and administered during each multifamily therapy session between 2016 and 2019. The sample consisted of designated patients and their family members participating in the groups. RESULTS: The results obtained from measuring participant satisfaction during the specified time period indicate a consistent and increasing level of satisfaction with the group activities conducted by all participants. DISCUSSION AND CONCLUSIONS: The obtained results indicate that the experience of multifamily psychoanalysis seems to be well-received and positively perceived by both users and family members, thereby contributing to an overall increase in satisfaction with the mental health service. The measurement of subjective satisfaction ratings in scientific literature is explored in relation to satisfaction, adherence, compliance, and treatment persistence, and can also be included as part of a broader set of variables aimed at identifying objective indicators of intervention outcomes in multifamily psychotherapies.
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Serviços de Saúde Mental , Psicanálise , Psicoterapia de Grupo , Humanos , Família/psicologiaRESUMO
OBJECTIVE: To study the impact of social skills group training (SSGT) in children with autism aged 8-12 years. To compare baseline (T1), post-intervention immediate (T2) and 3 months post-intervention (T3) scores. METHODS: Single-arm interventional study in 30 children with autism, aged 8-12 years with intelligence quotient >70. Interdisciplinary therapists conducted a 90-minute weekly SSGT (10 sessions) for 3 months (August-October, 2019). Outcomes were evaluated with standardized tests- Vineland Social Maturity Scale (VSMS), Vineland Social Maturity Scale- Social Quotient (VSMS-SQ), Social Communication Questionnaire (SCQ), Parent Rated Social Responsiveness Scale-2 (pSRS-2) done at baseline and at T2 and T3. RESULTS: The mean (SD) scores at T1 and T3 were as follows: VSMS score at T1 was 66.63 (5.05), T3 was 71.03 (5.84) (P<0.001); SQ at T1 = 75.99 (6.399), T3 = 79.83 (8.94) (P=0.016), respectively. The mean (SD) SCQ score at T1 was 27.3 (12.28), T2 was 25.8 (6.36), T3 = 27.1 (7.16) (P>0.05 for T1- T2, T2-T3, P=0.013 for T1-T3). The mean (SD) pSRS-2 score at T1 = 83.5 (6.68), T2 = 80.1 (7.87), T3 = 76.9 (8.07) (P<0.001), showing decline in severity after SSGT. CONCLUSIONS: Weekly SSGT done over 3 months showed significant improvement in social skills, which were sustained up to 3 months post-intervention.
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Transtorno Autístico , Psicoterapia de Grupo , Humanos , Criança , Transtorno Autístico/terapia , Habilidades Sociais , Pais , Inquéritos e QuestionáriosRESUMO
In this proof-of-concept study, we used a systems perspective to conceptualize and investigate treatment-related dynamics (temporal and cross-sectional associations) of symptoms and elements related to the manifestation of a common functional somatic syndrome (FSS), Globus Sensations (GS). We analyzed data from 100 patients (M = 47.1 years, SD = 14.4 years; 64% female) with GS who received eight sessions of group psychotherapy in the context of a randomized controlled trial (RCT). Symptoms and elements were assessed after each treatment session. We applied a multilevel graphical vector-autoregression (ml GVAR) model approach resulting in three separate, complementary networks (temporal, contemporaneous, and between-subject) for an affective, cognitive, and behavioral dimension, respectively. GS were not temporally associated with any affective, cognitive, and behavioral elements. Temporally, catastrophizing cognitions predicted bodily weakness (r = 0.14, p < 0.01, 95% confidence interval (CI) [0.04-0.23]) and GS predicted somatic distress (r = 0.18, p < 0.05, 95% CI [0.04-0.33]). Potential causal pathways between catastrophizing cognitions and bodily weakness as well as GS and somatic distress may reflect treatment-related temporal change processes in patients with GS. Our study illustrates how dynamic NA can be used in the context of outcome research.
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Sensação de Globus , Psicoterapia de Grupo , Feminino , Humanos , Masculino , Estudo de Prova de Conceito , Catastrofização , CogniçãoRESUMO
ABSTRACT: Cognitive-behavioral group therapy is one of the most effective forms of intervention in therapy for women with breast cancer. The present study aimed to investigate the efficacy of cognitive-behavioral group therapy on depression, anxiety, and pain-coping strategies in women with breast cancer. The present study is a semiexperimental research with a pretest-posttest with the control group. For this purpose, 50 people of women with breast cancer were admitted to the medical university hospitals of Tehran to method purposive sampling and were randomly selected as experimental ( n = 25) and control ( n = 25) groups. The results showed that cognitive-behavioral group therapy significantly reduces depression and anxiety and increases the use of pain-coping strategies in women with breast cancer. Also in the field of pain-coping strategies between the experimental and control groups, there is a significant difference.
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Neoplasias da Mama , Psicoterapia de Grupo , Feminino , Humanos , Adaptação Psicológica , Ansiedade/terapia , Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Cognição , Depressão/terapia , Irã (Geográfico) , DorRESUMO
BACKGROUND: Due to the growing gap between the demand and supply of therapeutic services for people suffering from depression, with this study, we are investigating the effectiveness and factors of influence of new approaches in group treatments for depression. Two previous studies have already identified bouldering psychotherapy (BPT) as an effective option. It combines psychotherapeutic interventions with action- and body-oriented bouldering exercises. Mental model therapy (MMT) is a new cognitive-behavioral approach for treating depression. It focuses on identifying cognitive distortions, biases in decision making, and false assumptions and aims to correct and replace them with useful mental models. We aim to investigate the effectiveness of the interventions compared with a control group (CG) and to assess the factors of influence in a mixed methods approach. METHODS: The study is being conducted as a randomized controlled intervention trial. Adult participants with unipolar depression are being randomized into three groups (BPT, MMT, or CG), and the first two groups are undergoing a 10-week treatment phase. CG follows their individual standard treatment as usual. A priori power analysis revealed that about 120 people should be included to capture a moderate effect. The primary outcome of the study is depression rated with the Montgomery and Asberg Depression Rating Scale (MADRS) before (t0), directly after (t1), and 12 months after the intervention phase (t2). Data are being collected via questionnaires, computer-assisted video interviews, and physical examinations. The primary hypotheses will be statistically analyzed by mixed model ANOVAs to compare the three groups over time. For secondary outcomes, further multivariate methods (e.g., mixed model ANOVAs and regression analyses) will be conducted. Qualitative data will be evaluated on the basis of the qualitative thematic analysis. DISCUSSION: This study is investigating psychological and physical effects of BPT and MMT and its factors of influence on outpatients suffering from depression compared with a CG in a highly naturalistic design. The study could therefore provide insight into the modes of action of group therapy for depression and help to establish new short-term group treatments. Methodological limitations of the study might be the clinical heterogeneity of the sample and confounding effects due to simultaneous individual psychotherapy. TRIAL REGISTRATION: ISRCTN, ISRCTN12347878. Registered 28 March 2022, https://www.isrctn.com/ISRCTN12347878 .
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Terapia Cognitivo-Comportamental , Psicoterapia de Grupo , Adulto , Humanos , Depressão/diagnóstico , Depressão/terapia , Psicoterapia , Modelos Psicológicos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Several evidence-based psychotherapies for personality disorders have been developed in recent decades, including transference-focused psychotherapy (TFP), a contemporary model of psychodynamic psychotherapy developed by Otto Kernberg. Kernberg established Group TFP (TFP-G) as an alternative or adjunct treatment to individual TFP. Although not yet manualized, TFP-G is used in publicly and privately funded mental health services, including outpatient clinics, subacute hospitals, therapeutic inpatient units, partial hospitalization services, and rehabilitation services serving people with borderline personality. Kernberg's model of TFP-G psychotherapy, its application in clinical settings, and what differentiates it from other group psychotherapy models is described as well as illustrated with some examples useful to practitioners.