RESUMO
Cognitive−behavioral therapy is a well-established treatment for obsessive−compulsive disorder (OCD). There are a variety of cognitive and behavioral strategies, and it is necessary to analyze the outcomes of the treatments. The aim of the present study is to verify the effectiveness of a treatment that combines evidence-based procedures and specific cognitive interventions highlighting the issue of acceptance. Forty patients with OCD were recruited and underwent a specific treatment procedure. All patients had a psychodiagnostic assessment for OCD using the Y−BOCS (Yale−Brown obsessive−compulsive scale) performed twice: before treatment (t0) and after nine months (t1). Data analysis showed a decrease in the scores between t0 and t1 according to the Y−BOCS in terms of the interference, severity, and impairment of obsessive−compulsive symptoms. A repeated-measures ANOVA showed a significant reduction in symptoms after treatment, with values of F (1, 39) = 137.56, p < 0.001, and η2 = 0.78. The ANOVA results were corroborated by a Wilcoxon signed-rank test. A reliable change index analysis indicated that 33 participants reported improvements in symptoms, of which 23 were clinically significant. The results showed clinical relevance for OCD treatment and highlighted how this cognitive procedure favored positive outcomes.
RESUMO
BACKGROUND AND OBJECTIVES: Criticism is thought to play an important role in obsessive-compulsive disorder (OCD), and obsessive behaviors have been considered as childhood strategies to avoid criticism. Often, patients with OCD report memories characterized by guilt-inducing reproaches. Starting from these assumptions, the aim of this study is to test whether intervening in memories of guilt-inducing reproaches can reduce current OCD symptoms. The emotional valence of painful memories may be modified through imagery rescripting (ImRs), an experiential technique that has shown promising results. METHODS: After monitoring a baseline of symptoms, 18 OCD patients underwent three sessions of ImRs, followed by monitoring for up to 3 months. Indexes of OCD, depression, anxiety, disgust, and fear of guilt were collected. RESULTS: Patients reported a significant decrease in OCD symptoms. The mean value on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) changed from 25.94 to 14.11. At the 3-month follow-up, 14 of the 18 participants (77.7%) achieved an improvement of ≥35% on the Y-BOCS. Thirteen patients reported a reliable improvement, with ten reporting a clinically significant change (reliable change index = 9.94). Four reached the asymptomatic criterion. Clinically significant changes were not detected for depression and anxiety. CONCLUSIONS: Our findings suggest that after ImRs intervention focusing on patients' early experiences of guilt-inducing reproaches there were clinically significant changes in OCD symptomatology. The data support the role of ImRs in reducing OCD symptoms and the previous cognitive models of OCD, highlighting the role of guilt-related early life experiences in vulnerability to OCD.
RESUMO
The report begins with the latest debate on Cochlear Implants (CI) - the role they play during the development of a deaf child, analyzing the psychological aspects which characterize the experiences of families of children who do get implanted, starting from the detection of deafness until after implantation. The aim is to demonstrate how in these experiences and during all developmental phases the significant role the psychologist plays and how important timely intervention of specific programs is for both child and parents. Numerous studies have demonstrated that CI offers advantages in terms of recuperating capacity to hear and the development of spoken language. Recent studies focusing on psychological aspects have shifted the attention to the positive results of CI in comparison to the social environment in addition to family traits such as the parental reaction to the diagnosis of their child's deafness, mental coping strategies and the subsequent behaviors they adopt. In 90% of these cases, the parents are hearing and often have no experience in regards to deafness, and this is why when they find out that their child is deaf, their reaction is similar to that of bereavement. Consequently, prior to implantation it is necessary that a psychologist makes an accurate assessment in order to be able to intervene in situations where there is parental stress and help them cope by implementing a copying paradigm. The reaction to child deafness and the strategies of copying that they have acquired influence the family's expectations in respects to the CI, and in turn this influences the outcome after implantation. During the assessment, an important aspect for the psychologist is evaluating the motivation towards the rehabilitative program and the strong interaction between the parents and the child - both of these elements are closely connected to a positive outcome of the CI. During the post implant period, recent studies have shown an improvement of parental behavior as well as the development of the child in the domains of shared attention, problem solving, symbolic play and social functioning. In addition, during this stage the relationships between parents and children are more effective, and all parental figures are positively motivated towards appropriate behaviors. Hence the effects of CI are no longer limited to the implanted child, but now entail the entire family. In fact, the parents judge the quality of their lives on the basis of how successful they perceive the results obtained by having their child undergo a CI. Consequently, they regulate their behavior and attitudes influencing the child's development. Parents themselves maintain that specialized psychological support is fundamental during all stages connected to CI and more generally to the overall development of their child.
