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1.
Psychother Res ; : 1-16, 2023 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-38090772

RESUMO

Objective: Although evidence for benefits of psychotherapy is substantial, less is known about potential harm. Therefore, we systematically summarized randomized controlled trials (RCTs) to compile evidence-based data on the frequency and characteristics of adverse events (AEs) of psychotherapy. Method: This systematic review of result publications is based on a review of harm consideration in psychotherapy study protocols. Results: On the basis of 115 study protocols, 85 RCTs with 126 psychotherapy and 61 control conditions were eligible for inclusion. The sample consisted of 14,420 participants with the most common mental disorders. Harmful events, e.g., AEs, number of individuals with symptom deterioration, were explicitly reported in 60% of the studies. Conceptualization, recording, and reporting of AEs were heterogeneous. For most reported AEs, the association to study treatment remained unclear. Conclusions: Because the AE recording approaches of the individual studies differed substantially, results could only be compared to a limited extent. Consistent with other findings, this review demonstrates that AEs can be expected to affect more than one in ten participants. Serious AEs occurred more than in one in 21 participants in psychotherapy RCTs. To allow a balanced risk/benefit evaluation of psychotherapy, systematic harm monitoring and reporting should become standard in psychotherapy RCTs.

2.
Psychother Psychosom Med Psychol ; 73(11): 449-456, 2023 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-37487505

RESUMO

OBJECTIVE: In this study, treatment- and disease-associated consequences of intensive care treatment of COVID-19 in patients and relatives were investigated and compared with data from the general population and sepsis patients. In addition, dyadic associations in symptoms of patients and relatives were analyzed. METHODS: In a monocentric, prospective, non-controlled observational study, patients who underwent intensive care treatment due to Covid-19 disease at Jena University Hospital between November 2020 and March 2021 and their relatives were included. We assessed the long-term outcome between three and six months after discharge from the intensive care unit (ICU) using the Hospital Anxiety and Depression Scale, the Posttraumatic Stress Scale-14, the Multidimensional Fatigue Inventory-10, and the EQ-5D-5L. RESULTS: Seventy-two patients (Mdn 64 years, 67% men) and 56 relatives (Mdn 60 years, 80% women, 80% partners) were included in the study. 39,4% of the patients reported clinically relevant anxiety symptoms, 38,8% depressive symptoms, and 45,1% PTSD symptoms, with most cases having abnormal scores in multiple symptom domains. Among relatives, a smaller proportion had clinically relevant scores (29,2%/15,3%/31,5%). Compared with the general population, Covid 19 patients reported significantly higher anxiety and fatigue scores and a reduced quality of life. In relatives, significantly higher anxiety scores for women and lower quality of life for men were found. Compared to ICU patients with severe sepsis, Covid-19 patients were found to have significantly higher PTSD symptoms and lower quality of life. Significant dyadic associations were found for anxiety and fatigue. DISCUSSION: The results of this study on psychological symptoms after ICU treatment confirm findings from previous studies, but also indicate a stronger PTSD symptomatology, which can be explained by the increased traumatizing potential of isolation and protective measures during treatment. Compared to the general population, particularly elevated anxiety scores of the patients are noticeable, which can be explained by the possible risk of re-infection. CONCLUSION: Psychological long-term consequences of intensive care treatment of Covid-19 disease should be diagnosed and adequately addressed in the outpatient follow-up of affected individuals.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Masculino , Humanos , Feminino , Transtornos de Estresse Pós-Traumáticos/psicologia , Qualidade de Vida , Estudos Prospectivos , Cuidados Críticos/psicologia , Ansiedade/psicologia , Pacientes Ambulatoriais , Depressão/psicologia
3.
Psychotherapy (Chic) ; 60(2): 194-205, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36996160

RESUMO

Chronic pain is common among adults and frequently interferes with regular functioning while reducing quality of life. Though pharmacological approaches are used most frequently to treat pain-related issues, the side effects often lead to other problems. Group therapy has been used and studied for decades in treating pain although its general efficacy in this is not clear. We conducted a meta-analysis to determine group therapy's effectiveness in reducing pain intensity and improving adjacent issues. Potential randomized clinical trials were selected from various databases and included if published between 1990 and 2020, investigated group treatment's efficacy for pain-related concerns, measured pain intensity, included a comparison condition, and reported sufficient data in each trial arm at the first postassessment. We included 29 studies representing 4,571 participants in group therapy being treated for pain. The analysis yielded a significant, small effect when group was contrasted against passive control groups (g = 0.26, 95% CI [0.11, 0.41], p = .001) on the reduction of pain intensity. Two variables were found to moderate group therapy's efficacy: gender composition of groups and theoretical orientation. Although effects on reducing pain intensity are small, group psychotherapy should be considered a viable treatment option for chronic pain patients given the lower risks of side effects compared to pharmaceutical analgesics and comparable effects compared to other chronic conditions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Dor Crônica , Psicoterapia de Grupo , Adulto , Humanos , Dor Crônica/terapia , Qualidade de Vida , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Psychiatr Prax ; 50(5): 256-263, 2023 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-36758588

RESUMO

OBJECTIVE: To investigate the differential effects of an internet-based cognitive-behavioral writing therapy (iCBT) on post-traumatic stress disorder (PTSD) symptoms after intensive care in patients and their spouses. METHODS: This reanalysis of a randomized controlled trial compared PTSD symptom severity (measured by PCL-5) before and after therapy considering potential influencing factors in the per-protocol population. RESULTS: A significant reduction in post-traumatic symptom severity after iCBT was found. Eleven of the 25 treated participants showed a clinically significant change (PCL-5 difference≥10 points). The number of words written by the participants in the therapy modules had a significant impact on iCBT efficacy. CONCLUSION: iCBT appears to be a promising option to augment therapy for PTSD, particularly for physically impaired patients following critical illness.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia , Alemanha , Cuidados Críticos , Redação , Cognição , Internet , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Psychooncology ; 32(3): 331-341, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36588187

RESUMO

OBJECTIVE: Group treatments have proven to be effective for many mental disorders and showed beneficial effects in patients with medical illness. Aim of this systematic review and meta-analysis is to summarize the efficacy of group therapy for women with non-metastatic breast cancer. METHODS: We included studies comparing group therapy for women with non-metastatic breast cancer to non-active control groups, active control conditions, and individual psychotherapy. The primary outcome was mental distress, secondary outcomes were quality of life, coping, existential outcomes, fatigue, pain, and side effects. A comprehensive search was conducted in Medline, Web of Science, CENTRAL, PsycINFO, and DARE complemented by a manual search. Random-effects meta-analyses were run separately for different types of control groups. RESULTS: Thirty-seven studies (5902 patients) were included. Small effects on mental distress in favor of group treatment were found (non-active control groups: n = 19, g = 0.42, 95% CI [0.29; 0.56], I2  = 61.6%; active control conditions: n = 6, g = 0.20, 95% CI [0.06; 0.35], I2  = 0%). Cognitive-behavioral therapy (CBT) and third wave CBT group approaches proved to be most effective. Group treatments also showed beneficial effects on secondary outcomes, with most profound evidence on quality of life and coping. CONCLUSIONS: Results suggest that group interventions have the potential to reduce mental distress in women facing breast cancer. In the light of the considerable heterogeneity of most study effects, there is a need for more rigorous studies to strengthen the promising evidence and for trials examining the impact of patient and intervention characteristics on outcomes. REGISTRATION: PROSPERO international prospective register of systematic reviews, CRD42020184357.


Assuntos
Neoplasias da Mama , Transtornos Mentais , Psicoterapia de Grupo , Humanos , Feminino , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
BMJ Open ; 13(1): e063468, 2023 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-36693695

RESUMO

OBJECTIVES: An acute critical illness and secondary complications may necessitate a prolonged treatment on an intensive care unit (ICU). As long-term consequences, ICU survivors may suffer from both physical and psychological sequelae. To improve the aftercare of these patients, the present study aimed to assess the use of mental healthcare and associated factors following prolonged ICU stay. METHODS: N=197 patients with a primary diagnosis of critical illness polyneuropathy/myopathy were enrolled within 4 weeks (T1) and interviewed three (T2) and six (T3) months following the transfer from acute-care to postacute ICU. Symptoms and a current diagnosis of major depression/post-traumatic stress disorder (PTSD) were assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The potential need for mental healthcare, its current and past use and reasons for non-use were raised. RESULTS: Full syndromal and subsyndromal major depression/PTSD were diagnosed in 8.3%/15.6% at T2, 12.2%/23.5% at T3. About 29% of the patients reported mental healthcare utilisation. Considering somatic complaints, more important was a common reason for the non-use of mental healthcare. Female gender, previous mental healthcare, number of sepsis episodes and pension receipt increased the chance for mental healthcare utilisation, a pre-existing mental disorder decreased it. CONCLUSION: Every fourth patient surviving prolonged ICU treatement makes use of mental healthcare . Particularly male patients with pre-existing mental disorders should be targeted preventively, receiving specific psychoeducation about psychological long-term sequelae and mental healthcare options post-ICU.Trial registration numberDRKS00003386.


Assuntos
Unidades de Terapia Intensiva , Transtornos de Estresse Pós-Traumáticos , Humanos , Masculino , Feminino , Estudos Prospectivos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Ansiedade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Estado Terminal/psicologia , Qualidade de Vida
7.
Personal Ment Health ; 17(1): 55-66, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35905979

RESUMO

There is disagreement among researchers regarding the conceptualization of resilience as a dynamic state or stable trait. Aiming to shed light on the state-versus-trait debate, we explored the stability and construct validity of four of the most frequently utilized state or trait resilience scales in a longitudinal assessment. Additionally, we examined the predictive validity of these scales. Our study was conducted before and during the COVID-19 pandemic, which served as collectively experienced adversity. Correlations among the resilience scales and among resilience scales and Big Five personality traits were strong. All except one scale showed high test-retest correlations. Experience of an additional critical life event during the pandemic led to an increase in resilience. Other than in cross-sectional studies, associations between resilience and psychological distress were weak, because personality and baseline psychological distress were controlled for. Nevertheless, next to personality, resilience explained additional variance in distress change. Our results show relatively high stability of resilience overall. Yet, they also confirm dynamic resilience features, suggesting that resilience change occurs with significant adversity, leading to improved adaptation. To gauge the true association between resilience and mental health, baseline levels of these variables as well as personality traits should be considered.


Assuntos
COVID-19 , Resiliência Psicológica , Humanos , Pandemias , Estudos Transversais , Personalidade
8.
Psychotherapy (Chic) ; 60(1): 130-148, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35049321

RESUMO

The assessment of safety data has become a standard across many clinical interventions. The aim of this systematic review is to investigate the extent to which harm is addressed within psychotherapy study protocols. The review includes study protocols of randomized controlled trials published between 2004 and 2017 investigating the effects of psychotherapy in adult patients with affective disorders, phobia, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and/or personality disorders. We conducted a systematic search in the CENTRAL, Medline, PsycINFO, and Web of Science databases as well as in relevant journals. In total, 115 study protocols were included, examining 168 psychotherapy and 85 control conditions. These protocols differed considerably in the way they conceptualized harm: 77 explicitly addressed harm, 62 considered serious adverse events, and 39 considered adverse events. Although serious adverse events were defined somewhat consistently, adverse events were not. Our results imply that clinical researchers do not apply standardized approaches with regard to harm concepts, assessment, and management. To gather data on frequencies of harmful effects, we argue a higher degree of standardization would be useful. Feasible recommendations are provided based on examples of good practice from the reviewed study protocols. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Psicoterapia , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Ansiedade , Transtornos de Ansiedade/terapia , Transtornos da Personalidade , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Front Psychol ; 14: 1330238, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38268815

RESUMO

Introduction: Documented use and investigation of hypnosis spans centuries and its therapeutic use has received endorsement by multiple medical associations. We conducted a comprehensive overview of meta-analyses examining the efficacy of hypnosis to provide a foundational understanding of hypnosis in evidence-based healthcare, insight into the safety of hypnosis interventions, and identification of gaps in the current research literature. Methods: In our systematic review, meta-analyses of randomized controlled trials on the efficacy of hypnosis in patients with mental or somatic health problems compared to any control condition published after the year 2000 were included. A comprehensive literature search using Medline, Scopus, PsycINFO, The Cochrane Library, HTA Database, Web of Science and a manual search was conducted to identify eligible reviews. Methodological quality of the included meta-analyses was rated using the AMSTAR 2 tool. Effect estimates on various outcomes including at least three comparisons (k ≥ 3) were extracted and transformed into a common effect size metric (Cohen's d). If available, information on the certainty of evidence for these outcomes (GRADE assessment) was obtained. Results: We included 49 meta-analyses with 261 distinct primary studies. Most robust evidence was reported for hypnosis in patients undergoing medical procedures (12 reviews, 79 distinct primary studies) and in patients with pain (4 reviews, 65 primary studies). There was a considerable overlap of the primary studies across the meta-analyses. Only nine meta-analyses were rated to have high methodological quality. Reported effect sizes comparing hypnosis against control conditions ranged from d = -0.04 to d = 2.72. Of the reported effects, 25.4% were medium (d ≥ 0.5), and 28.8% were large (d ≥ 0.8). Discussion: Our findings underline the potential of hypnosis to positively impact various mental and somatic treatment outcomes, with the largest effects found in patients experiencing pain, patients undergoing medical procedures, and in populations of children/adolescents. Future research should focus on the investigation of moderators of efficacy, on comparing hypnosis to established interventions, on the efficacy of hypnosis for children and adolescents, and on identifying patients who do not benefit from hypnosis. Clinical Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023395514, identifier CRD42023395514.

10.
J Clin Epidemiol ; 151: 65-74, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35926822

RESUMO

OBJECTIVES: Intervention integrity is the degree to which the study intervention is delivered as intended. This article presents the RIPI-f checklist (Reporting Integrity of Psychological Interventions delivered face-to-face) and summarizes its development methods. RIPI-f proposes guidance for reporting intervention integrity in evaluative studies of face-to-face psychological interventions. STUDY DESIGN AND SETTING: We followed established procedures for developing reporting guidelines. We examined 56 documents (reporting guidelines, bias tools, and methodological guidance) for relevant aspects of face-to-face psychological intervention integrity. Eighty four items were identified and grouped as per the template for intervention description and replication (TIDieR) domains. Twenty nine experts from psychology and medicine and other scholars rated the relevance of each item in a single-round Delphi survey. A multidisciplinary panel of 11 experts discussed the survey results in three online consensus meetings and drafted the final version of the checklist. RESULTS: We propose RIPI-f, a checklist with 50 items. Our checklist enhances TIDieR with important extensions, such as therapeutic alliance, provider's allegiance, and the adherence of providers and participants. CONCLUSION: RIPI-f can improve the reporting of face-to-face psychological interventions. The tool can help authors, researchers, systematic reviewers, and guideline developers. We suggest using RIPI-f alongside other reporting guidelines.


Assuntos
Lista de Checagem , Intervenção Psicossocial , Humanos , Lista de Checagem/métodos , Projetos de Pesquisa , Pesquisadores , Consenso , Técnica Delphi
11.
Front Psychiatry ; 13: 842410, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935439

RESUMO

Objective: Many women experience traumatic events already prior to or during pregnancy, and delivery of a child may also be perceived as a traumatic event, especially in women with prior post-traumatic stress disorder (PTSD). Birth-related PTSD might be unique in several ways, and it seems important to distinguish between lifetime PTSD and birth-related traumatization in order to examine specific consequences for mother and child. This post-hoc analysis aims to prospectively examine the relation of both, lifetime PTSD (with/without interpersonal trauma) and birth-related traumatization (with/without postpartum depression) with specific maternal and infant outcomes. Methods: In the prospective-longitudinal Maternal in Relation to Infants' Development (MARI) study, N = 306 women were repeatedly assessed across the peripartum period. Maternal lifetime PTSD and birth-related traumatization were assessed with the Composite International Diagnostic Interview for women. Maternal health during the peripartum period (incl. birth experience, breastfeeding, anxiety, and depression) and infant outcomes (e.g., gestational age, birth weight, neuropsychological development, and regulatory disorders) were assessed via standardized diagnostic interviews, questionnaires, medical records, and standardized observations. Results: A history of lifetime PTSD prior to or during pregnancy was reported by 25 women who indicated a less favorable psycho-social situation (lower educational level, less social support, a higher rate of nicotine consumption during pregnancy). Lifetime PTSD was associated with pregnancy-related anxieties, traumatic birth experience, and anxiety and depressive disorders after delivery (and in case of interpersonal trauma additionally associated with infant feeding disorder). Compared to the reference group, women with birth-related traumatization (N = 35) indicated numerous adverse maternal and infant outcomes (e.g., child-related fears, sexual problems, impaired bonding). Birth-related traumatization and postpartum depression was additionally associated with infant feeding and sleeping problems. Conclusion: Findings suggest that both lifetime PTSD and birth-related traumatization are important for maternal and infant health outcomes across the peripartum period. Larger prospective studies are warranted. Implications: Women with lifetime PTSD and/or birth related traumatization should be closely monitored and supported. They may benefit from early targeted interventions to prevent traumatic birth experience, an escalation of psychopathology during the peripartum period, and adverse infant outcomes, which in turn may prevent transgenerational transmission of trauma in the long term.

12.
Psychotherapy (Chic) ; 59(2): 136-139, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35666917

RESUMO

This brief response addresses questions and concerns raised by Moritz and colleagues regarding our Burlingame et al.'s (2020) meta-analysis of group protocols effectiveness with patients diagnosed with schizophrenia (PsycInfo Database Record (c) 2022 APA, all rights reserved).

13.
BMJ Open ; 12(3): e050305, 2022 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-35264337

RESUMO

OBJECTIVES: To investigate the efficacy, safety and applicability of internet-based, therapist-led partner-assisted cognitive-behavioural writing therapy (iCBT) for post-traumatic stress disorder (PTSD) symptoms after intensive care for sepsis in patients and their spouses compared with a waitlist (WL) control group. DESIGN: Randomised-controlled, parallel group, open-label, superiority trial with concealed allocation. SETTING: Internet-based intervention in Germany; location-independent via web-portal. PARTICIPANTS: Patients after intensive care for sepsis and their spouses of whom at least one had a presumptive PTSD diagnosis (PTSD-Checklist (PCL-5)≥33). Initially planned sample size: 98 dyads. INTERVENTIONS: ICBT group: 10 writing assignments over a 5-week period; WL control group: 5-week waiting period. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: pre-post change in PTSD symptom severity (PCL-5). SECONDARY OUTCOMES: remission of PTSD, depression, anxiety and somatisation, relationship satisfaction, health-related quality of life, premature termination of treatment. Outcomes measures were applied pre and post treatment and at 3, 6 and 12 months follow-up. RESULTS: Twenty-five dyads representing 34 participants with a presumptive PTSD diagnosis were randomised and analysed (ITT principle). There was no evidence for a difference in PCL-5 pre-post change for iCBT compared with WL (mean difference -0.96, 95% CI (-5.88 to 3.97), p=0.703). No adverse events were reported. Participants confirmed the applicability of iCBT. CONCLUSIONS: ICBT was applied to reduce PTSD symptoms after intensive care for sepsis, for the first time addressing both patients and their spouses. It was applicable and safe in the given population. There was no evidence for the efficacy of iCBT on PTSD symptom severity. Due to the small sample size our findings remain preliminary but can guide further research, which is needed to determine if modified approaches to post-intensive care PTSD may be more effective. TRIAL REGISTRATION NUMBER: DRKS00010676.


Assuntos
Intervenção Baseada em Internet , Sepse , Transtornos de Estresse Pós-Traumáticos , Cognição , Humanos , Internet , Qualidade de Vida , Sepse/terapia , Cônjuges , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia , Resultado do Tratamento , Redação
14.
Complement Ther Clin Pract ; 47: 101552, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35183038

RESUMO

BACKGROUND AND PURPOSE: Laughter-inducing interventions hold promise as affordable and easy to implement treatments for a range of ailments. The aim of this study was to build on meta-analytic evidence for the efficacy of such interventions in treating somatic or mental health patients. METHODS: Studies eligible for the meta-analysis were identified by a comprehensive literature search in MEDLINE, CENTRAL, Web of Science, and PsycINFO and by a manual search (date of last search 22/06/2021). All randomized controlled trials comparing spontaneous laughter or simulated laughter to treatment as usual, no treatment/waitlist, or attention control groups were included. There were no language or date restrictions. Separate random-effects meta-analyses were conducted for mental health, physiological, and physical health outcomes. Hedges' g is reported as the standardized mean difference estimate. The study was registered on PROSPERO (#CRD42019139299). RESULTS: Forty-five studies comprising 2,547 randomized participants were included. Laughter-inducing interventions showed significant positive effects on mental health (31 studies, 1,543 patients, g = 0.74, 95% CI [0.48; 1.00], I2 = 81%), physiological (14 studies, 761 patients, g = 0.61 [0.20; 1.03], I2 = 86%), and physical health outcomes (21 studies, 1,105 patients, g = 0.59 [0.30; 0.88], I2 = 80%). Only one study reported adverse events, which were mild in nature. CONCLUSION: Laughter-inducing interventions can have beneficial effects on a variety of health-related outcomes including mental health, physical health, and physiological parameters. Future research should focus on examining differential intervention effects and mechanisms of action.


Assuntos
Riso , Saúde Mental , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Int J Behav Med ; 29(5): 531-542, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34705227

RESUMO

BACKGROUND: Autogenic training (AT) is frequently used as therapeutic approach in multimodal pain therapy. The aim of this systematic review and meta-analysis is to investigate the efficacy of AT in individuals suffering from chronic pain in comparison to passive and active control groups. METHODS: A comprehensive literature search in Medline, Web of Science, PsycInfo, and PubPsych and manual searches (last search April 7, 2021) were conducted to locate randomized controlled trials (RCTs). Treatment guidelines and references of relevant articles and previous reviews were checked. ProQuest Dissertations and Theses Full Text database, DART-Europe E-theses Portal, Networked Digital Library of Theses and Dissertations (NDLTD), and the Theses Database of the German National Library were screened to identify any unpublished material. RESULTS: A total of 13 eligible studies (k = 15 comparisons) including 576 participants were identified. Random-effects meta-analyses revealed a significantly positive, moderate effect of AT on the primary outcome pain compared to passive control groups (g = 0.58, 95% CI [0.36; 0.79], k = 9, I2 = 0%). In comparison with other psychological interventions, no difference was found (g = - 0.05, 95% CI [- 0.30; 0.20], k = 6, I2 = 0%). Sensitivity analyses proved the robustness of findings. Overall risk-of-bias judgment was 'some concerns' in the majority of studies. CONCLUSIONS: Beneficial effects of AT on pain reduction were demonstrated, but findings are prone to bias. Furthermore, high methodological quality RCTs are needed to strengthen the promising evidence of AT for individuals with chronic pain.


Assuntos
Treinamento Autógeno , Dor Crônica , Ansiedade , Dor Crônica/terapia , Europa (Continente) , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
J Prev (2022) ; 43(1): 5-23, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34962632

RESUMO

Body ideals conveyed by the media and by body comparisons often result in body dissatisfaction, which can cause risky health behaviours and eating disorders, especially in adolescents. We conducted a meta-analytic review of existing school-based interventions designed to enhance media literacy in order to reduce body dissatisfaction and to promote a positive body image. We included controlled trials examining children and adolescents from grade five to nine (age 10-15 years) after a manual search and a comprehensive literature search using PsycINFO, Medline, Web of Science, and CENTRAL. We computed average weighted effect sizes (Hedges' g) with the help of a random effects model and identified seventeen different programme evaluations with 7392 participants. We found a significantly larger effect on positive body image and media literacy in the intervention compared to control groups. However, heterogeneity was substantial for both outcomes. Results suggest that media literacy interventions have the potential to improve media literacy and reduce body dissatisfaction. Interventions that worked with the principle of induction of cognitive dissonance were the most effective.


Assuntos
Insatisfação Corporal , Transtornos da Alimentação e da Ingestão de Alimentos , Adolescente , Imagem Corporal/psicologia , Criança , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Humanos , Alfabetização , Instituições Acadêmicas
17.
Transl Psychiatry ; 11(1): 443, 2021 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-34455419

RESUMO

Since the Covid-19 outbreak, pandemic-specific stressors have potentiated the-already severe-stress load across the world. However, stress is more than an adverse state, and chronic exposure is causally involved in the development of mental and physical disease. We ask the question whether resilience and the Big Five personality traits predict the biological stress response to the first lockdown in Germany. In a prospective, longitudinal, observational study, N = 80 adult volunteers completed an internet-based survey prior to the first Covid-19-related fatality in Germany (T0), during the first lockdown period (T1), and during the subsequent period of contact restrictions (T2). Hair strands for the assessment of systemic cortisol and cortisone levels were collected at T2. Higher neuroticism predicted higher hair cortisol, cortisone and subjective stress levels. Higher extraversion predicted higher hair cortisone levels. Resilience showed no effects on subjective or physiological stress markers. Our study provides longitudinal evidence that neuroticism and extraversion have predictive utility for the accumulation of biological stress over the course of the pandemic. While in pre-pandemic times individuals high in neuroticism are typically at risk for worse health outcomes, extraverted individuals tend to be protected. We conclude that, in the pandemic context, we cannot simply generalize from pre-pandemic knowledge. Neurotic individuals may currently suffer due to their general emotional lability. Extraverted individuals may primarily be socially stressed. Individualized stress management programs need to be developed, and offered in a lockdown-friendly format, to minimize the stress burden caused by Covid-19 or future pandemics and to protect the most severely affected individuals from the development of stress-associated disease.


Assuntos
COVID-19 , Pandemias , Adulto , Controle de Doenças Transmissíveis , Alemanha/epidemiologia , Humanos , Personalidade , Estudos Prospectivos , SARS-CoV-2 , Estresse Fisiológico
19.
Psychotherapeut (Berl) ; 66(3): 186-194, 2021.
Artigo em Alemão | MEDLINE | ID: mdl-33776213

RESUMO

Based upon the findings related to the impact of the coronavirus disease 2019 (COVID-19) pandemic on human living conditions and psychological health, in the first part of this review the authors discuss the consequences of the pandemic for public health. It is surprising to see that related to public health but also psychological factors and sequelae of the pandemic, a broad knowledge was already available based upon former pandemics and disasters long before the outbreak of COVID-19. This knowledge has been used very sparsely, if at all, for health political decisions. In view of the social significance of the pandemic and its social impact, findings from group psychology and group dynamics seem to be specifically important for a better understanding of behavior within the population as well as the conceptualization of public health interventions. An increase in psychological disorders was described related to the pandemic. For the treatment of these disorders, a range of psychotherapeutic approaches including evidence-based group psychotherapy are available. Whereas the use of telemedical and digital techniques is increasingly more common within individual psychotherapy, many questions are still open related to online group treatment.

20.
Psychotherapeut (Berl) ; 66(3): 175-185, 2021.
Artigo em Alemão | MEDLINE | ID: mdl-33776214

RESUMO

The pandemic triggered by the coronavirus disease 2019 (COVID-19) has, apart from a few positive effects, led to massive and manifold impairments of human living conditions for which this article suggests a taxonomy. According to the severity, these impairments have resulted in a deterioration of the psychological well-being for many people and an increased vulnerability for psychological disorders. This has been confirmed by numerous studies and review articles, which also dealt with the question of factors that positively as well as negatively influencing mental health. This review shows that, e.g. suffering from COVID-19 disease, younger age and female gender as well as a pre-existing psychiatric or somatic disease must be considered as special risk factors. Psychotherapists are confronted with the pandemic in different ways. In view of the societal impact psychotherapists have a special role. In addition, the pandemic raises questions on specific issues and specific groups which must be addressed.

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