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1.
Psychodyn Psychiatry ; 52(3): 370-407, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39254940

RESUMEN

Interpersonal psychotherapy (IPT) is an empirically validated treatment for mood disorders, anxiety disorders, eating disorders, and trauma. IPT is based on the concept of "relational frame"-that an individual's experience of psychological distress impacts those around them, and that their social support network impacts the distressed individual. This concept, along with the specific techniques and tools that flow from it and the theoretical bases of IPT (attachment and interpersonal theory) make IPT unique. In this article we review the theoretical bases of IPT (attachment and communication) and provide a brief history of IPT, as well as the evidence supporting its use for a variety of disorders. We also describe its application to groups, adolescents, and other diverse populations. Future directions for research and treatment development are proposed, particularly research in the area of combining IPT with other psychotherapeutic modalities.


Asunto(s)
Psicoterapia Interpersonal , Humanos , Relaciones Interpersonales , Historia del Siglo XX , Trastornos de Ansiedad/terapia , Apego a Objetos
2.
Medicine (Baltimore) ; 103(36): e39505, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39252333

RESUMEN

BACKGROUND: Fibromyalgia syndrome (FMS) affects 2% to 4% of people, with increasing prevalence in Saudi Arabia reaching 13.4%. FMS can occur in adolescents, known as juvenile-onset fibromyalgia (JFM) with comorbidities including depression, anxiety, and psychological stress. Our patient presented to the child and adolescent psychiatry clinic at King Saud University Hospital Medical City. A year before coming to our clinic, at the age of 15 she was initially diagnosed with JFM followed by a comorbid persistent depressive disorder. METHODS: As a novel treatment method, a combination treatment approach was used, including a pharmacological intervention with Duloxetine, and a non-pharmacological intervention with interpersonal psychotherapy for adolescents. She completed 16 weeks of therapy while monitoring for duloxetine response and side effects. RESULTS: Depressive symptoms were in remission by treatment's end and continued to be in her first month posttreatment follow-up, and the FMS symptoms were also controlled. CONCLUSION: Our present case highlights a combined approach to treat depression and JFM in adolescents as a novel intervention method thus we strongly recommend utilizing it for similar cases.


Asunto(s)
Clorhidrato de Duloxetina , Fibromialgia , Humanos , Femenino , Fibromialgia/terapia , Fibromialgia/complicaciones , Fibromialgia/psicología , Adolescente , Clorhidrato de Duloxetina/uso terapéutico , Psicoterapia Interpersonal/métodos , Antidepresivos/uso terapéutico , Terapia Combinada , Trastorno Depresivo/terapia , Trastorno Depresivo/complicaciones
3.
Am J Psychother ; 77(3): 119-128, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-39104248

RESUMEN

OBJECTIVE: Established trauma-focused cognitive-behavioral therapies for posttraumatic stress disorder (PTSD) have remission rates of approximately 30%-40%. Alternatively, interpersonal psychotherapy (IPT) and psychodynamic psychotherapy (PDT) focus on disrupted attachment, mentalization, and social connection in PTSD and may help some patients. The authors conducted a meta-analysis on these interpersonal and affect-oriented approaches to treating PTSD. METHODS: Building on a prior meta-analysis, the authors searched for randomized controlled trials (RCTs) comparing IPT or PDT with other established PTSD treatments or control conditions for adults diagnosed as having PTSD. Random-effects meta-analyses were conducted to assess outcome effect sizes and dropout rates. RCTs were rated via the Randomized Controlled Trial Psychotherapy Quality Rating Scale. RESULTS: Ten RCTs (eight of IPT) comparing IPT or PDT with control (k=7) or active treatment (k=4) conditions were identified, nine of which were of adequate quality. IPT (k=5) and PDT (k=2), when analyzed together, were superior to control conditions overall (g=-1.14, p=0.011 [as was IPT alone: g=-0.88, p=0.034]) and to waitlist (g=-1.49) and treatment-as-usual (g=-0.70) groups. Effect sizes, however, may have been inflated by outliers or publication bias. IPT (k=3) and PDT (k=1), when analyzed together, were equally efficacious compared with other active PTSD treatments (primarily exposure-based psychotherapies), as was IPT alone, and had lower dropout rates (relative risk=0.63, p=0.049 for IPT and PDT analyzed together; relative risk=0.61, p=0.098 for IPT alone). CONCLUSIONS: Affect-focused therapies hold promise in the treatment of PTSD. IPT has demonstrated efficacy in multiple trials, whereas the evidence base for PDT is sparse.


Asunto(s)
Psicoterapia Interpersonal , Psicoterapia Psicodinámica , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología , Psicoterapia Psicodinámica/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
4.
Implement Sci ; 19(1): 55, 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-39075590

RESUMEN

BACKGROUND: This study is a cost-effectiveness study of two implementation strategies designed to train therapists in college and university counseling centers to deliver interpersonal psychotherapy. Costs of implementing a train-the-trainer (TTT) strategy versus an expert consultation strategy were estimated, and their relative effects upon therapist outcomes were calculated and compared. METHODS: Twenty four counseling centers were recruited across the United States. These centers were randomized to either a TTT (experimental) condition, in which an in-house therapist trained other center therapists, or an expert consultation condition, in which center therapists participated in a workshop and received 12 months of ongoing supervision. The main outcome was therapist fidelity (adherence and competence) to interpersonal psychotherapy, assessed via audio recordings of therapy sessions, and analyzed using linear mixed models. Costs of each condition were quantified using time-driven activity-based costing methods, and involved a costing survey administered to center directors, follow up interviews and validation checks, and comparison of time tracking logs of trainers in the expert condition. Mean costs to produce one therapist were obtained for each condition. The costs to produce equivalent improvements in therapist-level outcomes were then compared between the two conditions. RESULTS: Mean cost incurred by counseling centers to train one therapist using the TTT strategy was $3,407 (median = $3,077); mean cost to produce one trained therapist in the control condition was $2,055 (median = $1,932). Therapists in the TTT condition, on average, demonstrated a 0.043 higher adherence score compared to therapists in the control condition; however, this difference was not statistically significant. For the competence outcome, effect size for therapists in the TTT condition was in the large range (1.16; 95% CI: 0.85-1.46; p < .001), and therapists in this condition, on average, demonstrated a 0.073 higher competence score compared to those in the expert consultation condition (95% CI, 0.008-0.14; p = .03). Counseling centers that used the TTT model incurred $353 less in training costs to produce equivalent improvements in therapist competence. CONCLUSIONS: Despite its higher short run costs, the TTT implementation strategy produces greater increases in therapist competence when compared to expert consultation. Expanding resources to support this platform for service delivery can be an effective way to enhance the mental health care of young people seeking care in college and university counseling centers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02079142.


Asunto(s)
Análisis Costo-Beneficio , Humanos , Estados Unidos , Psicoterapia Interpersonal/métodos , Femenino , Masculino , Servicios de Salud para Estudiantes/economía , Universidades , Consejo/economía , Consejo/métodos , Adulto , Derivación y Consulta/economía , Ciencia de la Implementación
5.
Indian J Public Health ; 68(1): 38-43, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38847631

RESUMEN

BACKGROUND: Depression is a serious illness; approximately 40%-60% of patients develop relapse, and this risk increases up to 90%. Interpersonal psychotherapy (IPT) is an effective method to minimize depressive symptoms and relapse. OBJECTIVES: This randomized control trial study is designed to assess the effectiveness of IPT on depression symptom reduction and relapse prevention. MATERIALS AND METHODS: Three hundred depressed patients from a selected psychiatric hospital in UP, India, were recruited by a simple random sampling technique that randomly allocated 150 participants to the experimental group and 150 to the control group by tossing a coin. Depressive symptoms were assessed using the Hamilton Depression Rating Scale, which has 17 items. On the 2nd day of the trial, the experimental group received IPT. It helped the participants recognize their emotions and urge themselves to express them, both of which had a direct positive impact on their sad mood. The IPT efficacy assessment was done at the end of the 4 weeks of the intervention, and the relapse prevention assessment was undertaken 4 months later. The control group was kept with the actual treatment modalities and psychoeducation sessions, and they were assessed in the same way as the experimental group. RESULTS: Findings illustrated that the reduction of depressive symptoms with (t = 33.61) (P = 0.0000) and relapse prevention with (t = 2.7484) (P = 0.0067) are significant, respectively. Furthermore, symptom reduction and relapse prevention had an association with some demographical data at P < 0.05, 0.001. CONCLUSION: IPT is an effective intervention for reducing depressive symptoms and preventing relapse.


Asunto(s)
Depresión , Psicoterapia Interpersonal , Prevención Secundaria , Humanos , Masculino , Femenino , Adulto , Prevención Secundaria/métodos , India , Depresión/prevención & control , Depresión/terapia , Persona de Mediana Edad , Adulto Joven , Escalas de Valoración Psiquiátrica
6.
J Clin Psychiatry ; 85(2)2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38814110

RESUMEN

Importance: Extensively researched, exposure-focused therapies have dominated the treatment of posttraumatic stress disorder (PTSD). No treatment benefits all patients. Interpersonal psychotherapy (IPT), a nonexposure, affect-focused treatment, has emerged over 2 decades as an alternative evidence-based PTSD intervention.Objective: This narrative review critically assesses IPT outcomes for PTSD. Time limited IPT focuses on affect toleration and the interpersonal consequences of trauma rather than on reconstructing the trauma narrative and exposure to traumatic cues.Evidence Review: The author searched the outcome literature on IPT for adults with syndromal PTSD and drew upon personal involvement in studies since 2001. Subsyndromal PTSD studies and 1 adolescent trial were excluded.Findings: Thirteen published studies of IPT targeted PTSD in individual and group formats for 592 civilians (n = 8, 6 randomized controlled trials [RCTs]) and 187 military veterans (n = 5, 1 RCT). Some trials had methodological limitations. IPT surpassed outcomes of waiting lists and other weak controls and was noninferior to evidence-based PTSD treatments including Prolonged Exposure (n = 2) and sertraline (n = 1). Depression and other outcomes improved. The RCTs demonstrate IPT efficacy for PTSD and allow preliminary exploration of outcome mediators and moderators and differential therapeutics.Conclusion: While the number of studies remains limited, research by multiple investigators in differing populations supports the efficacy of IPT as a non trauma-focused PTSD treatment and justifies its inclusion in PTSD treatment guidelines. More research is necessary to determine how IPT compares to exposure-focused treatments in patient preference, attrition, and response for PTSD comorbid with major depression or due to sexual trauma.


Asunto(s)
Psicoterapia Interpersonal , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/terapia , Adulto
7.
Cuestiones infanc ; 25(1): 1-10, May. 10, 2024.
Artículo en Español | LILACS, UNISALUD, BINACIS | ID: biblio-1562016

RESUMEN

En este trabajo se presentan recortes del caso clínico de una joven de 14 años, en tratamiento durante dos años y medio, encuadrado en el consultorio privado. Se abordan los acontecimientos que generaron quiebres en la continuidad de su historia, y cómo, a través del trabajo con los adultos referentes y con la joven, se habilitaron las posibilidades de un rearmado psíquico que apuntó a la subjetivación de su historia, y a posibilitar las condiciones psíquicas para el ingreso a la adolescencia AU


Cet ouvrage présente des coupures d'un cas clinique d'une jeune fille de 14 ans, en traitement depuis deux ans et demi, cadré dans le cabinet privé. Les événements qui ont généré des ruptures dans la continuité de son histoire sont abordés et comment, à travers le travail avec les références adultes et avec la jeune femme, les possibilités d'un réarmement psychique visant à la subjectivation de son histoire ont été activées et ont permis au conditions psychologiques d'entrée à l'adolescence AU


This work presents clippings of a clinical case of a 14-year-old girl, during twoand a half years of treatment, framed in the private office. The events that generated breaks in the continuity of her story are addressed, and how, through work with the adult references and with the young woman, the possibilities of a psychic rearming that aimed at the subjectivation of her story were enabled, and to enable the psychological conditions for entering adolescence AU


Este trabalho apresenta recortes do caso clínico de uma jovem de 14 anos, durante doisanos e meio de tratamento, enquadrado em consultório particular. São abordados os acontecimentos que geraram rupturas na continuidade de sua história e como, por meio do trabalho com as referências adultas e com a jovem, foram viabilizadas as possibilidades de um rearmamento psíquico que visava à subjetivação de sua história, e possibilitar a condições psicológicas para entrar na adolescencia AU


Asunto(s)
Humanos , Femenino , Adolescente , Identificación Social , Psicoterapia Interpersonal/métodos , Relaciones Profesional-Familia , Estructura Familiar/historia
8.
Cuestiones infanc ; 25(1): 11-16, May. 10, 2024.
Artículo en Español | LILACS, UNISALUD, BINACIS | ID: biblio-1562102

RESUMEN

Este trabajo se apoya en los conceptos contrato narcisista primario y secundario para dar cuenta del proceso de filiación y afiliación de la paciente (caso de Agustina) AU


This work relies on the concepts of primary and secondary Narcissistic Contract to understand the process of affiliation and filiation of the patient (Agustina ́s case) AU


Ce travail s'appuie sur les concepts de contrat narcissique primaire et secondaire pour rendre compte du processus de filiation et du processus d ́adhésiondu patient (cas d ́Agustina) AU


Este trabalho baseia-se nos conceitos de contrato narcísico primário e secundário para dar conta do processo de filiação e afiliaçãodo paciente (caso de Agustina) AU


Asunto(s)
Humanos , Femenino , Adolescente , Familia/psicología , Identificación Psicológica , Psicoterapia Interpersonal/métodos
9.
PLoS One ; 19(5): e0288182, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38743716

RESUMEN

BACKGROUND: There are 10 million admissions to U.S. prisons and jails each year. More than half of those admitted have mental health problems. The goal of this article is to inform: (1) implementation of evidence-based mental health treatments in prisons and jails, an important effort that needs more evidence to guide it; (2) psychotherapy and interpersonal psychotherapy (IPT) training efforts, especially in low-resource settings. METHODS: A randomized hybrid effectiveness-implementation trial of group IPT for major depressive disorder (MDD) in state prisons found that IPT increased rates of MDD remission and lowered posttraumatic stress disorder symptoms relative to prison treatment as usual. The trial used prison counselors, only some of whom had prior psychotherapy training/experience, to deliver IPT. IPT treatment adherence was high (96%), but trial training and supervision were too costly to be scalable outside the trial. The current article reports results from a planned qualitative analysis of 460 structured implementation and supervision documents in that trial to describe training and supervision processes and lessons learned, inform training recommendations, and facilitate future work to optimize training and supervision for under-resourced settings. RESULTS: Themes identified in implementation and supervision process notes reflected: work on psychotherapy basics (reflective listening, focusing on emotions, open-ended questions, specific experiences), IPT case conceptualization (forming a conceptualization, what is and is not therapeutic work, structure and limit setting, structure vs. flexibility), IPT techniques (enhancing social support, role plays, communication analysis), psychotherapy processes (alliance repair, managing group processes), and managing difficult situations (avoidance, specific clients, challenging work settings). Counselors were receptive to feedback; some relied on study supervisors for support in managing stressful prison working conditions. CONCLUSIONS: Findings can be used to make future training and supervision more efficient. Based on our results, we recommend that initial and refresher training focus on IPT case conceptualization, steps for addressing each IPT problem area, and reflective listening. We also recommend supervision through at least counselors' first two rounds of groups. More low-cost, scalable training methods are needed to get mental health treatment to individuals who need it most, who are often served in challenging, low-resource settings such as prisons. This is a mental health access and equity issue. TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov (NCT01685294).


Asunto(s)
Trastorno Depresivo Mayor , Psicoterapia Interpersonal , Prisiones , Humanos , Trastorno Depresivo Mayor/terapia , Masculino , Femenino , Adulto , Psicoterapia/métodos , Prisioneros/psicología , Resultado del Tratamiento
10.
J Consult Clin Psychol ; 92(7): 432-444, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38635190

RESUMEN

OBJECTIVE: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. METHOD: Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive-behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy-Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent-adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. RESULTS: After adjusting for multiple comparisons, rumination (B = -2.02, SE = .61, p = .001, d = .47), hopelessness (B = -2.03, SE = .72, p = .005, d = .41), and conflict with father (B = 1.68, SE = .74, p = .02, d = .32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. CONCLUSIONS: These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Terapia Cognitivo-Conductual , Depresión , Humanos , Femenino , Masculino , Adolescente , Depresión/prevención & control , Depresión/psicología , Terapia Cognitivo-Conductual/métodos , Adaptación Psicológica , Psicoterapia Interpersonal , Apoyo Social , Rumiación Cognitiva , Relaciones Interpersonales , Relaciones Padres-Hijo
11.
Int J Eat Disord ; 57(8): 1691-1706, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38623931

RESUMEN

OBJECTIVE: Individuals with eating disorders (EDs) often do not receive evidence-based care, such as interpersonal psychotherapy (IPT), partly due to lack of accessible training in these treatments. The standard method of training (i.e., in-person workshops) is expensive and time consuming, prompting a need for more scalable training tools. The primary aim of this pilot and open trial was to examine the effects of an IPT online training platform on training outcomes (i.e., IPT fidelity, knowledge, and acceptance) and, secondarily, whether online training was different from in-person training (using a comparative sample from a separate study) in terms of training outcomes and patient symptoms. METHOD: Participants were therapists (N = 60) and student patients (N = 42) at 38 college counseling centers. Therapists completed baseline questionnaires and collected data from a student patient with ED symptoms. Therapists then participated in an IPT online training program and completed post-training assessments. RESULTS: Following online training, acceptance of evidence-based treatments, therapist knowledge of IPT, therapist acceptance of IPT, and treatment fidelity increased; acceptance of online training was high at baseline and remained stable after training. Using the 90% confidence interval on outcome effect sizes, results suggested IPT online training was not different from in-person training on most outcomes. Results are based on 60% of therapists who originally enrolled due to high dropout rate of therapist participants. CONCLUSIONS: Findings from this preliminary pilot study support the use of IPT online training, which could increase access to evidence-based ED treatment and improve patient care. PUBLIC SIGNIFICANCE: Lack of accessible therapist training has contributed to many therapists not delivering, and therefore many patients not receiving, evidence-based treatment. This study evaluated a highly disseminable online training and compared outcomes to traditional in-person training and found that training and patient outcomes were not different. Online training has the potential to enhance access to evidence-base care, which could in turn optimize patient outcomes.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Psicoterapia Interpersonal , Humanos , Proyectos Piloto , Femenino , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Adulto , Masculino , Adulto Joven , Internet , Encuestas y Cuestionarios , Psicoterapia/educación , Psicoterapia/métodos
12.
Psychol Med ; 54(9): 2122-2132, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38445382

RESUMEN

BACKGROUND: Although both pharmacotherapy and psychological treatments are considered to be efficacious in the treatment of major depressive disorder (MDD), one third of patients do not respond to treatment and many experience residual symptoms post-treatment. In this double-blind placebo-controlled randomized control trial (RCT), we assessed whether intranasal oxytocin (OT) augments the therapeutic efficacy of psychotherapy for MDD and improves the therapeutic alliance. METHODS: Twenty-three volunteers (12 female) with MDD underwent 16 sessions of interpersonal therapy. Prior to each session, volunteers self-administered 24 International Units of intranasal OT (n = 12; Syntocinon) or placebo (n = 11). Depressive symptoms were assessed with the Inventory of Depressive Symptomatology at pre- and post-treatment, and at a six month follow-up. RESULTS: Multilevel modeling found a significant effect of OT on the negative slope of depressive symptoms over time (p < 0.05), with medium-large effect sizes at post-treatment (Cohen's d = 0.75) and follow-up (Cohen's d = 0.82). Drug intervention also predicted the intercept when examining the weekly ratings of the therapeutic alliance (p < 0.05), such that volunteers receiving OT, relative to placebo, reported improved therapeutic alliance at session 1. The agreement of goals between therapists and participants, a facet of the therapeutic alliance, mediated the relationship between drug intervention and clinical outcome. CONCLUSION: In this pilot study, the administration of intranasal OT, relative to placebo, improved the therapeutic alliance at the beginning of therapy and therapeutic efficacy of psychotherapy in persons with MDD. Future RCTs should attempt to replicate these findings in larger samples with different therapeutic modalities (ClinicalTrials.gov: NCT02405715).


Asunto(s)
Administración Intranasal , Trastorno Depresivo Mayor , Oxitocina , Humanos , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Mayor/tratamiento farmacológico , Femenino , Oxitocina/administración & dosificación , Oxitocina/farmacología , Masculino , Adulto , Proyectos Piloto , Método Doble Ciego , Persona de Mediana Edad , Terapia Combinada , Resultado del Tratamiento , Psicoterapia/métodos , Adulto Joven , Psicoterapia Interpersonal/métodos , Evaluación de Resultado en la Atención de Salud
13.
J Clin Psychol ; 80(7): 1568-1581, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38509753

RESUMEN

Persons with dependent personality disorder (DPD) have difficulties describing their inner world, and in realizing their negative ideas about the self, such as being weak, unworthy or powerless are just ideas. As a consequence, they tend to over-rely on others and may lose control over their emotions. Treating these persons can gain benefits from including body-focused techniques as they can promote a) awareness of internal states, b) better emotion regulation, c) the capacity to consider their negative ideas about themselves as not necessarily true, and d) gain power of and agency. We will describe the therapist used body-focused techniques in the context of Metacognitive Interpersonal Therapy when treating Lia, a 40-year-old woman suffering from DPD who also suffered from generalized anxiety disorder and had difficulties in making autonomous choices. She had a romantic relationship with a man she described as distant and judgmental so she felt lonely and not entitled to express her discomfort or capable to break up. The therapist used body-focused techniques, together with behavioural exposure, mindfulness and guided imagery, to let Lia be more aware of her thoughts and feelings, and then to regulate affects and realize she had previously capacities. At therapy termination anxiety diminished and she could break up with the partner and start a new one where she felt free to express herself. We suggest how bodily-focused techniques can be used to enhance therapy effectiveness in DPD.


Asunto(s)
Trastorno de Personalidad Dependiente , Metacognición , Humanos , Femenino , Adulto , Metacognición/fisiología , Trastorno de Personalidad Dependiente/terapia , Trastorno de Personalidad Dependiente/psicología , Psicoterapia Interpersonal/métodos , Relaciones Interpersonales
14.
Trials ; 25(1): 112, 2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38336803

RESUMEN

BACKGROUND: Depression continues to be an ongoing threat to adolescent well-being with Black adolescents being particularly vulnerable to greater burdens of depression as well as lower mental health service utilization. Black adolescents are likely to have untreated depression due to social network influences, varied perceptions of services and providers, or self-stigma associated with experiencing depressive symptoms. Furthermore, if or when treatment is initiated, low engagement and early termination are common. To address this gap, a trial is being conducted to preliminarily test the effectiveness of an engagement intervention targeting Black adolescents with depression in school mental health services in New York City. METHODS: A total of 60 Black middle and high school adolescents displaying depressive symptoms are equally randomized (based on school site) to the treatment arms. Both trial arms deliver Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), a time-limited, evidence-based treatment for depression. Additionally, one arm pairs IPT-A with a brief, multi-level engagement intervention, the Making Connections Intervention (MCI), involving adolescents, caregivers, and clinicians. Outcomes of interest are group differences in depression and suicide ideation, adolescent and caregiver engagement, and mental health service use. DISCUSSION: This trial will serve as an efficacy assessment of the MCI among a sample of Black adolescent students with depressive symptoms. Clinical and implementation results will be used to inform future research to further test the MCI intervention in a larger sample. TRIAL REGISTRATION: Registered by ClinicalTrials.gov on May 3, 2019, identifier: NCT03940508.


Asunto(s)
Psicoterapia Interpersonal , Servicios de Salud Mental , Servicios de Salud Mental Escolar , Humanos , Adolescente , Depresión/diagnóstico , Depresión/prevención & control , Prevención del Suicidio , Ensayos Clínicos Controlados Aleatorios como Asunto
15.
Am J Psychother ; 77(1): 7-14, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38196343

RESUMEN

OBJECTIVE: Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may be important for IPT but has received little attention in weight-related interventions. This study evaluated associations of adolescent-reported therapeutic alliance during IPT with weight- and eating-related outcomes. METHODS: Secondary analyses of a randomized controlled trial were conducted to compare group IPT to health education (HE) for preventing excess weight gain among 113 girls (ages 12-17) with body mass index (BMI) at the 75th to 97th percentile and LOC eating. BMI and LOC eating were measured at baseline, 12 weeks (postintervention), and 1 year. Multilevel modeling was used to test associations between change in therapeutic alliance (from session 1 to session 12) and changes in weight- and eating-related outcomes (from postintervention to 1 year). Analyses were controlled for therapeutic alliance after session 1 and for baseline and postintervention outcome values; group assignment (IPT vs. HE) was a moderator. RESULTS: Increases in emotional bond were associated with decreased weight and with greater decreases in number of LOC eating episodes at 1 year in the IPT group (p<0.05) and with weight gain in the HE group (p<0.05). Greater task collaboration was related to greater weight gain at 1-year follow-up, regardless of group assignment (p<0.05). CONCLUSIONS: The association of therapeutic alliance during IPT with weight and LOC eating outcomes among adolescent girls merits further investigation.


Asunto(s)
Psicoterapia Interpersonal , Alianza Terapéutica , Adolescente , Femenino , Humanos , Índice de Masa Corporal , Psicoterapia , Aumento de Peso , Niño , Ensayos Clínicos Controlados Aleatorios como Asunto
16.
Psychol Med ; 54(3): 517-526, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37665012

RESUMEN

BACKGROUND: Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run. AIMS: Compare the effects of twice weekly v. weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment. METHODS: Using a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II and the Longitudinal Interval Follow-up Evaluation. Intention-to-treat analyses were conducted. RESULTS: Compared with patients who received once weekly sessions, patients who received twice weekly sessions showed a significant decrease in depressive symptoms up through month 9, but this effect was no longer apparent at month 24. Patients who received CBT showed a significantly larger decrease in depressive symptoms up to month 24 compared to patients who received IPT, but the between-group effect size at month 24 was small. No differential effects between session frequencies or treatment modalities were found in response or relapse rates. CONCLUSIONS: Although a higher session frequency leads to better outcomes in the acute phase of treatment, the difference in depression severity dissipated over time and there was no significant difference in relapse.


Asunto(s)
Terapia Cognitivo-Conductual , Trastorno Depresivo Mayor , Psicoterapia Interpersonal , Adulto , Humanos , Psicoterapia , Depresión/terapia , Trastorno Depresivo Mayor/terapia , Recurrencia , Resultado del Tratamiento
17.
J Psychiatr Res ; 168: 157-164, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37913742

RESUMEN

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).


Asunto(s)
Trastorno de Personalidad Limítrofe , Psicoterapia Interpersonal , Psicoterapia de Grupo , Humanos , Trastorno de Personalidad Limítrofe/psicología , Calidad de Vida/psicología , Resultado del Tratamiento , Australia , Psicoterapia
18.
J Consult Clin Psychol ; 91(12): 683-693, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38032620

RESUMEN

OBJECTIVE: Test whether a group-delivered dissonance-based transdiagnostic eating disorder treatment, Body Project Treatment (BPT), produces greater reductions in eating disorder symptoms and higher abstinence from eating disorder behaviors and remittance from eating disorder diagnoses than group-delivered transdiagnostic interpersonal psychotherapy (IPT). METHOD: Women with a range of eating disorders (N = 73) were randomized to 8-week group-implemented BPT or IPT and completed surveys and masked diagnostic interviews at pretest, posttest, and 6-month follow-up. RESULTS: Participants randomized to BPT versus IPT showed significantly greater reductions in eating disorder symptoms (d = -.75), pursuit of the thin ideal (d = -.87), anxiety symptoms (d = -.76), and social impairment (d = -.59) through 6-month follow-up. By end of treatment, participants randomized to the BPT versus IPT did not significantly differ on abstinence from binge eating and purging (49% vs. 40%, respectively) or remittance from eating disorder diagnoses (54% vs. 40%, respectively). Participants randomized to BPT versus IPT did not differ significantly in average session attendance (5.8 vs. 6.9, respectively) or average homework assignments completed (4.6 vs. 5.6, respectively). The within-condition reductions in eating disorder symptoms for BPT did not significantly differ when implemented in person versus via synchronous video telepsychiatry (d = -1.39 vs. -1.09, respectively), though these effects should be considered preliminary because of the small cell sizes. CONCLUSIONS: The evidence that BPT produces greater reductions in eating disorder symptoms, pursuit of the thin ideal, anxiety symptoms, and social impairment than IPT is encouraging because it provides some assurance that the effects are present equating for the effects of expectancies, demand characteristics, and nonspecific factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Trastorno por Atracón , Trastornos de Alimentación y de la Ingestión de Alimentos , Psicoterapia Interpersonal , Psiquiatría , Telemedicina , Humanos , Femenino , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Trastorno por Atracón/terapia
19.
J Affect Disord ; 339: 823-831, 2023 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-37459968

RESUMEN

BACKGROUND: The current study endeavored to systematically integrate and quantitatively evaluate the effectiveness of interpersonal psychological interventions for postpartum depression patients. METHODS: Four electronic databases Pubmed, Embase, Cochrane and Web of Science were employed for literature retrieval, and the search time was from the inception of the database to May 30, 2022. Literature screening and data extraction were performed independently by two researchers. RESULTS: A total of 528 studies were screened, and 9 of them were finally included. There were 1012 subjects, 518 of them were assigned in experimental group and 494 in control. Evidence from interpersonal psychological interventions indicated that the data on postpartum depression, satisfaction with family, and social support in both groups after intervention included: depression score [MD = -2.80, 95%CI (-3.86 to -1.74), P < 0.05], satisfaction score [MD = 8.41, 95%CI (1.49 to -15.33), P < 0.05], and social support score [MD = 1.83, 95%CI (-2.10 to -5.76)] of postpartum depression patients. P values < 0.05 indicated substantial improvement as compared to control. LIMITATIONS: During the research process, it is impossible for the experimental group and the researchers to use double-blind trials simultaneously, which may present a Hawthorne effect, but this can be avoided by general psychological intervention for the control. CONCLUSIONS: Interpersonal psychotherapy could improve depression in patients with postpartum depression, but the appropriate intervention time was between 4 and 8 weeks, and it also improved satisfaction with family of patients, and the longer the intervention, the higher the satisfaction with the family.


Asunto(s)
Depresión Posparto , Psicoterapia Interpersonal , Femenino , Humanos , Depresión Posparto/prevención & control , Psicoterapia , Depresión/psicología , Apoyo Social , Ensayos Clínicos Controlados Aleatorios como Asunto
20.
J Pediatr Nurs ; 72: e193-e200, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37385939

RESUMEN

PURPOSE: First-time parents have an increased risk of depression during the transition to parenthood, which has long-term adverse effect on the infant development. Interpersonal psychotherapy (IPT) has been shown to effectively reduce postnatal depression. The objectives of this study were to explore first-time parents' perceptions of a couple-based IPT program and to identify positive and negative influences on the effectiveness of the intervention through a process evaluation. DESIGN AND METHODS: A process evaluation was conducted as part of a randomized controlled trial of a couple-based IPT program. A program satisfaction questionnaire was used to assess the participants' satisfaction with the structure, process and outcome of the program. Semi-structured telephone interviews were conducted with a purposive sample of 44 first-time parents who had received the couple-based IPT. The interview data were analyzed by thematic analysis. RESULTS: The qualitative findings showed that the parents perceived couple-based IPT as useful for enhancing their interpersonal relationship, emotional control and competence in child care. The successful implementation of the couple-based IPT program was influenced by its delivery by midwives, the interactive lessons used to engage the participants, the close fit of the teaching contents to the needs of first-time parents and the flexible program schedule and delivery mode. CONCLUSIONS: The process evaluation indicates that couple-based IPT is an acceptable and feasible intervention for first-time parents to facilitate a healthy transition to parenthood. PRACTICE IMPLICATIONS: The couple-based IPT can be used as an adjunct to standard care to promote perinatal health.


Asunto(s)
Psicoterapia Interpersonal , Padres , Femenino , Humanos , Depresión Posparto , Relaciones Interpersonales , Psicoterapia , Masculino
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