ABSTRACT
BACKGROUND: Suicide is a serious public health concern. Depression is the main gateway to suicidal behavior. The already established relationship between depression and suicidal risk should now focus on the investigation of more specific factors: recent studies have suggested an association between vulnerability to suicidal behavior and neurocognitive alterations, a nuclear symptom of depression. This project aims to identify alterations in the Executive Functions (EF) of patients suffering a first depressive episode that might constitute a risk factor for suicidal ideation, suicidal attempts and suicide, to allow for more adequate suicide prevention. METHODS: Prospective longitudinal design involving two groups (first depressive episodes with and without alterations in their EF) and four repeated measures (0, 6, 12 and 24 months). The estimated minimum sample size is 216 subjects. The variables and measurement instruments will include socio-demographic variables, clinical variables (age of illness onset, family and personal antecedents, psychopathological and medical comorbidity, suicidal ideation, suicide attempts and completed suicides, severity of depression, including melancholic or atypical, remission of the depressive episode), and neuropsychological variables (EF and decision-making processes evaluated through the Cambridge Neuropsychological Test Automated Battery (CANTAB)). DISCUSSION: First and foremost, the identification of clinical and neuropsychological risk factors associated with suicidal behavior will open the possibility to prevent such behavior in patients with a first depressive episode in the context of clinical practice. Secondly, interventions aimed at cognitive impairment (in particular: EF) derived from the study may be incorporated into strategies for the prevention of suicidal behavior. Finally, impaired neurocognitive function (even in early stages) could become an identifiable endophenotype or "marker" in clinical and neurobiological studies about suicidal behavior in depressive patients.
Subject(s)
Depressive Disorder, Major/psychology , Executive Function/physiology , Suicidal Ideation , Suicide, Attempted/psychology , Adolescent , Adult , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/therapy , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Neuropsychological Tests , Prospective Studies , Risk Factors , Suicide, Attempted/prevention & controlABSTRACT
BACKGROUND: New technologies have slowly become a part of psychologists' therapeutic office. However, many therapists still have doubts about the possibility of creating a good therapeutic relationship with patients in the presence of technology. AIMS: This study evaluates the development of the therapeutic alliance in individuals with small animal phobia disorder who were treated with Augmented Reality Exposure Therapy or In Vivo Exposure Therapy. METHOD: Twenty-two participants received an intensive session of cognitive behavioural therapy in either a technology-mediated therapeutic context or in a traditional therapeutic context. RESULTS: The results show no significant difference for the therapeutic alliance between two conditions. CONCLUSIONS: The results seem to show that technologies such as Augmented Reality do not represent a danger to negatively influence the therapeutic alliance.
Subject(s)
Cognitive Behavioral Therapy/methods , Implosive Therapy/methods , Phobic Disorders/therapy , Professional-Patient Relations , Reality Testing , User-Computer Interface , Adult , Female , Humans , Male , Phobic Disorders/diagnosis , Phobic Disorders/psychology , Young AdultABSTRACT
Evidence is growing that two modalities of computer-based exposure therapies--virtual reality and computer-aided psychotherapy--are effective in treating anxiety disorders, including fear of flying. However, they have not yet been directly compared. The aim of this study was to analyze the efficacy of three computer-based exposure treatments for fear of flying: virtual reality exposure therapy (VRET), computer-aided exposure with a therapist's (CAE-T) assistance throughout exposure sessions, and self-administered computer-aided exposure (CAE-SA). A total of 60 participants with flying phobia were randomly assigned to VRET, CAE-T, or CAE-SA. Results indicate that the three interventions were effective in reducing fear of flying at posttreatment and at 1-year follow-up; furthermore, there were no significant differences between them in any of the outcome measure. Large within-group effect sizes were found for all three treatment conditions at both posttreatment and at follow-up. The results suggest that therapist involvement might be minimized during computer-based treatments and that CAE can be as effective as VRET in reducing fear of flying.
