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1.
PLoS One ; 19(7): e0306324, 2024.
Article de Anglais | MEDLINE | ID: mdl-38959279

RÉSUMÉ

BACKGROUND: In recent years, a growing body of evidence has demonstrated the efficacy of non-pharmacological interventions for schizophrenia spectrum disorders (SSD) including positive symptoms such as auditory hallucinations (AH). However, clinical trials predominantly examine general treatment effects for positive symptoms. Therefore, previous research is lacking in comprehensive and clear evidence about psychological and psychosocial approaches that are primarily tailored to treat AH. To overcome this knowledge gap in the current literature, we will conduct a systematic review and meta-analysis to assess the efficacy of clearly targeted psychological and psychosocial interventions for AH in persons with SSD. METHODS AND ANALYSIS: This study protocol has been developed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will include all randomized controlled trials analyzing the efficacy of targeted psychological and psychosocial interventions especially aimed at treating AH in SSD. We will include studies on adult patients with SSD experiencing AH. The primary outcome will be the change on a published rating scale measuring AH. Secondary outcomes will be delusions, overall symptoms, negative symptoms, depression, social functioning, quality of life, and acceptability (drop-out). We will search relevant databases and the reference lists of included literature. The study selection process will be conducted by two independent reviewers. We will conduct a random-effect meta-analysis to consider heterogeneity across studies. Analyses will be carried out by software packages in R. The risk of bias in each study will be evaluated using the Cochrane Risk of Bias tool. Assessment of heterogeneity and sensitivity analysis will be conducted. DISCUSSION: The proposed study will augment the existing evidence by providing an overview of effective treatment approaches and their overall efficacy at treating AH in SSD. These findings will complement existing evidence that may impact future treatment implementations in clinical practice by addressing effective strategies to treat AH and therefore improve outcomes for the addressed population. ETHICS AND DISSEMINATION: No ethical issues are foreseen. We will publish the results from this study in peer-reviewed journals and at relevant scientific conferences. TRIAL REGISTRATION: PROSPERO registration number: CRD42023475704.


Sujet(s)
Hallucinations , Intervention psychosociale , Troubles psychotiques , Revues systématiques comme sujet , Humains , Hallucinations/thérapie , Hallucinations/psychologie , Troubles psychotiques/thérapie , Troubles psychotiques/psychologie , Intervention psychosociale/méthodes , Méta-analyse comme sujet , Qualité de vie , Schizophrénie/thérapie , Essais contrôlés randomisés comme sujet , Psychothérapie/méthodes , Plan de recherche
2.
Ther Umsch ; 81(3): 95-98, 2024 Jun.
Article de Allemand | MEDLINE | ID: mdl-38984932

RÉSUMÉ

INTRODUCTION: This contribution highlights novel developments and innovations in psychological psychotherapy for patients with obesity. It underscores the importance of an interdisciplinary approach to treatment, which incorporates not only traditional methods but also contemporary psychotherapeutic modalities such as Acceptance and Commitment Therapy (ACT). Current research suggests that assessing the effectiveness of psychotherapy should not solely rely on changes in weight, but should also consider other outcomes such as subjective quality of life and mental health. Furthermore, the role of telemedicine and blended psychotherapy is emphasized as promising approaches to enhance accessibility and effectiveness of treatment. Through a case study of a 55-year-old woman with obesity and psychiatric comorbidities, the effectiveness of a multimodal psychotherapeutic approach is demonstrated.


Sujet(s)
Obésité , Psychothérapie , Télémédecine , Humains , Obésité/thérapie , Obésité/psychologie , Femelle , Psychothérapie/méthodes , Psychothérapie/tendances , Adulte d'âge moyen , Télémédecine/tendances , Association thérapeutique , Collaboration intersectorielle , Communication interdisciplinaire , Thérapie d'acceptation et d'engagement/méthodes , Comorbidité , Résultat thérapeutique
3.
Annu Rev Clin Psychol ; 20(1): 201-228, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38996078

RÉSUMÉ

Depression is an eminently treatable disorder that responds to psychotherapy or medications; the efficacy of each has been established in hundreds of controlled trials. Nonetheless, the prevalence of depression has increased in recent years despite the existence of efficacious treatments-a phenomenon known as the treatment-prevalence paradox. We consider several possible explanations for this paradox, which range from a misunderstanding of the very nature of depression, inflated efficacy of the established treatments, and a lack of access to efficacious delivery of treatments. We find support for each of these possible explanations but especially the notion that large segments of the population lack access to efficacious treatments that are implemented as intended. We conclude by describing the potential of using lay therapists and digital technologies to overcome this lack of access and to reach historically underserved populations and simultaneously guarantee the quality of the interventions delivered.


Sujet(s)
Psychothérapie , Humains , Prévalence , Psychothérapie/méthodes , Trouble dépressif/thérapie , Trouble dépressif/épidémiologie , Accessibilité des services de santé/statistiques et données numériques
4.
J Nerv Ment Dis ; 212(7): 392-397, 2024 Jul 01.
Article de Anglais | MEDLINE | ID: mdl-38949659

RÉSUMÉ

ABSTRACT: The study was set out to establish the potential for psychotherapy to effect improvements in patients with narcissistic personality disorder (NPD). Eight patients with NPD who improved in treatment were identified. Consensus clinician/investigator diagnostic scores from before and after the psychotherapies were retroactively established on the Diagnostic Interview for Narcissism (DIN) and the Diagnostic Statistic Manual for Psychiatric Disorders, 5th Edition (DSM-5) Personality Disorder Section II criteria. Psychosocial functioning (work or school, romantic relationships) before and after the psychotherapies was retroactively evaluated as well. At the completion of the therapies after 2.5 to 5 years, all patients had improved, no longer met DIN or DSM-5 criteria for NPD, and showed better psychosocial functioning. Symptomatic improvements were associated with large effect sizes. In conclusion, changes in NPD can occur in treatment after 2.5 to 5 years. Future research should identify patient characteristics, interventions, and common processes in such improved cases that could help with development of treatments.


Sujet(s)
Troubles de la personnalité , Humains , Troubles de la personnalité/thérapie , Troubles de la personnalité/diagnostic , Adulte , Femelle , Mâle , Adulte d'âge moyen , Psychothérapie/méthodes , Résultat thérapeutique , Narcissisme , Jeune adulte , Diagnostic and stastistical manual of mental disorders (USA) , Fonctionnement psychosocial , Trouble de la personnalité narcissique
5.
J Couns Psychol ; 71(4): 203-214, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38949778

RÉSUMÉ

Mental health researchers have focused on promoting culturally sensitive clinical care (Herman et al., 2007; Whaley & Davis, 2007), emphasizing the need to understand how biases may impact client well-being. Clients report that their therapists commit racial microaggressions-subtle, sometimes unintentional, racial slights-during treatment (Owen et al., 2014). Yet, existing studies often rely on retrospective evaluations of clients and cannot establish the causal impact of varying ambiguity of microaggressions on clients. This study uses an experimental analogue design to examine offensiveness, emotional reactions, and evaluations of the interaction across three distinct levels of microaggression statements: subtle, moderate, and overt. We recruited 158 adult African American participants and randomly assigned them to watch a brief counseling vignette. We found significant differences between the control and three microaggression statements on all outcome variables. We did not find significant differences between the microaggression conditions. This study, in conjunction with previous correlational research, highlights the detrimental impact of microaggressions within psychotherapy, regardless of racially explicit content. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Sujet(s)
Agressivité , , Relations entre professionnels de santé et patients , Psychothérapie , Humains , Adulte , Mâle , /psychologie , Femelle , Agressivité/psychologie , Psychothérapie/méthodes , Racisme/psychologie , Adulte d'âge moyen , Jeune adulte
7.
Harv Rev Psychiatry ; 32(4): 160-163, 2024 Jul 01.
Article de Anglais | MEDLINE | ID: mdl-38990904

RÉSUMÉ

ABSTRACT: This column first reviews evidence that veterans have poorer response to trauma-focused therapies for PTSD compared to civilians. We then consider several explanations for this trend, starting with gender as a possible confounding variable. We also examine other hypotheses, including the effects of the military acculturation process, the unique influences of military traumas, such as combat and military sexual traumas, and the roles of traumatic brain injuries (TBIs) and moral injury. Future research, we conclude, must determine whether gender explains the differences in trauma-focused therapy response. If so, then the underlying reasons must be further explored. If not, then we must determine the unique characteristics of the veteran population that make it more resistant to treatment. Mining these elements will help us adapt our trauma-focused therapies to better help this population and close the response-rate gap.


Sujet(s)
Troubles de stress post-traumatique , Anciens combattants , Humains , Anciens combattants/psychologie , Troubles de stress post-traumatique/thérapie , Psychothérapie/méthodes , Mâle , Facteurs sexuels , Femelle
8.
BMC Psychiatry ; 24(1): 499, 2024 Jul 10.
Article de Anglais | MEDLINE | ID: mdl-38987737

RÉSUMÉ

BACKGROUND: For people with autism spectrum disorder (ASD), daily life can be highly stressful with many unpredictable events that can evoke emotion dysregulation (ED): a strong difficulty with appropriately negative affect regulation. For some of the patients with ASD, treatment as usual does not prove to be effective for ED. They may be at risk of life-long impairment, development of other disorders and loss of motivation for most regular forms of therapy. A highly promising method that may prove effective for therapy-resistant individuals with ASD is Psychotherapy incorporating horses (PIH). PIH uses the interactions of the horse and the patients on the ground and does not include horseriding. While often met with prejudgment and scepticism, reports from parents and therapists as well as a recent systematic review suggest that PIH may have beneficial effects on youths with ASD. Therefore, we examine clinical outcomes both in the short and in the long terms of PIH offered to adolescents with ASD and severe ED despite regular therapy. METHODS: A total of 35 adolescents aged 11-18 years with ASD will receive PIH during 15 sessions once a week with randomization to five different groups differentiating in baseline phase from 2 to 6 weeks. PIH uses horses to promote social awareness and self-awareness as well as relationship management and self-management. The primary outcome is the response to treatment on the Emotion Dysregulation Index (EDI). The secondary outcome measures include ASD symptom severity, quality of life, self-esteem, global and family functioning, and goal attainment. Assessments take place at the baseline (T0), at the end of baseline phase A (T1), after completion of intervention phase B (T2), after the end of post-measurement phase C (T3) and after one year (T4). Qualitative interviews of participants, parents and therapists will be held to reveal facilitators and barriers of PIH and a cost-effectiveness study will be performed. DISCUSSION: This study aims at contributing to clinical practice for adolescents with ASD and persistent emotion regulation problems despite 1.5 year of treatment by offering Psychotherapy incorporating horses in a study with series of randomised, baseline controlled n-of-1 trials. TRIAL REGISTRATION: www. CLINICALTRIALS: gov NCT05200351, December 10th 2021.


Sujet(s)
Trouble du spectre autistique , Équithérapie , Trouble du spectre autistique/thérapie , Trouble du spectre autistique/psychologie , Adolescent , Humains , Enfant , Animaux , Équithérapie/méthodes , Equus caballus , Mâle , Femelle , Essais contrôlés randomisés comme sujet , Régulation émotionnelle , Psychothérapie/méthodes
9.
Sci Rep ; 14(1): 16466, 2024 Jul 16.
Article de Anglais | MEDLINE | ID: mdl-39014099

RÉSUMÉ

Despite a significant accumulation of research, there has been little systemic implementation of evidence-based practices (EBP) in youth mental health care. The fragmentation of the evidence base complicates implementation efforts. In light of this challenge, we sought to pilot a system that consolidates and coordinates the entire evidence base in a single direct service model (i.e., Managing and Adapting Practice; MAP) in the context of a legal reform of psychotherapy training in Germany. This pilot study aimed to evaluate the feasibility of the implementation of MAP into the curriculum of the reformed German master's program. Eligible participants were students in the master's program at Philipps-University Marburg during the winter-term 2022/2023. Students first learned about MAP through introductions and role plays (seminar 1), followed by actively planning and conducting interventions using MAP resources for patients in a case seminar under supervision (seminar 2). A repeated-measures survey was conducted to investigate students' knowledge gains, perception of MAP and changes in their self-rated confidence to use EBP. Results indicated that students perceive MAP to be manageable to learn. Positive progress was achieved with regard to their knowledge and self-reported confidence to use EBP, although interpretation and generalization of the results are limited by small and homogeneous samples, lack of statistical power and missing comparison groups. The feasibility of the implementation and suitability of measures are discussed. Important implications could be drawn with regard to future investigations.


Sujet(s)
Psychothérapie , Humains , Allemagne , Projets pilotes , Psychothérapie/enseignement et éducation , Psychothérapie/méthodes , Femelle , Mâle , Programme d'études , Pratique factuelle , Adulte , Enquêtes et questionnaires
10.
Clin Psychol Psychother ; 31(3): e3014, 2024.
Article de Anglais | MEDLINE | ID: mdl-38837842

RÉSUMÉ

BACKGROUND: Clients' adverse experiences during psychotherapy are rarely monitored in clinical practice or research trials. One obstacle here is the lack of a measure to gauge both positive and negative experiences during psychotherapy. We developed and evaluated a new instrument for measuring such experiences. METHOD: The Positive and Negative Experiences of Psychotherapy (PNEP) questionnaire was developed based on pilot data, a literature review, and two existing scales for measuring primarily adverse experiences during psychotherapy. Mental healthcare clients (N = 200) anonymously completed and evaluated the PNEP. Subsequently, a sample of professionals (N = 34) who underwent psychotherapy in the context of their training filled in the PNEP twice, with a 2-week interval in between. RESULTS: The positive and negative experiences subscales of the PNEP were found to possess excellent internal consistencies (αs ≥ 0.90). The PNEP test-retest reliability was 0.93 for the positive experiences subscale and 0.78 for the negative experiences subscale. For the positive subscale, four factors were extracted: symptom reduction and positive well-being, high quality of therapy and therapeutic relation, personal growth and acceptance and interpersonal functioning. For the negative subscale, exploratory factor analysis suggested a three-factor solution: escalation of symptoms and emotional distress, low quality of therapy and therapeutic relation and (self-)stigmatization and dependency. Participants related a median of 13 positive and six negative therapy experiences to their most recent treatment. The most frequently endorsed negative experiences were having more negative thoughts and memories, feeling emotionally overwhelmed and an increase in stress due to the therapy. A minority of participants (10.5%) reported no negative treatment experiences. CONCLUSIONS: In the field of psychotherapy, the evaluation of risks and benefits is crucial for assessing safety and effectiveness. The PNEP could be a promising instrument for achieving this objective, although further research is needed to replicate and expand upon the current findings.


Sujet(s)
Psychométrie , Psychothérapie , Humains , Femelle , Mâle , Adulte , Psychothérapie/méthodes , Reproductibilité des résultats , Enquêtes et questionnaires , Adulte d'âge moyen , Troubles mentaux/thérapie , Troubles mentaux/psychologie , Satisfaction des patients/statistiques et données numériques , Jeune adulte
11.
Article de Anglais | MEDLINE | ID: mdl-38929001

RÉSUMÉ

Globally, there are around 1.3 billion cigarette consumers, indicating it to be the second highest risk factor for early death and morbidity. Meanwhile, psychological therapy offers tools based on its different models and techniques, which can contribute to smoking cessation. In this context, this study gathers scientific evidence to identify psychological therapies that can be used to reduce cigarette consumption. A systematic review of controlled clinical studies was conducted, implementing the PRISMA methodology. Search queries were performed with terms extracted from MESH (Medical Subject Headings) and DECS (Descriptors in Health Sciences). Subsequently, the search was queried in the scientific databases of Medline/PubMed, Cochrane, Scopus, Science Direct, ProQuest, and PsycNet, with subsequent verification of methodological quality using the Joanna Briggs Institute checklists. The selected documents revealed that cognitive behavioral therapy prevails due to its use and effectiveness in seven publications (25%). The cognitive approach with mindfulness therapy is found in 4 publications (14%), the transtheoretical model with motivational therapy in 4 publications (14%), brief psychological therapy in 3 publications (10%), and the remaining 10 documents (37%) correspond with others. Intervention studies refer to cognitive behavioral therapy as the most used in reducing cigarette consumption; in terms of the duration of abstinence, scientific evidence shows beneficial effects with short-term reduction.


Sujet(s)
Fumer des cigarettes , Arrêter de fumer , Humains , Arrêter de fumer/psychologie , Arrêter de fumer/méthodes , Fumer des cigarettes/psychologie , Thérapie cognitive , Psychothérapie/méthodes
12.
Behav Ther ; 55(4): 738-750, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38937047

RÉSUMÉ

Past studies repeatedly found that biological explanations of mental disorders cause laypeople and clinicians to doubt the effectiveness of psychotherapy. This could be clinically detrimental, as combined pharmacotherapy and psychotherapy is often optimal. The distrust of psychotherapy is theorized to stem from dualistic reasoning that psychotherapy, perceived as occurring in the mind, does not necessarily affect the brain. The current study aims to mitigate this belief in a randomized controlled trial. Participants (individuals with symptoms of depression (n = 262), the general public (n = 374), and mental health clinicians (n = 607)) rated the efficacy of psychotherapy for a depression case before and after learning that the case was biologically caused. Participants also received either an intervention passage describing how psychotherapy results in brain-level changes, an active control passage emphasizing the effectiveness of psychotherapy without explaining the underlying biological mechanisms, or no intervention. Unlike the active control and no-intervention control conditions, the intervention caused participants to judge psychotherapy as significantly more effective than at baseline even though they learned that depression was biologically caused. An intervention counteracting dualism can mitigate the belief that psychotherapy is less effective for biologically caused depression. Future research should examine the durability of this intervention in clinical settings.


Sujet(s)
Psychothérapie , Humains , Psychothérapie/méthodes , Mâle , Femelle , Adulte , Encéphale , Adulte d'âge moyen , Dépression/thérapie , Dépression/psychologie , Jeune adulte , Résultat thérapeutique
13.
JMIR Ment Health ; 11: e56529, 2024 Jun 11.
Article de Anglais | MEDLINE | ID: mdl-38861302

RÉSUMÉ

Recent breakthroughs in artificial intelligence (AI) language models have elevated the vision of using conversational AI support for mental health, with a growing body of literature indicating varying degrees of efficacy. In this paper, we ask when, in therapy, it will be easier to replace humans and, conversely, in what instances, human connection will still be more valued. We suggest that empathy lies at the heart of the answer to this question. First, we define different aspects of empathy and outline the potential empathic capabilities of humans versus AI. Next, we consider what determines when these aspects are needed most in therapy, both from the perspective of therapeutic methodology and from the perspective of patient objectives. Ultimately, our goal is to prompt further investigation and dialogue, urging both practitioners and scholars engaged in AI-mediated therapy to keep these questions and considerations in mind when investigating AI implementation in mental health.


Sujet(s)
Intelligence artificielle , Empathie , Humains , Psychothérapie/méthodes , Troubles mentaux/thérapie , Troubles mentaux/psychologie
14.
Bull Menninger Clin ; 88(2): 148-170, 2024.
Article de Anglais | MEDLINE | ID: mdl-38836850

RÉSUMÉ

Research specific to obsessive-compulsive disorder (OCD) among individuals of Hispanic and Latin American (H/L) ancestry is limited, as are culturally relevant assessment and treatment recommendations. This article discusses the implications of underrepresentation of H/L populations in OCD research and emphasizes the need to consider issues related to assessment, treatment, and structural barriers that hinder delivery of culturally appropriate first-line psychotherapy. Recommendations for assessment and treatment are provided to aid clinicians in distinguishing culturally normative thoughts and behaviors from OCD, as well as to inform the implementation of psychotherapeutic interventions with cultural humility. This manuscript offers recommendations for future research to tackle health equity concerns with respect to assessment and treatment and structural factors limiting access to culturally appropriate psychotherapy. Wide-scale efforts are needed to comprehensively understand how H/L cultures intersect with various OCD presentations and to further disseminate treatments to populations that have historically lacked access to mental health care.


Sujet(s)
Hispanique ou Latino , Trouble obsessionnel compulsif , Psychothérapie , Humains , Trouble obsessionnel compulsif/thérapie , Trouble obsessionnel compulsif/ethnologie , Amérique latine/ethnologie , Psychothérapie/méthodes , Soins adaptés sur le plan culturel , Compétence culturelle
15.
Psychodyn Psychiatry ; 52(2): 150-172, 2024 Jun.
Article de Anglais | MEDLINE | ID: mdl-38829230

RÉSUMÉ

Patients with primary or co-occurring narcissistic disorders are seen routinely in general psychiatry settings. Contemporary trends in training and practice have impacted psychiatrists' skills and confidence in identifying and treating these disorders, which can range from relatively benign to high-acuity presentations. The goal of this article is to introduce key principles derived from transference-focused psychotherapy (TFP) for use by clinicians in general practice in their work with patients with narcissistic disorders, even when those clinicians do not routinely provide individual psychotherapy. Practical application of TFP principles in work with patients with narcissistic disorders in general psychiatry are proposed, including in diagnostic evaluation, family engagement, prescribing, and safety assessment and risk management calculus. Many psychiatrists whose practices are focused primarily on psychopharmacology, or a "medical model," may not appreciate fully the impact of pathological narcissism in their work. Clinicians who may benefit from familiarity with TFP principles in work with patients with narcissistic disorders include the approximately one-half of U.S. psychiatrists who do not offer psychotherapy in their practice.


Sujet(s)
Psychiatrie , Psychothérapie , , Humains , Psychothérapie/méthodes , Troubles de la personnalité/thérapie , Narcissisme
16.
BMJ Open ; 14(6): e081281, 2024 Jun 04.
Article de Anglais | MEDLINE | ID: mdl-38834328

RÉSUMÉ

INTRODUCTION: Patients with breast cancer often suffer from depressive symptoms throughout various stages of cancer, significantly impacting their quality of life and treatment outcomes. Non-pharmaceutical interventions such as psychotherapy, mind-body therapies and physical exercise have shown effectiveness in addressing cancer-related depression. However, the efficacy and safety of different non-pharmacological interventions remain a topic of debate. Therefore, to provide an objective assessment and comparison of the impact of different non-pharmaceutical interventions on depression, we will conduct a network meta-analysis (NMA) to explore the effects of different non-pharmaceutical interventions on reducing depressive symptoms among patients with breast cancer. METHODS AND ANALYSIS: We will search nine Chinese and English-language databases, from database inception to 31 July 2023, for randomised controlled trials published in Chinese or English. The English-language databases are PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials, and the Chinese databases are CBM, CNKI, VIP and Wanfang. Two independent researchers will perform information extraction from eligible articles. The primary outcome will be the changes in depressive symptoms, while the secondary outcome will include adverse events. STATA V.15.0 will be used to conduct paired meta-analysis and NMA. Grading of Recommendations Assessment, Development and Evaluation will be used to assess the quality of evidence, and the Cochrane tool for assessing the risks of bias in randomised trials V.2 will be used for risk of bias assessment. ETHICS AND DISSEMINATION: The study does not require ethical approval as it will analyse data from existing studies. It is expected that the results of the study will be published in peer-reviewed journals and presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42023450494.


Sujet(s)
Tumeurs du sein , Dépression , Méta-analyse en réseau , Revues systématiques comme sujet , Humains , Tumeurs du sein/complications , Tumeurs du sein/psychologie , Femelle , Dépression/thérapie , Dépression/étiologie , Méta-analyse comme sujet , Qualité de vie , Plan de recherche , Psychothérapie/méthodes , Essais contrôlés randomisés comme sujet
17.
Clin Psychol Psychother ; 31(3): e3015, 2024.
Article de Anglais | MEDLINE | ID: mdl-38850261

RÉSUMÉ

OBJECTIVE: Telepresence may play a fundamental role in establishing authentic interactions and relationships in online psychological interventions and can be measured by the Telepresence in Videoconference Scale (TVS), which was validated only with patients to date. This post hoc study aimed to validate the Italian version of the TVS with mental health professionals. METHOD: The Italian TVS was included in an online survey, whose primary aim was to assess the experiences of Italian psychologists and psychotherapists with online interventions during the first wave of the COVID-19 pandemic and was filled in by 296 participants (83.4% females, mean age = 42 years old). RESULTS: Exploratory factor analysis supported the original factor structure only partially because the scale 'Absorption' (i.e., the feeling of losing track of time), as it was formulated, did not measure telepresence. Correlations were also explored between the TVS scales and some survey items pertaining to intimacy and emotional closeness to patients, comfort and positive as well as negative experiences with online interventions. CONCLUSION: The TVS may be a useful tool to measure physical and social telepresence in online interventions, both in patients and in professionals.


Sujet(s)
COVID-19 , Psychothérapeutes , Communication par vidéoconférence , Humains , COVID-19/psychologie , Femelle , Mâle , Adulte , Italie , Psychothérapeutes/psychologie , Télémédecine , Enquêtes et questionnaires , Adulte d'âge moyen , SARS-CoV-2 , Reproductibilité des résultats , Psychométrie , Pandémies , Psychothérapie/méthodes , Psychologie/méthodes
18.
Dialogues Clin Neurosci ; 26(1): 28-37, 2024.
Article de Anglais | MEDLINE | ID: mdl-38837043

RÉSUMÉ

INTRODUCTION: Treatment of individuals who have committed sexual offences with Testosterone-Lowering Medication (TLM) is a comparatively intrusive kind of intervention, which regularly takes place in coercive contexts. Thus, the question of efficacy, but also the question of who should be treated, when and for how long, are of great importance. METHODS: Recidivism rates of TLM-treated high-risk individuals (+TLM; n = 54) were compared with high-risk individuals treated with psychotherapy only in the same forensic outpatient clinic (-TLM; n = 79). RESULTS: Group differences suggested a higher initial risk of + TLM (e.g. higher ris-assessment, previous convictions). Despite the increased risk, after an average time at risk of six years, +TLM recidivated significantly less often and significantly later than - TLM (27.8% vs. 51.9%). Such an effect was also found for violent (1.9% vs. 15.2%), but not for sexual (5.6% vs. 10.1%) and serious recidivism (5.6% vs. 10.1%), which could be explained partly by the small number of cases. In the course of treatment, TLM proved to be a significant variable for a positive process, whereas a high risk-assessment score indicated a rather negative course. In total, n = 19 individuals had stopped their TLM treatment, of these 31.6% recidivated. CONCLUSION: The results support the efficacy of TLM, particularly in the group of high-risk offenders.


Sujet(s)
Récidivisme , Infractions sexuelles , Testostérone , Humains , Mâle , Récidivisme/statistiques et données numériques , Adulte , Testostérone/usage thérapeutique , Adulte d'âge moyen , Criminels/psychologie , Criminels/statistiques et données numériques , Femelle , Résultat thérapeutique , Psychothérapie/méthodes , Jeune adulte
19.
Math Biosci Eng ; 21(4): 5118-5137, 2024 Mar 04.
Article de Anglais | MEDLINE | ID: mdl-38872529

RÉSUMÉ

Our actions and decisions in everyday life are heavily influenced by social interactions, which are dynamic feedback loops involving actions, reactions, and internal cognitive processes between individual agents. Social interactions induce interpersonal synchrony, which occurs at different biobehavioral levels and comprises behavioral, physiological, and neurological activities. Hyperscanning-a neuroimaging technique that simultaneously measures the activity of multiple brain regions-has provided a powerful second-person neuroscience tool for investigating the phase alignment of neural processes during interactive social behavior. Neural synchronization, revealed by hyperscanning, is a phenomenon called inter-brain synchrony- a process that purportedly facilitates social interactions by prompting appropriate anticipation of and responses to each other's social behaviors during ongoing shared interactions. In this review, I explored the therapeutic dual-brain approach using noninvasive brain stimulation to target inter-brain synchrony based on second-person neuroscience to modulate social interaction. Artificially inducing synchrony between the brains is a potential adjunct technique to physiotherapy, psychotherapy, and pain treatment- which are strongly influenced by the social interaction between the therapist and patient. Dual-brain approaches to personalize stimulation parameters must consider temporal, spatial, and oscillatory factors. Multiple data fusion analysis, the assessment of inter-brain plasticity, a closed-loop system, and a brain-to-brain interface can support personalized stimulation.


Sujet(s)
Encéphale , Neurosciences , Humains , Encéphale/physiologie , Neurosciences/méthodes , Relations interpersonnelles , Interaction sociale , Stimulation magnétique transcrânienne/méthodes , Plasticité neuronale , Psychothérapie/méthodes , Neuroimagerie/méthodes , Comportement social , Interfaces cerveau-ordinateur
20.
Lancet Psychiatry ; 11(7): 545-553, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38879276

RÉSUMÉ

BACKGROUND: Many patients with schizophrenia have symptoms that do not respond to antipsychotics. This condition is called treatment-resistant schizophrenia and has not received specific attention as opposed to general schizophrenia. Psychological and psychosocial interventions as an add-on treatment to pharmacotherapy could be useful, but their role and comparative efficacy to each other and to standard care in this population are not known. We investigated the efficacy, acceptability, and tolerability of psychological and psychosocial interventions for patients with treatment-resistant schizophrenia. METHODS: In this systematic review and network meta-analysis (NMA), we searched for published and unpublished randomised controlled trials (RCTs) through a systematic database search in BIOSIS, CINAHL, Embase, LILACS, MEDLINE, PsychInfo, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform for articles published from inception up to Jan 31, 2020. We also searched the Cochrane Schizophrenia Group registry for studies published from inception up to March 31, 2022, and PubMed and Cochrane CENTRAL for studies published from inception up to July 31, 2023. We included RCTs that included patients with treatment-resistant schizophrenia. The primary outcome was overall symptoms. We did random-effects pairwise meta-analyses and NMAs to calculate standardised mean differences (SMDs) or risk ratios with 95% CIs. No people with lived experience were involved throughout the research process. The study protocol was registered in PROSPERO, CRD42022358696. FINDINGS: We identified 30 326 records, excluding 24 526 by title and abstract screening. 5762 full-text articles were assessed for eligibility, of which 5540 were excluded for not meeting the eligibility criteria, and 222 reports corresponding to 60 studies were included in the qualitative synthesis. Of these, 52 RCTs with 5034 participants (1654 [33·2%] females and 3325 [66·8%] males with sex indicated) comparing 20 psychological and psychosocial interventions provided data for the NMA. Mean age of participants was 38·05 years (range 23·10-48·50). We aimed to collect ethnicity data, but they were scarcely reported. According to the quality of evidence, cognitive behavioural therapy for psychosis (CBTp; SMD -0·22, 95% CI -0·35 to -0·09, 35 trials), virtual reality intervention (SMD -0·41, -0·79 to -0·02, four trials), integrated intervention (SMD -0·70, -1·18 to -0·22, three trials), and music therapy (SMD -1·27, -1·83 to -0·70, one study) were more efficacious than standard care in reducing overall symptoms. No indication of publication bias was identified. INTERPRETATION: We provide robust findings that CBTp can reduce the overall symptoms of patients with treatment-resistant schizophrenia, and therefore clinicians can prioritise this intervention in their clinical practice. Other psychological and psychosocial interventions showed promising results but need further investigation. FUNDING: DAAD-ASFE.


Sujet(s)
Méta-analyse en réseau , Intervention psychosociale , Schizophrénie résistante au traitement , Humains , Intervention psychosociale/méthodes , Schizophrénie résistante au traitement/thérapie , Essais contrôlés randomisés comme sujet , Psychothérapie/méthodes , Neuroleptiques/usage thérapeutique , Résultat thérapeutique , Schizophrénie/thérapie
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