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1.
J Psychiatr Res ; 175: 68-74, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38718441

RESUMO

OBJECTIVE: Numerous psychiatric populations have demonstrated reduced tendency to adopt others' perspectives relative to those without psychiatric illness; yet, the clinical implications of these deficits remain unclear. We examined whether impairments in perspective-taking are prospectively associated with symptom severity and functional outcomes in an acute psychiatric sample. We hypothesized that poorer perspective-taking would prospectively predict more severe depressive symptoms, functional impairment, and relationship problems. METHOD: Participants were 421 adults seeking psychiatric treatment at a partial hospital program. Participants completed the following self-report questionnaires at admission and discharge: Interpersonal Reactivity Index, Patient Health Questionnaire, Work and Social Adjustment Scale, and Behavior and Symptom Identification Scale. We conducted cross-lagged panel models to estimate directional effects. RESULTS: Consistent with hypotheses, more frequent perspective-taking was significantly and prospectively associated with less overall functional impairment (ß = -0.08, p = 0.04) and fewer relationship problems (ß = -0.11, p = 0.02). When modelled together, perspective-taking remained a significant and bidirectional predictor of relationship problems, but not overall functional impairment. Inconsistent with hypotheses, perspective-taking did not prospectively predict depressive symptoms. CONCLUSIONS: Results suggest that perspective-taking deficits are uniquely associated with relationship problems among adults with severe mental illness and highlight a potential target for future intervention.

2.
J Exp Psychol Gen ; 153(6): 1489-1499, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38635167

RESUMO

A common conjecture is that social success relies on "theory of mind"-the everyday skill of imputing mental states to others. We test the hypothesis that individuals with stronger theory of mind skills and motivation garner more positive first impressions because of how they interact with others. Participants included 334 young adults who were paired with a peer for a first-time meeting. Dyads completed a cooperative Lego-building task, which was videotaped and later coded for behavioral manifestations of theory of mind by independent raters. Theory of mind accuracy and motivation were assessed with validated laboratory tasks and a self-report questionnaire, respectively. First impressions were assessed based on partner's ratings of participant likeability, enjoyment of the interaction, and changes in positive affect. Results of actor-partner interdependence mediation models revealed that the associations between theory of mind and first impressions are indirect and mediated through behaviors. Specifically, participants with stronger theory of mind demonstrated greater cognitive sensitivity and pragmatic conversational skills. However, only cognitive sensitivity subsequently predicted more favorable first impressions. This research shows that social-cognitive skills can affect others' social impressions through their behavioral manifestations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Percepção Social , Teoria da Mente , Humanos , Teoria da Mente/fisiologia , Feminino , Masculino , Adulto Jovem , Adulto , Interação Social , Motivação , Adolescente , Relações Interpessoais
3.
N Z Med J ; 137(1593): 14-30, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38603784

RESUMO

AIMS: To examine the impact of intensive management of type 1 diabetes (T1D) from diagnosis on HbA1c 12 months from diagnosis. METHODS: HbA1c measured 12 months after diagnosis for 70 consecutively newly diagnosed children with T1D following implementation of an intensive management protocol was compared with 70 children consecutively diagnosed immediately pre-implementation. Intensive management involved carbohydrate counting and flexible insulin dosing from first meal with subcutaneous insulin, targeted blood glucose levels from 4-8mmol/L irrespective of time of day, avoidance of twice daily insulin regimen and promotion of continuous glucose monitoring (CGM). HbA1c, diabetes technology use and insulin regimen at 12 months post-diagnosis were compared. RESULTS: The post-intensive management implementation cohort had an improved mean HbA1c of 58.2±15.3mmol/mol vs 63.7±10.7mmol/mol at 12 months (p=0.014). The proportion of young people with diabetes meeting a target HbA1c of <53mmol/mol at 12 months improved from 11% to 40% (p=<0.001). There was a reduction of twice daily insulin regimen from 66% to 11% (p=<0.001), and increased CGM use from 57% to 76% (p=0.02). CONCLUSION: Intensive management when implemented with consistent messaging from the multi-disciplinary team resulted in clinic-wide improvements in HbA1c and the proportion meeting HbA1c targets.


Assuntos
Diabetes Mellitus Tipo 1 , Criança , Humanos , Adolescente , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hemoglobinas Glicadas , Glicemia , Automonitorização da Glicemia/métodos , Estudos Prospectivos , Nova Zelândia , Insulina/uso terapêutico , Hipoglicemiantes/uso terapêutico
4.
J Clin Psychol ; 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38579178

RESUMO

BACKGROUND: Despite the pervasiveness of patient-reported emptiness and the high burden it carries, emptiness is poorly understood. In the current study, we used a general inductive approach to examine experiences with emptiness in a diagnostically diverse sample of treatment-seeking patients with severe and acute psychopathology. As a secondary aim, we also examined whether identified themes differed among patients with a primary diagnosis of borderline personality disorder or major depressive disorder. METHOD: Participants (n = 150) ranged from 18 to 69 years old (M = 33.15, SD = 12.41; 79.3% non-Hispanic White; 57.3% females). All patients completed the borderline personality disorder module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Personality Disorders and the Mini International Neuropsychiatric Interview. Interviewers documented patients' responses to follow-up questions. Patients were included in the study if they endorsed chronic feelings of emptiness and elaborations were documented. RESULTS: We identified 10 themes associated with patient-reported emptiness: (1) purposeless, (2) lack of connection, (3) numbness, (4) self-deprecation, (5) lack of identity, (6) lack of motivation, (7) hopelessness, (8) lack of pleasure, (9) physical sensation, and (10) dissociation. Themes were consistent across diagnostic status, with one exception: patients with borderline personality disorder were more likely to report that emptiness was associated with dissociation relative to patients with major depressive disorder. CONCLUSION: Our results suggest that emptiness may reflect a multifaceted and transdiagnostic construct. Identified themes may help to support the assessment of emptiness and can be used to guide individualized treatments.

5.
Suicide Life Threat Behav ; 54(3): 575-583, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38414307

RESUMO

INTRODUCTION: Religion is a salient aspect of patient background in treatment (The psychology of religion and coping: Theory, research, practice; Guilford Press). However, research investigating the role of religion in suicide is lacking and inconsistent (Journal of Religion and Health, 57, 2478-2499). The current study (1) clarifies the association between religious identity and fearlessness about death in a psychiatric sample and (2) tests whether religious identity moderates the association between fearlessness about death and suicidal ideation. METHODS: Participants were 155 patients seeking treatment in a partial hospital program. Religious identity was assessed using the Identities in Treatment Scale (The Behavior Therapist). Fearlessness about death was assessed with two relevant items from the acquired capability with rehearsal for suicide scale (Psychological Assessment, 28, 1452-1464), as in prior studies (Suicide & Le-Threatening Behavior, 50, 1230-1240; Journal of Affective Disorders Reports, 12, 100492). RESULTS: Fearlessness about death interacted with religious identity to predict suicidal ideation, b = 0.47, 95% C.I. [0.02, 0.91], p = 0.042. Conditional effects showed that greater fearlessness about death was associated with greater suicidal ideation among non-religious patients, b = -0.56, 95% C.I. [-0.88, -0.24], p = 0.001, but not in religious patients, b = -0.09, 95% C.I. [-0.41, 0.22], p = 0.559. CONCLUSIONS: Our results suggest that fearlessness about death is a risk factor for suicidal ideation, but only among those who do not identify as religious. Results from this study inform theories of suicide and elucidate the influence of religious identity on links among suicide risk factors and suicide-related outcomes.


Assuntos
Atitude Frente a Morte , Medo , Religião e Psicologia , Ideação Suicida , Humanos , Masculino , Feminino , Adulto , Medo/psicologia , Pessoa de Meia-Idade , Adulto Jovem
6.
Behav Res Ther ; 173: 104476, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38199180

RESUMO

OBJECTIVE: Although impairments in attentional control are pervasive across psychopathology, there is substantial individual differences. In the current study, we examined whether individual differences in self-reported and performance-based measures of attentional control predict changes in depressive symptoms and well-being in a diagnostically diverse sample of patients attending a CBT-based partial hospital program. METHOD: Participants were 89 patients (56.2% men, 75.3% non-Hispanic White). At baseline, patients completed the self-reported Attentional Control Scale and the Rapid Serial Visual Presentation task (RSVP), a behavioral measure of attentional control. Depressive symptoms were assessed daily using the Patient Health Questionnaire and well-being was assessed using the Mental Health Continuum Short Form. RESULTS: On average, greater self-reported attentional control was significantly associated with lower depressive symptoms, ß = -0.49, t(52) = 4.84, p < .001, 95% CIs [-0.69, -0.29], and greater well-being, ß = 0.45, t(53) = 3.90, p < .001, 95% CIs [0.22, 0.67]. More accurate task-based performance was associated with a decline in depressive symptoms over time, ß = -0.02, t(32) = 2.50, p = .02, 95% CIs [-0.04, -0.01]. Neither self-reported nor performance-based measures of attentional control predicted changes in well-being. Finally, exploratory analyses suggest that depressive symptoms also improved over time for individuals who underestimated self-reported attentional control abilities relative to task-based performance, ß = -0.19, t(32) = 2.23, p = .03, 95% CIs [-0.36, -0.02]. CONCLUSIONS: Results suggest that performance-based attentional control may be an important target for assessment and intervention, as well as a potential mechanism underlying risk and recovery.


Assuntos
Psicoterapia Breve , Masculino , Humanos , Feminino , Depressão/psicologia , Atenção , Autorrelato , Individualidade
7.
Appl Neuropsychol Adult ; : 1-8, 2023 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-37255330

RESUMO

Rapid serial visual presentation (RSVP) tasks have been frequently used to assess attentional control in psychiatric samples; however, it is unclear whether RSVP tasks exhibits the psychometric properties necessary to assess these individual differences. In the current study, we examined the reliability and validity of single-target computerized RSVP task outcomes in a sample of 63 participants with moderate to severe psychiatric illness. At the group level, we observed the classical attentional blink phenomenon. At the individual level, conventional indices of attentional blink magnitude exhibited poor internal consistency. We empirically evaluated a novel index for assessing attentional blink magnitude using a single-target RSVP task that involves collapsing across experimental trials in which the attentional blink phenomenon occurs and disregarding performance on control trials, which suffer from ceiling effects. We found that this new index resulted in much improved reliability estimates. Both novel and conventional indices provided evidence of convergent validity. Consequently, this novel index may be worth examining and adopting for researchers interested in assessing individual differences in attentional blink magnitude.

8.
Psychother Res ; 33(2): 235-250, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35748859

RESUMO

OBJECTIVE: Despite a proliferation of virtual partial hospital programs (PHP) during the COVID-19 pandemic, there is a dearth of research on such programs. In the current study, we compared treatment outcomes and patient satisfaction between an in-person and a virtual PHP. Further, we examined patients' qualitative feedback about the virtual PHP. METHOD: Participants included 282 patients attending a virtual PHP during the COVID-19 pandemic and 470 patients attending an in-person PHP one year prior. Patients completed daily measures of symptom severity, and post-treatment measures of patient satisfaction and treatment outcomes. Patients in the virtual PHP provided feedback about virtual care. Quantitative data were analyzed using multilevel modeling, and qualitative data were analyzed using the principles of inductive analysis. RESULTS: Patients experienced a reduction in depression (b = -.28, p < .001) and anxiety symptoms (b = -.25, p < .001) over time and reported high satisfaction in both the in-person and virtual PHPs. There were no significant differences across programs. Virtual PHP patients identified unique advantages and disadvantages of virtual care. CONCLUSION: Our results suggest that virtual PHPs should be explored as an ongoing model of care that may help to systematically reduce barriers to accessing mental health services.


Assuntos
COVID-19 , Satisfação do Paciente , Humanos , Pandemias , Resultado do Tratamento , Hospitais
9.
Assessment ; 29(8): 1901-1916, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-34372690

RESUMO

Intraindividual change over time is commonly used to estimate treatment effectiveness. However, patients may not respond similarly to a scale after treatment, rendering pre-post change an unreliable metric. The current objective was to investigate longitudinal measurement invariance of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 among 4,323 patients completing a partial hospital program. We used confirmatory factor analysis to determine (1) factor structure at pretreatment and posttreatment and (2) longitudinal invariance, accounting for dependent observations, using both classical and approximate measurement invariance approaches. Results indicated a two-factor solution for both scales. Longitudinal invariance was not established for either scale, thus, using raw score differences from the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 for measuring symptom change over time may be problematic. The most longitudinally consistent items captured somatic as opposed to affective/cognitive symptoms. We discuss the potential use of these measures for diagnostic screening and between-group comparisons and suggest alternative ways to monitor client progress over time. Limitations included a majority White sample and uniqueness of a partial hospital setting.


Assuntos
Programas de Rastreamento , Questionário de Saúde do Paciente , Humanos , Análise Fatorial
10.
Clin Psychol Rev ; 90: 102088, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34598054

RESUMO

This paper is the first systematic review of the literature on the relationship between shame and social anxiety (SA). We reviewed a total of 60 peer-reviewed empirical articles that met criteria for inclusion. We begin by summarizing literature investigating the empirical association between shame and SA and review literature on whether this association is impacted by cultural or diagnostic differences. Next, we briefly describe the updated version of Rapee and Heimberg's (1997) cognitive-behavioral model of social anxiety disorder (SAD; Heimberg, Brozovich, & Rapee, 2014) and propose how shame may interact with five processes described therein: environmental experiences, observations/images of the self, perceived negative evaluation by others, post-event cognitive processes, and behavioral manifestations of SA. We review the current literature on shame and SA as it relates to each of these domains. Thereafter, we discuss existing research on the role of shame in the treatment of SAD and the implications of the research discussed in this review. Finally, we conclude with a discussion of some key limitations in the existing literature and areas for future research.


Assuntos
Fobia Social , Transtornos Fóbicos , Ansiedade , Medo , Humanos , Vergonha
11.
J Appl Res Intellect Disabil ; 34(3): 805-817, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33599087

RESUMO

INTRODUCTION: Preliminary evidence suggests dialectical behaviour therapy (DBT) may be beneficial for persons with intellectual disabilities. This pilot randomized controlled trial aimed to determine the feasibility of adapted DBT for adults with intellectual disabilities and co-morbid psychiatric disorders in the community. METHODS: An adapted DBT programme (aDBT-ID) was delivered to adults with mild-to-moderate intellectual disability (n = 20) and their caregivers (n = 20). A single-blind, mixed-methods design was employed with treatment (n = 10) and control (n = 10). In addition to feasibility, pre-post-measures of emotional regulation, anger and mental health were taken from clients and caregivers. RESULTS: Results suggest it was feasible and beneficial to deliver adapted DBT in the community. Qualitative findings found both participants and caregivers were satisfied with the treatment delivery. No differences between conditions were found. CONCLUSION: This pilot study highlights the feasibility of adapted DBT for individuals with intellectual disabilities and the practicalities of delivering community-based inclusive research.


Assuntos
Terapia do Comportamento Dialético , Deficiência Intelectual , Adulto , Criança , Deficiências do Desenvolvimento , Estudos de Viabilidade , Humanos , Deficiência Intelectual/terapia , Projetos Piloto , Método Simples-Cego , Resultado do Tratamento
12.
Res Child Adolesc Psychopathol ; 49(2): 241-253, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33404948

RESUMO

Social Networking Sites (SNS) have close to 3 billion users worldwide. Recently, however, SNS have come under media scrutiny for their potential association with depression. Two previous meta-analyses failed to find evidence for a robust concurrent association between SNS use and depression symptoms. However, these analyses focused primarily on the time spent using SNS. The current meta-analysis is the first to consider the multi-dimensional nature of SNS use, and examines separately the quantitative associations of depression symptoms to SNS use in three types of SNS studies examining three distinct constructs of SNS use: time spent using SNS, intensity of SNS use, and problematic SNS use. Sixty-two studies (N = 451, 229) met inclusion criteria. Depression symptoms were significantly, but weakly, associated with time spent using SNS (r = 0.11) and intensity of SNS use (r = 0.09). However, the association of depression symptoms to problematic SNS use was moderate (r = 0.29), was significantly higher than for time spent using SNS (Qbetween = 35.85, p < 0.001) or intensity of SNS use (Qbetween = 13.95, p < 0.001), and was not significantly moderated by age, gender, year of study publication, or mode of recruitment. These results suggest that future research examining causal models of the relation of SNS use and depression, as well as research on intervention and prevention, should focus in more detail on individuals who are engaging in a pattern of problematic SNS use.


Assuntos
Mídias Sociais , Depressão/epidemiologia , Humanos , Rede Social
13.
Eat Weight Disord ; 26(5): 1691-1695, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32710364

RESUMO

Cases of nontuberculous Mycobacterium (NTM) are on the rise across North America. This is the first clinical description of a 31-year old male patient in North America with Mycobacterium kansasii who met DSM-5 diagnostic criteria for anorexia nervosa (AN) and obsessive compulsive disorder (OCD), and who was engaged in specialized outpatient treatment of an eating disorder. The patient did not disclose at intake assessment that he was experiencing symptoms of a persistent cough, blood in his sputum, or that he was simultaneously being assessed outside of the eating disorders program for NTM until he had a positive smear for Mycobacterium kansasii in March 2017. The patient made progress in treatment in his weight status and some psychological symptoms despite the concurrent NTM symptoms. However, later treatment attendance was negatively impacted by the side effects of his medication regime for NTM and careful follow-up was required to monitor for potential interactions between his treatment for NTM and psychiatric medication. This case report provides an initial window into clinicians' ability to treat a patient with a concurrent eating disorder and an NTM infection and lessons learned in the process. LEVEL OF EVIDENCE: Level V: Opinions of respected authorities, based on descriptive studies, clinical experience, or reports of expert committees.


Assuntos
Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/tratamento farmacológico , Comorbidade , Humanos , Masculino , Micobactérias não Tuberculosas , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/tratamento farmacológico
14.
Psychol Assess ; 32(7): 623-634, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32237882

RESUMO

The Reading the Mind in the Eyes task (RMET; Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001) is commonly used to assess theory of mind abilities in adults. In the task, participants pair one of four mental state descriptors with a picture of the eye region of a face. The items have varying emotional valence, and nearly 100 studies have examined whether performance on this task varies with item valence. However, efforts to address this question have been hampered by cross-study inconsistencies in how item valence is assessed. Thus, the goal of this study was to establish reference ratings for the valence of RMET items. In Study 1, we recorded valence ratings for each RMET item with a large sample of raters (n = 164). We illustrated how valence categories are essentially arbitrary and largely influenced by sample size. In addition, valence ratings were continuously distributed, further questioning the validity of imposing categorical distinctions. In Study 2, we used an archival dataset to demonstrate how the different categorization schemes resulted in conflicting conclusions about the association between item valence and RMET performance. However, when we examined the association between item valence and performance in a continuous manner, a clear U-shaped pattern emerged: Items that had more extreme valence ratings (negative or positive) were associated with better performance than items with more neutral ratings. We conclude that using the item valence ratings we report, and treating item valence as a continuous rather than categorical predictor, will help bring consistency to the study of the association between item valence and performance in the RMET. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Emoções , Testes Neuropsicológicos/normas , Percepção Social , Teoria da Mente , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
15.
Pflugers Arch ; 472(2): 271-280, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31396757

RESUMO

The optimal timing between meal ingestion and simple physical activity for improving blood glucose control is unknown. This study compared the effects of physical activity on postprandial interstitial glucose responses when the activity was conducted either immediately before, immediately after, or 30 min after breakfast. Forty-eight adults were randomized to three separate physical activity interventions: standing still (for 30 min), walking (for 30 min), and bodyweight exercises (3 sets of 10 squats, 10 push-ups, 10 lunges, 10 sit-ups). In each intervention, 16 participants completed four trials (A to D) during which a 500 kcal mixed nutrient liquid breakfast meal was consumed. Interstitial glucose responses were recorded using continuous glucose monitoring for 2 h after the meal. The activity was completed either after the glucose monitoring period (trial A; control) or immediately before (trial B), immediately after (trial C), or 30 min after (trial D) the breakfast. Mean, coefficient of variance (CV), and area under the curve (AUC) for glucose were calculated and compared between the four trials. Walking and bodyweight exercises immediately after the meal improved mean, CV, and AUC glucose (P ≤ 0.05 vs. control), while standing immediately after the meal only improved AUC glucose (P ≤ 0.05 vs. control) and nearly improved mean glucose (P = 0.06). Mean, CV, and AUC glucose were not affected by standing, walking, or bodyweight exercise conducted immediately before, or 30 min after the meal (all P > 0.05 vs. control). Energy intake (diet records) and energy expenditure (Actigraph) were consistent throughout the studies and did not influence the findings. Low- to moderate-intensity activity should be implemented soon after eating to improve glucose control following breakfast. The type of activity appears less important than the timing. These findings will help optimize exercise-meal timing in general health guidelines. ClinicalTrials.gov Identifier: NCT03730727.


Assuntos
Desjejum/fisiologia , Hiperglicemia/prevenção & controle , Condicionamento Físico Humano/métodos , Adulto , Glicemia/metabolismo , Metabolismo Energético , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Posição Ortostática , Caminhada
16.
J Autism Dev Disord ; 50(5): 1822-1826, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-30171508

RESUMO

Although there is evidence to suggest that adolescents with autism spectrum disorder (ASD) have difficulty interpreting complex social situations, little is known about their understanding of bullying. Given the high rates of victimization in this population, it is important to investigate how adolescents with ASD comprehend bullying. Male adolescents with ASD and IQ-matched typically-developing (TD) controls (Mage = 14.62, SD = 1.91) watched six videos portraying bullying scenarios and were interviewed after each video. The interviews were coded for the participants' understanding of the bullying scenarios. Results indicated that adolescents with ASD had significantly lower bullying understanding scores than TD adolescents. These novel findings suggest that male adolescents with ASD understand bullying differently than their TD peers. Implications for experiences with victimization are discussed.


Assuntos
Transtorno do Espectro Autista/psicologia , Bullying/psicologia , Compreensão , Adolescente , Estudos de Casos e Controles , Vítimas de Crime/psicologia , Humanos , Masculino
17.
Behav Modif ; 44(2): 214-227, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-30339047

RESUMO

We explored whether a single-item self-report measure (i.e., the Readiness Ruler) was an appropriate measure of treatment engagement in adult outpatients with eating disorders. In total, 108 women diagnosed with an eating disorder completed the Readiness Ruler and measures of symptom severity at intake to a hospital-based outpatient treatment program. Treatment engagement was operationalized as attendance to a minimum of one session of a cognitive-behavioral therapy (CBT) treatment group, the number of CBT group sessions attended, and whether the participants dropped out of the CBT group prematurely. Results suggest that the Readiness Ruler was not associated with attending the CBT group. Among the participants who attended the program, the Readiness Ruler was not associated with the number of CBT group sessions attended or CBT group dropout. Higher Readiness Ruler score was associated with more severe symptomatology. In conclusion, the Readiness Ruler may not be a good predictor of CBT group treatment engagement for individuals with eating disorders and may instead be a proxy for symptom severity.


Assuntos
Terapia Cognitivo-Comportamental , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Pacientes Desistentes do Tratamento/psicologia , Autorrelato , Adulto Jovem
18.
Psychiatry Res ; 273: 58-66, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30640052

RESUMO

OBJECTIVE: Although prior meta-analyses have significantly enriched the available literature on the comorbidity of substance use disorders (SUD) among individuals with eating disorders (ED), there have been few, recent, comprehensive reviews, and limited meta-analyses that include a range of SUDs. METHOD: In accordance with the PRISMA guidelines, six electronic databases were searched, and a total of 1013 articles were identified using a combination of search terms to identify relevant prevalence studies: eating disorder, substance-related disorder, drug dependence, drug abuse, drug addiction, substance abuse, and prevalence. After two authors screened articles and extracted data independently, 43 articles met inclusion criteria. Data was coded, and a risk of bias assessment was conducted for each included study. Meta-analysis and moderator-analysis was carried out using random-effects modelling. RESULTS: The pooled lifetime and current prevalence of any comorbid SUD was 21.9% (95% CI 16.7-28.0) and 7.7% (95% CI 2.0-25.8), respectively. Tobacco (36.1 ±â€¯23.1%), caffeine (23.8 ±â€¯12.5%), and alcohol (20.6 ±â€¯16.0%) were the most prevalent SUD comorbidities. Higher prevalence was observed in all-female samples, primarily Caucasian samples, and binge-purge presentations. Neither lifetime nor current prevalence were associated with age. DISCUSSION: These results suggest that individuals with eating disorders should be regularly screened and offered treatment for substance use disorders concurrently during treatment for ED.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Humanos , Masculino , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
19.
J Abnorm Child Psychol ; 47(1): 165-175, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29497980

RESUMO

Substantial uncertainty exists about the prevalence of depressive disorders in individuals with autism spectrum disorder (ASD). This meta-analysis quantitatively summarized studies that assessed the lifetime and current prevalence of unipolar depressive disorders in children, adolescents, and adults with ASD. We also examined demographic, methodological, and study moderators. This meta-analysis adhered to PRISMA guidelines. A total of 7857 articles were identified through 5 databases (PubMed, Web of Science, PYSCInfo, CINAHL, ProQuest Dissertations and Theses), forward searches, and backward searches. Two reviewers independently screened articles and extracted data. Sixty-six articles met inclusion criteria. Results indicated that the pooled lifetime and current prevalence was 14.4% (95% CI 10.3-19.8) and 12.3% (95% CI 9.7-15.5), respectively. Rates of depressive disorders were highest among studies that used a standardized interview to assess depressive disorders (lifetime = 28.5%, 95% CI 20.1-38.8; current = 15.3%, 95% CI 11.0-20.9) and required participants to report on their own depressive symptoms (lifetime = 48.6%, 95% CI 33.3-64.2; current = 25.9%, 95% CI 17.0-37.3). Rates were also higher in studies that included participants with higher intelligence. Lifetime, but not current, prevalence was positively associated with age and the proportion of the sample that was White. In conclusion, we found that the rates of depressive disorders are high among individuals with ASD. Compared to typically developing individuals, individuals with ASD are 4-times more likely to experience depression in their lifetime. These results suggest that individuals with ASD should be regularly screened and offered treatment for depression.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Comorbidade , Transtorno Depressivo/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Prevalência , Adulto Jovem
20.
Eat Weight Disord ; 23(6): 817-824, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30306497

RESUMO

PURPOSE: Men with eating disorders are not well understood and there is a need for innovative methods for engaging men in specialized outpatient assessment and treatment. We examined data collected over a 4-year period to explore whether the addition of a designated track for men at a hospital-based adult eating disorders program influenced the number of referrals or treatment engagement. METHODS: During assessment and treatment as usual (ATAU; September 2013-August 2015), 283 referrals were received (275 women, 8 men), with 3 men engaging in assessment and treatment (Mage = 36 years, SD = 14.18). After instatement of a male assessment and treatment track (MATT; September 2015-August 2017), 320 referrals were received (300 women, 20 men), with 14 men engaging in the specialized assessment and treatment (Mage = 28.21 years, SD = 8.04). Both groups of men completed measures of demographic characteristics, life satisfaction, depressive and anxiety symptoms, and eating disorder symptoms. RESULTS: Significantly more referrals for men, but not women, were received after the instatement of the MATT (i.e., a 250% increase). More men also engaged in specialized assessment and treatment after the instatement of the MATT (i.e., a 467% increase in engagement). CONCLUSIONS: The current study describes the number of referrals and the number of men who engaged in treatment before and after the instatement of a specialized treatment track for men. The results suggest that the addition of the MATT helped to increase the number of men referred and promoted their engagement in recommended care. LEVEL OF EVIDENCE: V retrospective descriptive study.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Psicoterapia de Grupo , Estigma Social , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Humanos , Masculino , Adulto Jovem
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