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1.
J Behav Med ; 47(3): 483-491, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38393445

RESUMO

Pre-surgical psychological evaluations (PSPE) are required by many insurance companies and used to help identify risk factors that may compromise bariatric post-surgical outcomes. These evaluations, however, are not yet standardized. The present study investigated the utility of a semi-structured assessment, Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), on post-surgical outcomes across 18 months. A total of 272 adult patients underwent a psychosocial evaluation and received bariatric surgery November 2017 to September 2020 at a Midwestern academic medical center. Average age at pre-surgical evaluation was 45.2 (SD = 10.7) years and 82.3% of patients were female (n = 224). With an a priori α of 0.05, multi-level modeling with weight as the outcome and regression with complications as the outcome were used. Higher SIPAT Patient Readiness, indicating difficulty with adhering to health behaviors and a reduced understanding of bariatric surgery, was associated with elevated patient weight at the 18-month follow-up (𝛽 = 0.129, p = 0.03). Higher SIPAT Social Support, was associated with patient weight at the 18-month follow-up, with reduced support associated with greater weight (𝛽 = 0.254, p = 0.004). Higher SIPAT Social Support also was associated with a greater risk of complications across the 18-month follow-up window (𝛽 = -0.108, p = 0.05). Patients with higher readiness to adhere to behavioral changes, and those reporting an intact social support system, generally weighed less at 18 months. The SIPAT may be considered as part of the standardized pre-surgical assessment, however, further research is required to elucidate its utility.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Adulto , Humanos , Feminino , Masculino , Fatores de Risco
2.
Telemed J E Health ; 28(8): 1077-1089, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35007437

RESUMO

Introduction: The recent surge in telehealth service delivery represents a promising development in the field's ability to address access gaps in health care across underserved populations. Telehealth also carries the potential to help reduce the societal burden of mental illnesses such as major depression, which often go untreated. There is now a sufficiently large corpus of randomized controlled trials to examine the comparative effectiveness of teletherapy and in-person services meta-analytically. Methods: We searched the PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for articles from January 1, 2000 to February 1, 2021 to identify randomized head-to-head trials of video-based versus in-person delivery of psychotherapy to reduce depressive symptoms. We conducted a random-effects meta-analysis to evaluate potential differences in efficacy rates. We calculated and meta-analyzed odds ratios to examine differential attrition rates between video and in-person conditions. Finally, we conducted subgroup analyses based on the primary treatment focus (depression or another condition) of each trial. Results: Primary study analyses yielded evidence that video-based psychotherapy is roughly comparable in efficacy with in-person psychotherapy for reducing depressive symptoms (g = 0.04, 95% confidence interval [CI = -0.12 to 0.20], p = 0.60, I2 = 5%). Likewise, attrition rates between the two conditions were not significantly different (odds ratio = 1.07, 95% CI = [0.78 to 1.49], p = 0.63, I2 = 25%). Finally, we did not observe significant subgroup differences in either efficacy (p = 0.38) or attrition (p = 0.94). Conclusions: The present findings suggest that video-based teletherapy may be a feasible and effective alternative to in-person services for reducing depressive symptoms. Continued research on the effectiveness of telehealth in clinically depressed samples, and further elucidation of the access barriers entailed by each delivery modality, can help the field better determine which patients will derive the greatest benefit from each mode of intervention.


Assuntos
Depressão , Transtorno Depressivo Maior , Depressão/terapia , Transtorno Depressivo Maior/terapia , Humanos , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
J Clin Psychol Med Settings ; 29(4): 808-817, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35072842

RESUMO

How clinicians perform pre-surgical psychological evaluations (PSPE) for bariatric surgery remains variable across institutions. Bariatric PSPE guidelines state that self-report measures should be incorporated in the PSPE procedure, yet only 50-60% of PSPEs utilize patient self-report measures. Previous studies describing the presurgical psychological evaluation report a range of measures, however a gold standard in PSPE has yet to be agreed upon. Given this gap in how a presurgical psychological evaluation for bariatric patients is defined, incorporating more objective measures into this process may help clinicians identify specific areas in which a patient is struggling and benefit from additional psychosocial support. The present study proposes the use of the SIPAT, a semi-structured interview initially developed to assess organ transplant candidates, as part of this evaluation. A total of 292 adult patients underwent a pre-surgical psychological evaluation for bariatric surgery between November 2017 and February 2020 at a Midwest medical center. Patient average age was 45.2 (11.3) years and 83.3% were female. At time of analysis, 160 patients received bariatric surgery. Logistic regression and analyses of bivariate associations were conducted in R. The SIPAT exhibited good convergent validity via correlations with analogous scales on the PROMIS 43, and it yielded a small effect size predicting patients who ultimately received surgery. Accordingly, this semi-structured interview may be a useful tool to help differentiate patients for surgical candidacy.


Assuntos
Cirurgia Bariátrica , Transplante de Órgãos , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Cirurgia Bariátrica/psicologia , Transplante de Órgãos/psicologia , Autorrelato
4.
Cogn Emot ; 26(8): 1359-70, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22650378

RESUMO

There is evidence of maladaptive attentional biases for lexical information (e.g., Atchley, Ilardi, & Enloe, 2003; Atchley, Stringer, Mathias, Ilardi, & Minatrea, 2007) and for pictographic stimuli (e.g., Gotlib, Krasnoperova, Yue, & Joormann, 2004) among patients with depression. The current research looks for depressotypic processing biases among depressed out-patients and non-clinical controls, using both verbal and pictorial stimuli. A d' measure (sensitivity index) was used to examine each participant's perceptual sensitivity threshold. Never-depressed controls evidenced a detection bias for positive picture stimuli, while depressed participants had no such bias. With verbal stimuli, depressed individuals showed specific decrements in the detection of positive person-referent words (WINNER), but not with positive non-person-referent words (SUNSHINE) or with negative words. Never-depressed participants showed no such differences across word types. In the current study, depression is characterised both by an absence of the normal positivistic biases seen in individuals without mood disorders (consistent with McCabe & Gotlib, 1995), and by a specific reduction in sensitivity for person-referent positive information that might be inconsistent with depressotypic self-schemas.


Assuntos
Atenção , Percepção Auditiva , Transtorno Depressivo Maior/psicologia , Semântica , Percepção Visual , Estimulação Acústica/métodos , Estimulação Acústica/psicologia , Adulto , Ansiedade/psicologia , Feminino , Humanos , Masculino , Estimulação Luminosa/métodos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Desempenho Psicomotor
5.
Med Hypotheses ; 134: 109421, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31634771

RESUMO

Added sugars are ubiquitous in contemporary Western diets. Although excessive sugar consumption is now robustly associated with an array of adverse health consequences, comparatively little research has thus far addressed its impact on the risk of mental illness. But ample evidence suggests that high-dose sugar intake can perturb numerous metabolic, inflammatory, and neurobiological processes. Many such effects are of particular relevance to the onset and maintenance of depressive illness, among them: systemic inflammation, gut microbiota disruption, perturbed dopaminergic reward signaling, insulin resistance, oxidative stress, and the generation of toxic advanced glycation end-products (AGEs). Accordingly, we hypothesize that added dietary sugars carry the potential to increase vulnerability to major depressive disorder, particularly at high levels of consumption. The present paper: (a) summarizes the existing experimental and epidemiological research regarding sugar consumption and depression vulnerability; (b) examines the impact of sugar ingestion on known depressogenic physiological processes; and (c) outlines the clinical and theoretical implications of the apparent sugar-depression link. We conclude that the extant literature supports the hypothesized depressogenic impact of added dietary sugars, and propose that an improved understanding of the effects of sugar on body and mind may aid in the development of novel therapeutic and preventative measures for depression.


Assuntos
Transtorno Depressivo Maior/induzido quimicamente , Açúcares da Dieta/efeitos adversos , Anedonia , Animais , Transtorno Depressivo Maior/epidemiologia , Dieta Ocidental/efeitos adversos , Modelos Animais de Doenças , Dopamina/metabolismo , Disbiose/induzido quimicamente , Feminino , Seguimentos , Saúde Global , Produtos Finais de Glicação Avançada/efeitos adversos , Produtos Finais de Glicação Avançada/metabolismo , Humanos , Inflamação/induzido quimicamente , Resistência à Insulina , Microbiota/efeitos dos fármacos , Obesidade/epidemiologia , Obesidade/etiologia , Estresse Oxidativo/efeitos dos fármacos , Ratos , Bebidas Adoçadas com Açúcar/efeitos adversos
6.
Sci Rep ; 9(1): 261, 2019 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-30670723

RESUMO

Evidence from recent animal studies suggest that minocycline, a broad-spectrum antibiotic capable of regulating immune processes, may possess antidepressant properties. These studies, however, have yet to be comprehensively reviewed. Accordingly, this systematic review and meta-analysis summarizes the extant literature examining the effect of minocycline on depressive-like behavior in rodent models. PubMed, PsycINFO, and Web of Science databases were systematically searched for articles that met prespecified inclusion and exclusion criteria, and standardized mean differences (SMDs) were calculated for each continuous measure of depressive-like behavior. The overall effect of minocycline on depressive-like behavior was estimated using robust variance estimation meta-analysis. Separate subgroup analyses were conducted on diseased vs healthy animal models, different rodent species, and immobility-based vs anhedonia-based measures of depressive-like behavior. A total of 22 preclinical studies (816 animals) were included. Overall, minocycline reduced depressive-like behavior in rodents (SMD = -1.07, 95% CI -1.41--0.74, p < 0.001). Subgroup analyses revealed that minocycline reduced depressive-like behavior in diseased, but not healthy, animal models. Finally, minocycline was found to reduce both immobility-based and anhedonia-based outcomes. These findings suggest that minocycline may be an effective treatment of core depressive symptoms, and that further investigation of minocycline treatment for clinically relevant depression in humans is warranted.


Assuntos
Antibacterianos/administração & dosagem , Depressão/tratamento farmacológico , Minociclina/administração & dosagem , Animais , Técnicas de Observação do Comportamento , Comportamento Animal/efeitos dos fármacos , Depressão/diagnóstico , Depressão/etiologia , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Humanos , Camundongos , Ratos , Resultado do Tratamento
7.
Psychophysiology ; 56(7): e13345, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30793773

RESUMO

The current research examined how individuals with depression process emotional, self-relevant stimuli. Across two studies, individuals with depression and healthy controls read stimuli that varied in self-relevance while EEG data were recorded. We examined the late positive potential (LPP), an ERP component that captures the dynamic allocation of attention to motivationally salient stimuli. In Study 1, participants read single words in a passive-viewing task. Participants viewed negative, positive, or neutral words that were either normative or self-generated. Exploratory analyses indicated that participants with depression exhibited affective modulation of the LPP for self-generated stimuli only (both positive and negative) and not for normative stimuli; healthy controls exhibited similar affective modulation of the LPP for both self-relevant and normative stimuli. In Study 2, using a separate sample and a different task, stimuli were provided within the context of sentence stems referring to the self or other people. Participants with depression were more likely to endorse negative self-referent sentences and reject positive ones compared to healthy controls. Depressed participants also exhibited an increased LPP to negative stimuli compared to positive or neutral stimuli. Together, these two studies suggest that depression is characterized by relatively increased sensitivity to affective self-relevant stimuli, perhaps in the context of a broader reduction in emotional reactivity to stimuli that are not self-relevant. Thus, depression may be characterized by a more nuanced pattern based on the degree of stimulus self-relevance than either a global decrease or increase in reactivity to affective stimuli.


Assuntos
Atenção/fisiologia , Encéfalo/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Emoções/fisiologia , Potenciais Evocados/fisiologia , Adolescente , Adulto , Transtorno Depressivo Maior/psicologia , Eletroencefalografia , Feminino , Humanos , Masculino , Adulto Jovem
8.
PLoS One ; 13(6): e0199041, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29924822

RESUMO

BACKGROUND: Probiotics have generated intensive research interest in recent years as a novel mode of treatment for physical and mental illness. Nevertheless, the anxiolytic potential of probiotics remains unclear. The present systematic review and meta-analysis aimed to evaluate the clinical and preclinical (animal model) evidence regarding the effect of probiotic administration on anxiety. METHODS: The PubMed, PsycINFO, and Web of Science databases were reviewed for preclinical and clinical studies that met the defined inclusion and exclusion criteria. The effects of probiotics on anxiety-like behavior and symptoms of anxiety were analyzed by meta-analyses. Separate subgroup analyses were conducted on diseased versus healthy animals, specific preclinical probiotic species, and clinical versus healthy human samples. RESULTS: Data were extracted from 22 preclinical studies (743 animals) and 14 clinical studies (1527 individuals). Overall, probiotics reduced anxiety-like behavior in animals (Hedges' g = -0.47, 95% CI -0.77 --0.16, p = 0.004). Subgroup analyses revealed a significant reduction only among diseased animals. Probiotic species-level analyses identified only Lactobacillus (L.) rhamnosus as an anxiolytic species, but these analyses were broadly under-powered. Probiotics did not significantly reduce symptoms of anxiety in humans (Hedges' g = -0.12, 95% CI -0.29-0.05, p = 0.151), and did not differentially affect clinical and healthy human samples. CONCLUSIONS: While preclinical (animal) studies suggest that probiotics may help reduce anxiety, such findings have not yet translated to clinical research in humans, perhaps due to the dearth of extant research with clinically anxious populations. Further investigation of probiotic treatment for clinically relevant anxiety is warranted, particularly with respect to the probiotic species L. rhamnosus.


Assuntos
Ansiolíticos/uso terapêutico , Probióticos/uso terapêutico , Animais , Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/tratamento farmacológico , Avaliação Pré-Clínica de Medicamentos , Comportamento Exploratório/efeitos dos fármacos , Feminino , Humanos , Lacticaseibacillus rhamnosus , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Probióticos/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Ratos , Projetos de Pesquisa , Especificidade da Espécie
9.
Brain Lang ; 84(1): 105-19, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12537954

RESUMO

We examined hemispheric lateralization of emotion processing by comparing the performance of clinically depressed, previously depressed, and control individuals on a divided visual field task. Participants were asked to make affective valence judgments for each in a series of laterally presented person-descriptive adjectives. Study results suggest that the right cerebral hemisphere (RH) is preferentially sensitive to the affective context of language. Among targets presented to the RH, depressed and previously depressed participants were significantly faster and more accurate in their judgments of negative target words, while controls responded more quickly and accurately to positive target words. No such effects were observed for targets presented to the left hemisphere. It is hypothesized that affective sensitivity may result in differences in semantic network organization across individuals who vary in affective experience.


Assuntos
Afeto/fisiologia , Encéfalo/fisiologia , Depressão/psicologia , Lateralidade Funcional/fisiologia , Vocabulário , Adolescente , Adulto , Feminino , Humanos , Idioma , Masculino , Tempo de Reação , Semântica , Fatores de Tempo , Campos Visuais/fisiologia
10.
PLoS One ; 8(9): e75893, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24086658

RESUMO

Despite the emergence of numerous clinical and non-clinical applications of bright light therapy (LT) in recent decades, the prevalence and severity of LT side effects have not yet been fully explicated. A few adverse LT effects-headache, eye strain, irritability, and nausea-have been consistently reported among depressed individuals and other psychiatric cohorts, but there exists little published evidence regarding LT side effects in non-clinical populations, who often undergo LT treatment of considerably briefer duration. Accordingly, in the present study we examined, in a randomized sample of healthy young adults, the acute side effects of exposure to a single 30-minute session of bright white light (10,000 lux) versus dim red light (< 500 lux). Across a broad range of potential side effects, repeated-measures analyses of variance revealed no significant group-by-time (Pre, Post) interactions. In other words, bright light exposure was not associated with a significantly higher incidence of any reported side effect than was the placebo control condition. Nevertheless, small but statistically significant increases in both eye strain and blurred vision were observed among both the LT and control groups. Overall, these results suggest that the relatively common occurrence of adverse side effects observed in the extant LT literature may not fully extend to non-clinical populations, especially for healthy young adults undergoing LT for a brief duration.


Assuntos
Fototerapia/efeitos adversos , Fototerapia/métodos , Adulto , Relação Dose-Resposta à Radiação , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos , Fatores de Tempo
11.
J Clin Psychol ; 62(7): 881-91, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16541384

RESUMO

This study tested the folkloristic belief that doctoral degree recipients who pursue academic careers typically wind up at institutions ranked lower in prestige than the institutions at which they trained (the step-down thesis). We used a database of faculty members in 150 clinical psychology doctoral programs accredited by the American Psychological Association, and compared each faculty member's training institution with the current employing institution on three distinct reputation ranking systems: The Center (University of Florida, Gainesville) for overall university reputation, the National Research Council (Washington, DC) for doctoral degree department reputation, and the news magazine, U.S. News and World Report ranking for clinical psychology training program reputation. Although support for the step-down thesis was found across all three ranking systems, a disproportionately large number of professors were also observed to move laterally in terms of their employing institution's reputation.


Assuntos
Dissertações Acadêmicas como Assunto , Avaliação de Desempenho Profissional , Emprego , Docentes , Psicologia Clínica/educação , Humanos
12.
J Clin Psychol ; 61(1): 7-20, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15558628

RESUMO

From its inception, psychology has been characterized by conceptual fragmentation and slow scientific progress (Henriques, 2004; Meehl, 1978). In contrast, the natural sciences have achieved in recent decades a remarkable degree of consilience--the linking of fact, theory, and method across disciplines (and subdisciplines) and across nested levels of informational complexity (Wilson, 1998). Although such consilience serves as a potent catalyst of scientific discovery, there exists several barriers to the emergence of a consilient science of psychology (e.g., the persistent influence of dualism, longstanding internecine discord, resistance to perceived reductionism, etc.). We discuss the manner in which the development of metatheoretical frameworks (including Henriques' Tree of Knowledge model) may play an important role in addressing such barriers. Likewise, we describe the hybrid interdisciplinary domain of cognitive neuroscience, which provides an empirically testable metatheory and a promising consilient bridge between psychology and the natural sciences.


Assuntos
Relações Interprofissionais , Teoria Psicológica , Psicologia/métodos , Psicologia/tendências , Ciência Cognitiva , Comportamento Cooperativo , Previsões , Humanos , Neurociências
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