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Hot Research
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Alpha-Blockers Relieve PTSD-Related Insomnia, Nightmares |
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Monday, 06 October 2008 |
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A reviewer at the Michael E. DeBakey Veterans Administration Medical Center in Houston, Texas, reports on the value of pharmaceuticals for posttraumatic stress, and particularly of alpha-blockers for PTSD-related sleep disturbances.
The article reports that an estimated 70-87% of patients who suffer from posttraumatic stress experience sleep disruption – difficulty falling asleep and staying asleep, as well as distressing nightmares in which the traumatic event is reexperienced. Selective serotonin reuptake inhibitors (SSRI’s such as Zoloft, Prozac, Luvox, Celexa, Paxil, etc) are the pharmaceutical treatment of choice for PTSD, but with the exception of fluvoxamine (Luvox), they are often ineffective or only partially effective for sleep problems. |
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Hypnosis Reduces Headache Pain for People with Wide Suggestibility Range |
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Monday, 29 September 2008 |
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Researchers from the University of Hartford reviewed the findings to see if a high level of hypnotic suggestibility (considered a stable individual trait) is necessary for a hypnotic pain intervention to relieve headache pain.
Higher suggestibility has been found to be associated with greater relief from hypnotic pain interventions, and although individuals in the high suggestibility range show the strongest response to hypnotic analgesia, people of medium suggestibility (who represent approximately one third of the population) also have been found to obtain significant relief from hypnosis.
The researchers conclude that high hypnotic suggestibility is not necessary for successful hypnotic pain intervention for headache – medium suggestibility works too . But the available evidence does not support the efficacy of hypnotic pain interventions for people who fall in the low hypnotic suggestibility range. According to some studies, these subjects may benefit from imaginative analgesia suggestions (guided imagery), or suggestions for pain reduction that are delivered while the person is not under hypnosis.
Citation: Milling LS. Is high hypnotic suggestibility necessary for successful hypnotic pain intervention? Current Pain and Headache Reports. 2008 Apr;12 (2): pages 98-102.
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What Works Best for Depression?? Meta-Analysis from the UK |
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Sunday, 21 September 2008 |
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British researchers from the University of York in Road, Durham, UK, performed a meta-analysis of studies testing the efficacy of various behavioral therapies for depression. [Ed. Note: Generally speaking, behavioral therapies use changes in reactivity and behavior as opposed to changes in insight, thoughts and feelings to catalyze improvements.]
The study identified randomized trials of behavioral treatments for depression and compared them to controls or other psychotherapies. Seventeen randomized controlled trials, encompassing a total of 1109 subjects, were included in this meta-analysis.
A random-effects meta-analysis of symptom-levels, post-treatment, showed that behavioral therapies were superior to controls*, brief psychotherapy, supportive therapy and equal to cognitive behavioral therapy (CBT).
The results in this study indicate behavioral therapy is an effective treatment for depression, with outcomes equal to Cognitive Behavioral Therapy, the current recommended psychological intervention and preferable to brief psychotherapy and supportive therapy. Future research is needed to clarify and better sort out these findings.
Citation: Ekers D, Richards D, Gilbody S. A meta-analysis of randomized trials of behavioural treatment of depression. Psychological Medicine. 2008 May;38 (5): pages 611-23. Epub 2007 Oct 1,
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Biofeedback + Relaxation Work for Headaches |
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Sunday, 14 September 2008 |
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A review and meta-analysis of studies investigating the effects of biofeedback on tension headaches was undertaken by researchers at Philipps-University of Marburg in Marburg, Germany.
A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria. Meta-analytic integration resulted in a significant medium-to-large effect size (d = 0.73; 95% confidence interval = 0.61, 0.84) that proved stable over an average follow-up phase of 15 months.
Biofeedback was found to be more effective than headache monitoring, placebo, and relaxation therapy conditions. The strongest improvements resulted for frequency of headache episodes. Further significant effects were observed for muscle tension, self-efficacy, symptoms of anxiety, depression, and analgesic medication.
Most effective of all was biofeedback in combination with
relaxation. Effects were particularly large in children and
adolescents. The review concluded that biofeedback constitutes an
effective, evidence-based treatment option for tension-type headache. Citation: Nestoriuc Y, Rief W, Martin A. Meta-analysis of biofeedback for tension-type headache: efficacy, specificity, and treatment moderators. Journal of Consulting & Clinical Psychology. 2008 Jun; 76 (3): pages 379-96.
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Imagery Shows Big Gains for Post-Stroke Paralysis |
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Sunday, 07 September 2008 |
If you thought I was exaggerating about the recent spike in research on motor imagery for stroke, check out these 3 recent studies, and then click here for a whole other stash of them, already archived....
IMAGERY SHOWS BIG GAINS FOR POST-STROKE HEMIPARESIS
 Researchers from the Wingate Institute in Netanya, Israel, tested the feasibility of using a home-based motor imagery gait training program to improve walking performance of people suffering from chronic poststroke hemiparesis.
Seventeen community-dwelling volunteers with hemiparesis caused by a unilateral stroke that occurred at least 3 months before the study were recruited. They received 15 minutes of supervised imagery gait training in their homes 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training.
Walking ability was evaluated by kinematics and functional scales twice before the intervention, 3 and 6 weeks after the intervention began, and at the 3-week follow-up. |
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Lifting Depression for Family Caregivers of Mentally Ill |
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Sunday, 31 August 2008 |
An Italian study out of the Psychology Department of the University of Padua examined the impact of cognitive-behavioral therapy on the depressive symptoms of those who provide care at home for severely ill psychiatric patients.
Forty caregivers who were depressed or at risk of depression were randomly assigned to either a cognitive behavioral treatment (CBT) group or a mutual support treatment (MST) group, led respectively by 2 psychotherapists and 1 psychologist- facilitator. Before and after intervention, all participants were individually assessed with the Beck Depression Inventory and Family Problems questionnaire.
Both the CBT and MST therapies produced reductions in depression, though in the MST groups the trend was not significant. Nevertheless, analysis of the clinical significance of change in the Beck Depression Inventory score for each subject showed an improvement in 58.3% of depressed caregivers treated with CBT and in 45.4% of those treated with MST. And unlike CBT, MST produced an improvement in two dimensions of family burden.
Citation: Michielin P, Cenedese C, Cristofoli M, Zaros N. [Usefulness and effectiveness of group cognitive-behavioral psychotherapy and mutual support group therapy for depressed caregivers of psychiatric patients] G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl B):B18-25.
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[Article in Italian] |
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Mindfulness-Based Chronic Pain Management Study |
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Sunday, 24 August 2008 |
Researchers from St Michael's Hospital in Toronto conducted a 2 year follow-up study on the effects of a 10-week, 2 hours per week, Mindfulness-Based Chronic Pain Management course on chronic pain. The 99 chronic pain patients received the course either via traditional face-to-face, in-person teaching (Present site group) or via videoconferencing from their local hospital site (Distant site group) for those in rural areas, far from direct access to care. Wait list patients served as controls.
Pre- and postcourse measures of quality of life, pain catastrophizing and usual pain ratings were collected over a period of two years. Patients at Present and Distant sites achieved similar gains in mental health (P < 0.01) and pain catastrophizing levels (P < 0.01) relative to controls. However, the Present site group obtained significantly higher scores on the physical dimension of quality of life (P < 0.01) and lower usual-pain ratings (P < 0.05) than the Distant site group.
The results suggest that videoconferencing is an effective mode of delivery for the Mindfulness course and may represent a new way of helping chronic pain patients in rural areas manage their suffering, but it is not as effective as in-person teaching.
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Meta-Analysis: Relaxation Training’s Impact On Anxiety |
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Sunday, 17 August 2008 |
Researchers from the Psychology Research Laboratory at San Giuseppe Hospital in Verbania, Italy, performed a meta-analysis of studies evaluating the effectiveness of relaxation training for anxiety.
The studies were published between 1997-2007 and included randomized, controlled trials, as well as simple observational studies without control groups, evaluating the efficacy of relaxation training [including Jacobson's progressive relaxation, autogenic training, applied relaxation and meditation] for anxiety problems and disorders.
Comprehensive electronic searches through Pubmed, Psychinfo and Cochrane Registers yielded 27 qualified studies. The primary outcome was degree of anxiety, measured with psychometric questionnaires. Meta-analysis was undertaken synthesizing the data from all trials, distinguishing within and between effect sizes.
As hypothesized, relaxation training showed medium-to-large effect sizes in the treatment of anxiety. Efficacy was higher for meditation, among volunteers and for longer durations of treatments. The researchers conclude that their results show consistent and significant efficacy for relaxation training’s impact on the reduction of anxiety.
Citation:Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 2008 Jun 2; 8: page 41.
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Relaxation training for anxiety: a ten-years review |
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Sunday, 17 August 2008 |
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Researchers from the Psychology Research Laboratory at San Giuseppe Hospital in Verbania, Italy, performed a meta-analysis of studies evaluating the effectiveness of relaxation training for anxiety. |
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Effect of guided imagery on quality of life in older women with osteoarthritis |
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Monday, 11 August 2008 |
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Researchers from Purdue University School of Nursing tested the effectiveness of guided imagery with relaxation (GIR) to improve health-related quality of life (HRQOL) in older women with osteoarthritis (OA) - the most common cause of disability in older adults. |
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Enhanced Negative Emotion and Alcohol Craving |
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Monday, 04 August 2008 |
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Researchers from the Department of Psychiatry at Yale University’s School of Medicine investigated whether people who chronically abuse alcohol are extra-vulnerable to changes in stress levels altering their alcohol cravings. Twenty-eight treatment-engaged, 28-day abstinent, alcohol-dependent (AD) individuals - 6 females, 22 males - and another twenty-eight social drinkers (SD) - 10 females, 18 males - were exposed to three different brief, stress-evoking, guided imagery exercises: (1) a personalized stressful imagery, (2) an alcohol-related stressful imagery and (3)a neutral-relaxing imagery - one condition per session, presented in random order across 3 days. |
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