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Journal of Anxiety Disorders Jun 2024This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental... (Review)
Review
This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.
PubMed: 38945067
DOI: 10.1016/j.janxdis.2024.102891 -
Appetite Jun 2024The aim of this review is to provide an overview of parental communication patterns during mealtimes, with a special emphasis being placed on the differences between...
Parental verbal communication and modeling behavior during mealtimes shape offspring eating behavior - a systematic review with a focus on clinical implications for eating disorders.
OBJECTIVE
The aim of this review is to provide an overview of parental communication patterns during mealtimes, with a special emphasis being placed on the differences between families with and without a history of eating disorders.
METHODS
The systematic review was conducted according to the PRISMA statement. A systematic literature search was carried out in PubMed, PubPsych and PsycINFO and the results were assessed for eligibility by two independent raters using the PICOS criteria. Only studies that included a mealtime observation were considered suitable for analysis of both explicit and implicit parental communication.
RESULTS
The results of the review suggest that mothers communicate more, with more complexity, and with a greater variety of words with their children during mealtimes compared to fathers. The intention and type of communication is diverse and heterogeneous. In general, parents often tried to encourage their children to eat. Verbal modeling and co-eating appeared to be common behaviors. Mothers with a history of eating disorders expressed more negative emotions during eating than mothers without eating disorders. Findings regarding the use of positive comments and controlling speech are contradicting.
DISCUSSION
The review outlines major fields of parent-child communication and modeling behavior around family meals which might be relevant to investigate and integrate into models of intergenerational transmission of eating behavior and disordered eating.
PubMed: 38944057
DOI: 10.1016/j.appet.2024.107584 -
The American Journal of Drug and... Jun 2024Medications for opioid use disorder (MOUD) reduce risks for overdose among correctional populations. Among other barriers, daily dosing requirements hinder treatment... (Review)
Review
Medications for opioid use disorder (MOUD) reduce risks for overdose among correctional populations. Among other barriers, daily dosing requirements hinder treatment continuity post-release. Extended-release buprenorphine (XR-BUP) may therefore be beneficial. However, limited evidence exists. To conduct a systematic review examining the feasibility and effectiveness of XR-BUP among correctional populations. Searches were carried out in Pubmed, Embase, and PsychINFO in October 2023. Ten studies reporting on feasibility or effectiveness of XR-BUP were included, representing = 819 total individuals (81.6% male). Data were extracted and narratively reported under the following main outcomes: 1) Feasibility; 2) Effectiveness; and 3) Barriers and Facilitators. Studies were heterogeneous. Correctional populations were two times readier to try XR-BUP compared to non-correctional populations. XR-BUP was feasible and safe, with no diversion, overdoses, or deaths; several negative side effects were reported. Compared to other MOUD, XR-BUP significantly reduced drug use, resulted in similar or higher treatment retention rates, fewer re-incarcerations, and was cost-beneficial, with a lower overall monthly/yearly cost. Barriers to XR-BUP, such as side effects and a fear of needles, as well as facilitators, such as a lowered risk of opioid relapse, were also identified. XR-BUP appears to be a feasible and potentially effective alternative treatment option for correctional populations with OUD. XR-BUP may reduce community release-related risks, such as opioid use and overdose risk, as well as barriers to treatment retention. Efforts to expand access to and uptake of XR-BUP among correctional populations are warranted.
PubMed: 38940929
DOI: 10.1080/00952990.2024.2360984 -
Clinical Psychology & Psychotherapy 2024Paranoia is relatively common but can lead to significant distress, impairment and need for care. Digital technologies offer a valuable extension to service provision... (Review)
Review
BACKGROUND
Paranoia is relatively common but can lead to significant distress, impairment and need for care. Digital technologies offer a valuable extension to service provision and are increasingly being integrated into healthcare. This systematic review evaluated feasibility, acceptability, and effectiveness of digitally enhanced psychological assessments and treatments for paranoia across the paranoia continuum (PROSPERO: CRD42023393257).
METHODS
Databases PsychINFO, EMBASE, MEDLINE and Web of Science were searched until 12 June 2023; the Effective Public Health Practice Project (EPHPP) quality assessment tool evaluated studies; and a narrative synthesis was conducted.
RESULTS
Twenty-seven studies met inclusion criteria (n = 3457, 23 assessment and 4 treatment, 2005-2023, most in Europe). Technologies included virtual reality (VR, n = 23), experience sampling methodology (ESM, n = 2), an app (n = 1) and a combination of VR and ESM (n = 1). Assessments involved monitoring paranoia under various virtual conditions or in everyday life. Treatments were generally integrated with Cognitive Behaviour Therapy (CBT), which involved using VR to test out threat beliefs and drop safety behaviours or using an app to support slowing down paranoid thinking. EPHPP ratings were strong (n = 8), moderate (n = 12) and weak (n = 7).
CONCLUSIONS
Digitally enhanced assessments and treatments showed promising acceptability, feasibility and treatment effectiveness. Limitations of studies include small sample sizes, lack of comparison groups and long-term data and limited randomised controlled trials. Results support the potential future integration of VR in the assessment of paranoia and show promise for treatments such as CBT, although further clinical trials are required. Investigation of other technologies is limited.
Topics: Humans; Paranoid Disorders; Cognitive Behavioral Therapy
PubMed: 38940680
DOI: 10.1002/cpp.3019 -
Psychiatric Services (Washington, D.C.) Jun 2024Discriminatory practices in mental health care undermine the right to health of marginalized service users. Intersectional approaches enable consideration of multiple... (Review)
Review
OBJECTIVE
Discriminatory practices in mental health care undermine the right to health of marginalized service users. Intersectional approaches enable consideration of multiple forms of discrimination that occur simultaneously and remain invisible in single-axis analyses. The authors reviewed intersectionality-informed qualitative literature on discriminatory practices in mental health care to better understand the experiences of marginalized service users and their evaluation and navigation of mental health care.
METHODS
The authors searched EBSCO, PubMed, MEDLINE, and JSTOR for studies published January 1, 1989-December 14, 2022. Qualitative and mixed-methods studies were eligible if they used an intersectional approach to examine discrimination (experiences, mechanisms, and coping strategies) in mental health care settings from the perspective of service users and providers. A qualitative evidence synthesis with thematic analysis was performed.
RESULTS
Fifteen studies were included in the qualitative evidence synthesis. These studies represented the experiences of 383 service users and 114 providers. Most studies considered the intersections of mental illness with race, sexual and gender diversity, or both and were performed in the United States or Canada. Four themes were identified: the relevance of social identity in mental health care settings, knowledge-related concerns in mental health care, microaggressions in clinical practice, and service users' responses to discriminatory practices.
CONCLUSIONS
Discriminatory practices in mental health care lead to specific barriers to care for multiply marginalized service users. Universities and hospitals may improve care by building competencies in recognizing and preventing discrimination through institutionalized training.
PubMed: 38938095
DOI: 10.1176/appi.ps.20230252 -
Alzheimer's Research & Therapy Jun 2024Non-invasive brain stimulation (NIBS) combined with cognitive training (CT) may have shown some prospects on improving cognitive function in patients with Alzheimer's... (Meta-Analysis)
Meta-Analysis Review
The cognitive effect of non-invasive brain stimulation combined with cognitive training in Alzheimer's disease and mild cognitive impairment: a systematic review and meta-analysis.
BACKGROUND
Non-invasive brain stimulation (NIBS) combined with cognitive training (CT) may have shown some prospects on improving cognitive function in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, data from clinical trials or meta-analysis involving NIBS combined with CT have shown controversial results. The aim of this systematic review and meta-analysis was to evaluate short-term and long-term effects of NIBS combined with CT on improving global cognition and other specific cognitive domains in patients with AD and MCI.
METHODS
This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five electronic databases including PubMed, Web of Science, EBSCO, Cochrane Library and Embase were searched up from inception to 20 November 2023. The PEDro scale and the Cochrane's risk of bias assessment were used to evaluate risk of bias and methodological quality of included studies. All statistical analyses were conducted with Review Manager 5.3.
RESULTS
We included 15 studies with 685 patients. The PEDro scale was used to assess methodological quality with a mean score of 7.9. The results of meta-analysis showed that NIBS combined with CT was effective on improving global cognition in AD and MCI (SMD = 0.52, 95% CI (0.18, 0.87), p = 0.003), especially for patients accepting repetitive transcranial magnetic stimulation (rTMS) combined with CT (SMD = 0.46, 95% CI (0.14, 0.78), p = 0.005). AD could achieve global cognition improvement from NIBS combined with CT group (SMD = 0.77, 95% CI (0.19, 1.35), p = 0.01). Transcranial direct current stimulation (tDCS) combined with CT could improve language function in AD and MCI (SMD = 0.29, 95% CI (0.03, 0.55), p = 0.03). At evaluation follow-up, rTMS combined with CT exhibited larger therapeutic responses to AD and MCI in global cognition (SMD = 0.55, 95% CI (0.09, 1.02), p = 0.02). AD could achieve global cognition (SMD = 0.40, 95% CI (0.03, 0.77), p = 0.03) and attention/working memory (SMD = 0.72, 95% CI (0.23, 1.20), p = 0.004) improvement after evaluation follow-up from NIBS combined with CT group.
CONCLUSIONS
Overall, NIBS combined with CT, particularly rTMS combined with CT, has both short-term and follow-up effects on improving global cognition, mainly in patients with AD. tDCS combined with CT has advantages on improving language function in AD and MCI. Future more studies need evaluate cognitive effects of NIBS combined with CT on other specific cognitive domain in patients with cognitive deterioration.
Topics: Humans; Cognitive Dysfunction; Alzheimer Disease; Transcranial Magnetic Stimulation; Transcranial Direct Current Stimulation; Cognitive Behavioral Therapy; Cognition; Combined Modality Therapy; Cognitive Training
PubMed: 38937842
DOI: 10.1186/s13195-024-01505-9 -
Behavior Therapy Jul 2024Recent publications within Contextual Behavioral Science provided a rationale for the expansion of intervention efficacy research using methods that capture idiographic...
Recent publications within Contextual Behavioral Science provided a rationale for the expansion of intervention efficacy research using methods that capture idiographic factors and processes. We conducted a systematic review of the use and quality of single-case experimental designs (SCED) within the Acceptance and Commitment Therapy (ACT) literature in adult clinical populations. The systematic review was conducted according to PRISMA guidelines and the databases CINAHL, MEDLINE, PsycINFO, PsycArticles and OpenGrey were searched for peer-reviewed articles. Further studies were sought through review of reference lists of all full text studies. Studies were assessed against What Works Clearinghouse (WWC) single-case design standards. Twenty-six studies met eligibility criteria and were conducted within research teams all implementing multiple-baseline designs. Twenty-four studies did not meet WWC standards with most failing to ensure a degree of concurrence across participants. The extent of randomisation methods was also captured. The review highlights the sparsity of SCEDs within ACT literature in clinical populations and current methodological practices. Limitations of the review and implications for future research are discussed.
Topics: Adult; Humans; Acceptance and Commitment Therapy; Research Design; Single-Case Studies as Topic
PubMed: 38937055
DOI: 10.1016/j.beth.2024.01.008 -
European Archives of Psychiatry and... Jun 2024Current psychotherapeutic treatments for OCD, while effective, have complex outcomes with mixed efficacy. Previous research has observed baseline brain activation...
Effects of cognitive behavioural therapy and exposure-response prevention on brain activation in obsessive-compulsive disorder patients: systematic review and meta-analysis.
Current psychotherapeutic treatments for OCD, while effective, have complex outcomes with mixed efficacy. Previous research has observed baseline brain activation patterns in OCD patients, elucidating some of the implications of this disorder. Observing the effects of evidence-based psychotherapeutics for OCD on brain activation (through MRI) may provide a more comprehensive outline of pathology. This systematic review and meta-analysis evaluated the effects of cognitive behavioural therapy (CBT) with exposure-response prevention (ERP) on brain activation in OCD patients. Academic databases were systematically searched, and the outcomes evaluated included changes in brain activation and symptom severity between baseline and post-treatment. Patients (n = 193) had confirmed OCD diagnosis and underwent protocolized CBT with ERP programs delivered by trained therapists. Participants in the CBT with ERP programs demonstrated significant improvements in symptom severity (Cohen's d = - 1.91). In general, CBT with ERP resulted in decreased activation post-treatment in the frontal (Cohen's d = 0.40), parietal (Cohen's d = 0.79), temporal (Cohen's d = 1.02), and occipital lobe (Cohen's d = 0.76), and cerebellum (Cohen's d = - 0.78). The findings support CBT with ERP's ability to improve brain activation abnormalities in OCD patients. By identifying regions that improved activation levels, psychotherapy programs may benefit from the addition of function-specific features that could improve treatment outcomes.
PubMed: 38935215
DOI: 10.1007/s00406-024-01852-6 -
Psychological Trauma : Theory,... Jun 2024Several primary studies examined the effectiveness of various psychotherapies in treating earthquake-related posttraumatic stress disorder (PTSD). Variations in methods,...
Systematic review of psychotherapies and meta-analysis of cognitive behavior therapy and narrative exposure therapy for treating earthquake-related posttraumatic stress disorder.
OBJECTIVE
Several primary studies examined the effectiveness of various psychotherapies in treating earthquake-related posttraumatic stress disorder (PTSD). Variations in methods, employed psychotherapy approaches, and differences across studies warrant a systematic review and meta-analysis.
METHOD
In this study, first, a systematic review of experimental studies aiming to reduce the symptoms of PTSD in the aftermath of an earthquake was carried out. Second, a meta-analysis of cognitive behavior therapy (CBT) and narrative exposure therapy (NET) was conducted.
RESULTS
Several psychological treatments were used for treating earthquake-related PTSD. However, only CBT and NET were tested in multiple studies. Meta-analysis results suggested that CBT and NET significantly reduce earthquake-related PTSD symptoms compared to control groups.
CONCLUSIONS
Results suggest that CBT and NET are promising psychological treatment options. Further research on NET and other major PTSD interventions (e.g., prolonged exposure, eye movement desensitization and reprocessing, cognitive processing therapy) is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934933
DOI: 10.1037/tra0001743 -
Life (Basel, Switzerland) Jun 2024Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart... (Review)
Review
Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart rate variability (HRV) offers insight into the functioning of the autonomic nervous system and has been identified as a predictive factor for increased cardiovascular mortality, exploring the correlation between stress and HRV is pertinent. We systematically reviewed trials where researchers investigated the effects of stress-reducing interventions on biomarkers and time-domain/frequency-domain parameters of HRV in CVD. Eligible studies underwent meta-analysis utilizing a random-effects model. The meta-analysis showed overall beneficial effects of stress-reducing interventions on HRV for the standard deviation of Normal-to-Normal intervals (SDNN) in short-term and 24 h assessments, as well as for the low-frequency power (LF) in short-term assessment. Overall effect sizes were notably high and showed significant -values (short-term SDNN: MD = 6.43, = 0.01; 24 h SDNN: MD = 10.92, = 0.004; short-term LF: MD = 160.11, < 0.001). Our findings highlight the significant impact of stress-reducing interventions in modulating HRV by influencing short-term SDNN and LF parameters, as well as the 24 h assessment of SDNN. These results emphasize the importance of stress-reducing measures in lowering the risk of further progression in CVD and improving patient outcomes.
PubMed: 38929732
DOI: 10.3390/life14060749