Browsing by Subject "Cognitive Behavioral Therapy"

Now showing 1 - 5 of 5
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    Effect of menopausal symptom treatment options on palpitations: a systematic review
    (Taylor & Francis, 2022) Sheng, Y.; Carpenter, J. S.; Elomba, C. D.; Alwine, J. S.; Yue, M.; Chen, C. X.; Tisdale, J. E.; School of Nursing
    This systematic review provides an overview of the effects of menopausal symptom treatment options on palpitations, defined as feelings of missed or exaggerated heart beats, reported by perimenopausal and postmenopausal women. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searches were conducted in PubMed, CINAHL and PsycINFO to identify articles meeting pre-specified inclusion criteria. Of 670 unique articles identified, 37 were included in the review. Treatments included drug therapies and non-drug therapies. Palpitations were studied as an outcome in 89% of articles and as an adverse effect in 11%. Articles provided mostly level II/III evidence due to their design and/or small sample sizes. Based on available evidence, no therapies can be fully recommended for clinical practice. Only some hormonal agents (e.g. estradiol) can be recommended with caution based on some positive evidence for reducing palpitation prevalence or severity. However, other drug therapies (e.g. moxonidine, atenolol), dietary supplementary treatments (e.g. isoflavones, Rheum rhaponticum, sage), cognitive-behavioral intervention and auricular acupressure cannot be recommended given the existing evidence. Additional well-designed randomized controlled treatment trials focusing on palpitations during the menopause transition as an inclusion criteria and outcome are needed to advance the field.
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    Identification of neural and psychophysical predictors of headache reduction after cognitive behavioral therapy in adolescents with migraine
    (Wolters Kluwer, 2021) Nahman-Averbuch, Hadas; Schneider, Victor J., II.; Chamberlin, Leigh Ann; Kroon Van Diest, Ashley M.; Peugh, James L.; Lee, Gregory R.; Radhakrishnan, Rupa; Hershey, Andrew D.; Powers, Scott W.; Coghill, Robert C.; King, Christopher D.; Radiology and Imaging Sciences, School of Medicine
    Cognitive behavioral therapy (CBT) is a psychological intervention that involves development of coping strategies to reduce the experience of pain. Although CBT is a promising intervention to reduce headache days in patients with migraine, it may not be effective for all patients. Thus, there is a need to identify markers that could predict which patients will respond to CBT. We aimed to determine whether baseline brain function and amygdalar connectivity, assessed by functional magnetic resonance imaging, or pain modulation capacities, assessed by the conditioned pain modulation (CPM) response, can predict a reduction in headache days after CBT in adolescents with migraine. Patients with migraine (n = 20; age range 10-17 years) completed 8 weekly CBT sessions. The CPM response was examined in the trapezius and the leg. Headache days significantly decreased after CBT (P < 0.001). Greater functional connectivity before CBT between the right amygdala and frontal gyrus, anterior cingulate cortex, and precentral gyrus was related to greater headache reduction after CBT. Greater reduction in headache days after CBT was related with less efficient CPM response before CBT at the trapezius (r = -0.492, P = 0.028) but not at the leg. This study found that headache reduction after CBT was related to right amygdala connectivity with frontal and sensorimotor regions at baseline as well as baseline pain modulation capacities. These findings suggest that individual differences in brain function and pain modulation can be associated with clinical improvements and help with determination of CBT responsiveness.
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    Narrative enhancement and cognitive therapy (NECT) to improve social functioning in people with serious mental illness: study protocol for a stepped-wedge cluster randomized controlled trial
    (BMC, 2021-02-08) Dubreucq, J.; Faraldo, M.; Abbes, M.; Ycart, B.; Richard-Lepouriel, H.; Favre, S.; Jermann, F.; Attal, J.; Bakri, M.; Cohen, T.; Cervello, C.; Chereau, I.; Cognard, C.; De Clercq, M.; Douasbin, A.; Giordana, J.Y.; Giraud-Baro, E.; Guillard-Bouhet, N.; Legros-Lafarge, E.; Polosan, M.; Pouchon, A.; Rolland, M.; Rainteau, N.; Roussel, C.; Wangermez, C.; Yanos, P.T.; Lysaker, P.H.; Franck, N.; Psychiatry, School of Medicine
    Background: Self-stigma is highly prevalent in serious mental illness (SMI) and is associated with poorer clinical and functional outcomes. Narrative enhancement and cognitive therapy (NECT) is a group-based intervention combining psychoeducation, cognitive restructuring and story-telling exercises to reduce self-stigma and its impact on recovery-related outcomes. Despite evidence of its effectiveness on self-stigma in schizophrenia-related disorders, it is unclear whether NECT can impact social functioning. Methods: This is a 12-centre stepped-wedge cluster randomized controlled trial of NECT effectiveness on social functioning in SMI, compared to treatment as usual. One hundred and twenty participants diagnosed with schizophrenia, bipolar disorder or borderline personality disorder will be recruited across the 12 sites. The 12 centres participating to the study will be randomized into two groups: one group (group 1) receiving the intervention at the beginning of the study (T0) and one group (group 2) being a control group for the first 6 months and receiving the intervention after (T1). Outcomes will be compared in both groups at T0 and T1, and 6-month and 12-month outcomes for groups 1 and 2 will be measured without a control group at T2 (to evaluate the stability of the effects over time). Evaluations will be conducted by assessors blind to treatment allocation. The primary outcome is personal and social performance compared across randomization groups. Secondary outcomes include self-stigma, self-esteem, wellbeing, quality of life, illness severity, depressive symptoms and personal recovery. Discussion: NECT is a promising intervention for reducing self-stigma and improving recovery-related outcomes in SMI. If shown to be effective in this trial, it is likely that NECT will be implemented in psychiatric rehabilitation services with subsequent implications for routine clinical practice.
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    Potential Benefit with Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis
    (Elsevier, 2021) Billings, Wade; Mathur, Karan; Craven, Hannah J.; Xu, Huiping; Shin, Andrea; Medicine, School of Medicine
    Background & aims: Patients with irritable bowel syndrome (IBS) may pursue complementary and alternative medicine (CAM). We conducted a comprehensive systematic review and meta-analysis examining efficacy of CAM vs. placebo or sham in adults with IBS. Methods: Publication databases were searched for randomized controlled trials of CAM therapies (herbal therapy, dietary supplements, mind-body based, body-based, and energy-healing) in adults with IBS. Data were extracted to obtain pooled estimates of mean improvement in abdominal pain (standardized mean difference [SMD]) and relative risk (RR) of overall response using random effects models. Sensitivity and subgroup analyses along with quality assessments were completed. Results: Among 2825 articles identified, 66 were included. Herbal therapy (SMD=0.47, 95% CI: 0.20 to 0.75, I2=82%) demonstrated significant benefit over placebo for abdominal pain (low confidence in estimates). Benefit with mind-body based therapy for abdominal pain was of borderline significance (SMD=0.29, 95% CI: -0.01 to 0.59, I2=78%). Herbal therapy (RR=1.57, 95% CI: 1.31 to 1.88, I2=77%), dietary supplements (RR=1.95, 95% CI: 1.02 to 3.73, I2=75%), and mind-body based therapy (RR=1.67, 95% CI: 1.13 to 2.49, I2=63%) showed benefit for overall response compared to placebo (low confidence in estimates). Body-based and energy healing therapies demonstrated no significant benefit over placebo or sham for abdominal pain or overall response. Conclusions: CAM therapies such as herbal or dietary supplements and mind-body based approaches may be beneficial for abdominal pain and overall response in IBS. However, overall quality of evidence is low. Rigorous, high quality clinical trials are warranted to investigate CAM in IBS.
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    A Practical Application Primer on Cognitive Behavioral Therapy for Insomnia for Medical Residents
    (Association of American Medical Colleges, 2019-12-13) Chernyak, Yelena; Psychiatry, School of Medicine
    Introduction: Cognitive behavioral therapy for insomnia (CBT-I) is a well-established nonpharmacological intervention that is the gold standard treatment for insomnia. CBT-I has been utilized and empirically validated in many modalities, including group treatment, telemedicine, and primary care. Despite the wealth of evidence on its effectiveness, many medical providers, including those in primary care, where most insomnia complaints are raised, have limited exposure, knowledge, and resources to direct or implement this intervention. Methods: Medical educators from an academic medical center developed a module focused on teaching medical residents the techniques of CBT-I. The educational activity was an interactive 90-minute seminar that included a lecture followed by a case presentation illustrating the application of medical knowledge. A postseminar survey was used to evaluate the topic and content of the seminar. Results: In a survey of 32 primary care and psychiatry residents and sleep medicine fellows, 97% of respondents indicated that the topic of CBT-I should be included in the seminar series, and 84% indicated that the topic was of interest to them. Qualitative feedback underscored the relevance of this topic to trainees' clinical practice, as well as its underratedness. Discussion: The seminar on CBT-I was well received and viewed as a valuable tool in practicing medicine. The slides and vignettes provided enable replication of this workshop in other settings with medical learners who have a cursory knowledge of sleep medicine. The workshop is applicable to other health professionals, including medical students, nurses, social workers, and psychology trainees.