Standard and Innovative Strategies in Cognitive Behavior Therapy

Cognitive-behavioral therapy (CBT) is the fastest growing and the best empirically validated psychotherapeutic approach. Written by international experts, this book intends to bring CBT to as many mental health professionals as possible. Section 1 introduces basic and conceptual aspects. The reader is informed on how to assess and restructure cognitions, focusing on automatic thoughts and underlying assumptions as well as the main techniques developed to modify core beliefs. Section 2 of this book covers the cognitive therapy of some important psychiatric disorders, providing reviews of the recent developments of CBT for depression, bipolar disorder and obsessive-compulsive disorder. It also provides the latest advances in the CBT for somatoform disorders as well as a new learning model of body dysmorphic disorder. Two chapters on addiction close this book, providing a thorough review of the recent phenomenon of Internet addiction and its treatment, concluding with the CBT for substance abuse

Gender differences in core symptomatology in autism spectrum disorders across the lifespan

A preponderance of males with autism spectrum disorders (ASD) has been evident since the initial writings on the topic. This male predominance has consistently emerged in all ASD research to date in epidemiological as well as clinical populations. Despite this long recognized gender disparity in ASD, surprisingly there is a paucity of research addressing gender as it relates to core ASD symptom presentation. Gender differences may manifest with regard to symptom domains, severity, breadth, and so forth. The present research examined gender differences in ASD symptomatology in three populations: infants and toddlers at risk for developmental disability, children and adolescents, and adults with intellectual disability (ID). No significant gender differences in ASD symptoms were found in the infant/toddler or child/adolescent populations. In the adult population, in participants with ID alone, females had higher endorsements of social (i.e., participation in social games, sports, and activities; interest in other’s side of the conversation; and imitation) and communication (i.e., interest in other\u27s side of the conversation and reading body language) impairments compared to males. This study has considerable implications in both the clinical and research realms regarding identification and intervention issues for females with ASD, as well as stimulating a future research agenda in this area

Case Retrieval Nets as a Model for Building Flexible Information Systems

Im Rahmen dieser Arbeit wird das Modell der Case Retrieval Netze vorgestellt, das ein Speichermodell für die Phase des Retrievals beim fallbasierten Schliessen darstellt. Dieses Modell lehnt sich an Assoziativspeicher an, insbesondere wird das Retrieval als Rekonstruktion des Falles betrachtet anstatt als eine Suche im traditionellen Sinne. Zwei der wesentlichen Vorteile des Modells sind Effizienz und Flexibilität: Effizienz beschreibt dabei die Fähigkeit, mit grossen Fallbasen umzugehen und dennoch schnell ein Resultat des Retrievals liefern zu können. Im Rahmen dieser Arbeit wird dieser Aspekt formal untersucht, das Hauptaugenmerk ist aber eher pragmatisch motiviert insofern als der Retrieval-Prozess so schnell sein sollte, dass der Benutzer möglichst keine Wartezeiten in Kauf nehmen muss. Flexibilität betrifft andererseits die allgemeine Anwendbarkeit des Modells in Bezug auf veränderte Aufgabenstellungen, auf alternative Formen der Fallrepräsentation usw. Hierfür wird das Konzept der Informationsvervollständigung diskutiert, welches insbesondere für die Beschreibung von interaktiven Entscheidungsunterstützungssystemen geeignet ist. Traditionelle Problemlöseverfahren, wie etwa Klassifikation oder Diagnose, können als Spezialfälle von Informationsvervollständigung aufgefasst werden. Das formale Modell der Case Retrieval Netze wird im Detail erläutert und dessen Eigenschaften untersucht. Anschliessend werden einige möglich Erweiterungen beschrieben. Neben diesen theoretischen Aspekten bilden Anwendungen, die mit Hilfe des Case Retrieval Netz Modells erstellt wurden, einen weiteren Schwerpunkt. Diese lassen sich in zwei grosse Richtungen einordnen: intelligente Verkaufsunterstützung für Zwecke des E-Commerce sowie Wissensmanagement auf Basis textueller Dokumente, wobei für letzteres der Aspekt der Wiederbenutzung von Problemlösewissen essentiell ist. Für jedes dieser Gebiete wird eine Anwendung im Detail beschrieben, weitere dienen der Illustration und werden nur kurz erläutert. Zuvor wird allgemein beschrieben, welche Aspekte bei Entwurf und Implementierung eines Informationssystems zu beachten sind, welches das Modell der Case Retrieval Netze nutzt.In this thesis, a specific memory structure is presented that has been developed for the retrieval task in Case-Based Reasoning systems, namely Case Retrieval Nets (CRNs). This model borrows from associative memories in that it suggests to interpret case retrieval as a process of re-constructing a stored case rather than searching for it in the traditional sense. Tow major advantages of this model are efficiency and flexibility: Efficiency, on the one hand, is concerned with the ability to handle large case bases and still deliver retrieval results reasonably fast. In this thesis, a formal investigation of efficiency is included but the main focus is set on a more pragmatic view in the sense that retrieval should, in the ideal case, be fast enough such that for the users of a related system no delay will be noticeable. Flexibility, on the other hand, is related to the general applicability of a case memory depending on the type of task to perform, the representation of cases etc. For this, the concept of information completion is discussed which allows to capture the interactive nature of problem solving methods in particular when they are applied within a decision support system environment. As discussed, information completion, thus, covers more specific problem solving types, such as classification and diagnosis. The formal model of CRNs is presented in detail and its properties are investigated. After that, some possible extensions are described. Besides these more theoretical aspects, a further focus is set on applications that have been developed on the basis of the CRN model. Roughly speaking, two areas of applications can be recognized: electronic commerce applications for which Case-Based Reasoning may provide intelligent sales support, and knowledge management based on textual documents where the reuse of problem solving knowledge plays a crucial role. For each of these areas, a single application is described in full detail and further case studies are listed for illustration purposes. Prior to the details of the applications, a more general framework is presented describing the general design and implementation of an information system that makes uses of the model of CRNs

Textbook of Psychiatry First Edition, Draft 2

This multi-authored collaborative textbook on psychiatry, originally created on Wikibooks, discusses a range of psychiatric disorders, including psychotic, mood and and anxiety disorders, amongst many others. It covers other aspects of psychiatric care such as diagnosis, neurobiology, psychopharmacology, treatment methods, and dealing with agitated or violent patients

Social cognition in South African children with Fetal Alcohol Spectrum Disorders

Research on the social-cognitive profile of individuals with prenatal alcohol exposure (PAE) has confirmed poorer social skills in these children compared to healthy controls, independent of overall cognitive functioning. However, although children with fetal alcohol spectrum disorders (FASD) are known to have deficits in social-cognitive function, very little is known about the mechanisms underlying these impairments. I investigated social cognition in children with FASD by assessing Theory of Mind and emotion recognition ability as potential determinants of impaired social cognition, behaviourally and using neuroimaging. Study I showed that children aged 9-11 years (N =63) with fetal alcohol syndrome (FAS) and partial FAS performed more poorly on the Reading the Mind in the Eyes test, after controlling for IQ and executive function, suggesting difficulty in inferring people's mental states. Study II investigated the ability of 9-12 year old children (N = 88) to read people's facial emotions because this more basic level of social cue processing was considered a possible precursor to the impairments seen in Study I. An affective appraisal and working memory (WM) task (1- back and 2-back) was administered. Groups performed well on the 1-back, indicating ability to meet WM demands of the affective appraisal task. No behavioural group differences were shown on the affective appraisal task, which confirmed the suitability of this task to identify possible differences in neuronal activation, which I investigated in Study III. Analyses of these fMRI data on 64 children aged 9 -14 years showed that participants performed well on the relatively simple affective appraisal task. However, greater cortical activation was shown in exposed children when processing positive but less when processing negative facial expressions. These data demonstrate that heavy PAE alters activation within a cortical affective processing network. Because we know that children with FASD have alcohol-related social-cognitive impairments (Study I), differences in cortical activation may suggest that when children with FASD need to appraise affect in more challenging contexts, as in dynamic social interactions, they are likely to have greater difficulties. These data are consistent with two ideas: a) that alcohol-exposed children have difficulty appraising negative emotions and b) that difficulty contributes to the clinically described trouble these children have in "reading" facial social cues. If this is true, then an intervention program that improves the ability of these children to appraise negative emotions will likely (a) improve their ability to correctly interpret the context of their social interactions; (b) contribute to developing mental representations of an appropriate reaction to a given situation and (c) positively affect the various evaluation processes during social information processing, which in turn are imperative to social -cognitive functioning

Avoidant Personality Disorder and Social Phobia: Identification of Clinically Meaningful Differences

Background: Both avoidant personality disorder (AVPD) and social phobia (SP) feature social fears that lead to avoidant behaviour, distress and disability. The “severity continuum hypothesis” proposes that AVPD is essentially a more severe variant of SP, but a small number of studies posit the contrary, and clinical experience suggests that AVPD is a distinct disorder. Thus far AVPD is vastly under-researched compared to SP and this thesis targets this gap and investigates the extent to which AVPD is a distinct entity from SP. Methods: A literature review of the evidence for and against the severity continuum hypothesis identified factors that may differentiate AVPD and SP, in particular attachment style. Epidemiological data was interrogated to determine the prevalence and demographic correlates of AVPD with and without SP. Prospectively recruited participants were assigned to SP-only, AVPD-only or SP+AVPD groups and compared across variables of syndromic, aetiological and therapeutic interest for AVPD. A qualitative study was conducted to characterise the core lived experience features of AVPD, further informing development of a brief clinical screening measure. Results: Australian community epidemiological data confirmed international findings of a predominance of AVPD without SP. In both epidemiological and recruited samples the comorbid group separated from SP-only in the direction of greater severity, whereas AVPD-only showed a more variable relationship. Analysis of qualitative data suggested that greater emphasis would be warranted on the perceived catastrophic meaning of rejection and sense of self, and delineated cognitive-behavioural patterns worthy of further study. The brief, easily scored screening measure offers promise for use in clinical settings. Conclusions: Support is found for an alternative to the continuum hypothesis. In this, SP and AVPD share a focus on interpersonal concerns but are sufficiently distinct to justify retaining separate diagnostic categories. The brief screening tool and findings from the qualitative study add considerably to knowledge of AVPD and the insights from this thesis are likely to be of significance, informing our approach to establishing and maintaining a therapeutic alliance with this very difficult to engage patient population

Do informal caregivers of people with dementia mirror the cognitive deficits of their demented patients?:A pilot study

Recent research suggests that informal caregivers of people with dementia (ICs) experience more cognitive deficits than noncaregivers. The reason for this is not yet clear. Objective: to test the hypothesis that ICs ‘mirror' the cognitive deficits of the demented people they care for. Participants and methods: 105 adult ICs were asked to complete three neuropsychological tests: letter fluency, category fluency, and the logical memory test from the WMS-III. The ICs were grouped according to the diagnosis of their demented patients. One-sample ttests were conducted to investigate if the standardized mean scores (t-scores) of the ICs were different from normative data. A Bonferroni correction was used to correct for multiple comparisons. Results: 82 ICs cared for people with Alzheimer's dementia and 23 ICs cared for people with vascular dementia. Mean letter fluency score of the ICs of people with Alzheimer's dementia was significantly lower than the normative mean letter fluency score, p = .002. The other tests yielded no significant results. Conclusion: our data shows that ICs of Alzheimer patients have cognitive deficits on the letter fluency test. This test primarily measures executive functioning and it has been found to be sensitive to mild cognitive impairment in recent research. Our data tentatively suggests that ICs who care for Alzheimer patients also show signs of cognitive impairment but that it is too early to tell if this is cause for concern or not

Cardiac Arrhythmias

The most intimate mechanisms of cardiac arrhythmias are still quite unknown to scientists. Genetic studies on ionic alterations, the electrocardiographic features of cardiac rhythm and an arsenal of diagnostic tests have done more in the last five years than in all the history of cardiology. Similarly, therapy to prevent or cure such diseases is growing rapidly day by day. In this book the reader will be able to see with brighter light some of these intimate mechanisms of production, as well as cutting-edge therapies to date. Genetic studies, electrophysiological and electrocardiographyc features, ion channel alterations, heart diseases still unknown , and even the relationship between the psychic sphere and the heart have been exposed in this book. It deserves to be read

Genomic imprinting and disorders of the social brain; shades of grey rather than black and white

Crespi & Badcock (C&B) provide a novel hypothesis outlining a role for imprinted genes in mediating brain functions underlying social behaviours. The basic premise is that maternally expressed genes are predicted to promote hypermentalistic behaviours, and paternally expressed genes hypomentalistic behaviours. The authors provide a detailed overview of data supporting their ideas, but as we discuss, caution should be applied in interpreting these data