A narrative review of binge eating disorder in adolescence: prevalence, impact, and psychological treatment strategies

Binge eating disorder (BED) represents one of the most problematic clinical conditions among youths. Research has shown that the developmental stage of adolescence is a critical stage for the onset of eating disorders (EDs), with a peak prevalence of BED at the age of 16–17 years. Several studies among adults with BED have underlined that it is associated with a broad spectrum of negative consequences, including higher concern about shape and weight, difficulties in social functioning, and emotional-behavioral problems. This review aimed to examine studies focused on the prevalence of BED in the adolescent population, its impact in terms of physical, social, and psychological outcomes, and possible strategies of psychological intervention. The review of the international literature was made on paper material and electronic databases ProQuest, PsycArticles, and PsycInfo, and the Scopus index were used to verify the scientific relevance of the papers. Epidemiological research that examined the prevalence of BED in adolescent samples in accordance with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition showed a prevalence ranging from 1% to 4%. More recently, only a few studies have investigated the prevalence of BED, in accordance with the Diagnostic and Statistical Manual of Disorders, Fifth Edition criteria, reporting a prevalence of ~1%–5%. Studies that focused on the possible impact that BED may have on physical, psychological, and social functioning showed that adolescents with BED have an increased risk of developing various adverse consequences, including obesity, social problems, substance use, suicidality, and other psychological difficulties, especially in the internalizing area. Despite the evidence, to date, reviews on possible and effective psychological treatment for BED among the young population are rare and focused primarily on adolescent females

Models of collaboration between psychologist and family doctor: a systematic review of primary care psychology

open2noThe prevalence of psychological suffering is greater than the actual request for clinical consultation in Europe (Alonso et al., 2004). In Italy, no more than 5.5% of the population requested psychological assistance during lifetime (Miglioretti et al., 2008). There are different obstacles that prevent the access to mental health services, such as economic restrictions (Mulder et al., 2011), cultural prejudice (Kim et al., 2010), and lack of knowledge about the service providers that can answer to the patient’s psychological needs (Molinari et al., 2012). Therefore, the psychologist is often consulted as a last resort, only after everything else has failed, when problems have become severe, and thus requiring longer, more intensive, and expensive treatments. The introduction of the Primary Care Psychologist, a professional who works together with the family doctor, allows to overcome the above-mentioned problems and intercept unexpressed needs for psychological assistance. This professional role is operating in many countries since several years. In this study, current literature concerning different models of collaboration between physician and psychologist, in Europe and in Italy, was reviewed. A systematic search of Web of Science (ISI), Pubmed, Scopus, and PsychINFO was conducted using the initial search terms Primary Care Psychologist, Family Doctor, Primary Care, Collaborative Practice, and several relevant papers were identified. The review has shown the improved quality of care when mental health care is integrated into primary. Analyzing how different programs are implemented, results indicated that the more efficacious models of Primary Care Psychology are those tailored on the environment’s needs.The results of our systematic review stress the importance of the Primary Care Psychologist implementation also in Italy, to intercept unexpressed psychological needs and enhance clients’ quality of life.openFrancesca, Bianco; Enrico, BenelliBianco, Francesca; Benelli, Enric

Spectators’ aesthetic experiences of sound and movement in dance performance

In this paper we present a study of spectators’ aesthetic experiences of sound and movement in live dance performance. A multidisciplinary team comprising a choreographer, neuroscientists and qualitative researchers investigated the effects of different sound scores on dance spectators. What would be the impact of auditory stimulation on kinesthetic experience and/or aesthetic appreciation of the dance? What would be the effect of removing music altogether, so that spectators watched dance while hearing only the performers’ breathing and footfalls? We investigated audience experience through qualitative research, using post-performance focus groups, while a separately conducted functional brain imaging (fMRI) study measured the synchrony in brain activity across spectators when they watched dance with sound or breathing only. When audiences watched dance accompanied by music the fMRI data revealed evidence of greater intersubject synchronisation in a brain region consistent with complex auditory processing. The audience research found that some spectators derived pleasure from finding convergences between two complex stimuli (dance and music). The removal of music and the resulting audibility of the performers’ breathing had a significant impact on spectators’ aesthetic experience. The fMRI analysis showed increased synchronisation among observers, suggesting greater influence of the body when interpreting the dance stimuli. The audience research found evidence of similar corporeally focused experience. The paper discusses possible connections between the findings of our different approaches, and considers the implications of this study for interdisciplinary research collaborations between arts and sciences

Psychosocial interventions for patients with head and neck cancer.

BACKGROUND: A diagnosis of head and neck cancer, like many other cancers, can lead to significant psychosocial distress. Patients with head and neck cancer can have very specific needs, due to both the location of their disease and the impact of treatment, which can interfere with basic day-to-day activities such as eating, speaking and breathing. There is a lack of clarity on the effectiveness of the interventions developed to address the psychosocial distress experienced by patients living with head and neck cancer. OBJECTIVES: To assess the effectiveness of psychosocial interventions to improve quality of life and psychosocial well-being for patients with head and neck cancer. SEARCH METHODS: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 17 December 2012. SELECTION CRITERIA: We selected randomised controlled trials and quasi-randomised controlled trials of psychosocial interventions for adults with head and neck cancer. For trials to be included the psychosocial intervention had to involve a supportive relationship between a trained helper and individuals diagnosed with head and neck cancer. Outcomes had to be assessed using a validated quality of life or psychological distress measure, or both. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, extracted data and assessed the risk of bias, with mediation from a third author where required. Where possible, we extracted outcome measures for combining in meta-analyses. We compared continuous outcomes using either mean differences (MD) or standardised mean differences (SMD) and 95% confidence intervals (CI), with a random-effects model. We conducted meta-analyses for the primary outcome measure of quality of life and secondary outcome measures of psychological distress, including anxiety and depression. We subjected the remaining outcome measures (self esteem, coping, adjustment to cancer, body image) to a narrative synthesis, due to the limited number of studies evaluating these specific outcomes and the wide divergence of assessment tools used. MAIN RESULTS: Seven trials, totaling 542 participants, met the eligibility criteria. Studies varied widely on risk of bias, interventions used and outcome measures reported. From these studies, there was no evidence to suggest that psychosocial intervention promotes global quality of life for patients with head and neck cancer at end of intervention (MD 1.23, 95% CI -5.82 to 8.27) as measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). This quality of life tool includes five functional scales, namely cognitive, physical, emotional, social and role. There was no evidence to demonstrate that psychosocial intervention provides an immediate or medium-term improvement on any of these five functional scales. From the data available, there was no significant change in levels of anxiety (SMD -0.09, 95% CI -0.40 to 0.23) or depression following intervention (SMD -0.03, 95% CI -0.24 to 0.19). At present, there is insufficient evidence to refute or support the effectiveness of psychosocial intervention for patients with head and neck cancer. AUTHORS' CONCLUSIONS: The evidence for psychosocial intervention is limited by the small number of studies, methodological shortcomings such as lack of power, difficulties with comparability between types of interventions and a wide divergence in outcome measures used. Future research should be targeted at patients who screen positive for distress and use validated outcome measures, such as the EORTC scale, as a measure of quality of life. These studies should implement interventions that are theoretically derived. Other shortcomings should be addressed in future studies, including using power calculations that may encourage multi-centred collaboration to ensure adequate sample sizes are recruited

Preventing disease and saving resources:the potential contribution of increasing breastfeeding rates in the UK

Two challenges stand out as we contemplate the future of health services in the United Kingdom. The first is the state of the public finances and therefore the pressure in real terms on health services funding. The second is the recurring and vexing problem of health inequalities. The state of health inequalities in Britain has been commented on by many, but we have seen precious little real change in the disproportionate burden of early death and illness among the most disadvantaged and indeed across the whole health gradient in recent years.This work was funded by UNICEF UK

Annotating patient clinical records with syntactic chunks and named entities: the Harvey corpus

The free text notes typed by physicians during patient consultations contain valuable information for the study of disease and treatment. These notes are difficult to process by existing natural language analysis tools since they are highly telegraphic (omitting many words), and contain many spelling mistakes, inconsistencies in punctuation, and non-standard word order. To support information extraction and classification tasks over such text, we describe a de-identified corpus of free text notes, a shallow syntactic and named entity annotation scheme for this kind of text, and an approach to training domain specialists with no linguistic background to annotate the text. Finally, we present a statistical chunking system for such clinical text with a stable learning rate and good accuracy, indicating that the manual annotation is consistent and that the annotation scheme is tractable for machine learning

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy