Evaluating Outcomes And Response Profiles Of A Psychological Treatment For People With Chronic Pain

Chronic pain is a leading cause of suffering, disability, and high health care costs. Traditional treatment approaches such as medical or cognitive-behavioral interventions have produced variable and often limited results. Research has suggested that increased rates of stressful life events, emotional disorders, and emotion regulation deficits contribute to the development and maintenance of chronic pain problems that lack clear, peripheral, biological causes. This study examined the effectiveness of an innovative, emotion-focused treatment that directly targets patients\u27 unresolved stress and emotional avoidance and sought to identify predictors of treatment outcome. Additionally, this study explored the effects of a novel, emotional assessment on treatment outcome by randomizing half of the participants to complete this assessment prior to treatment. To be included in the study, patients reported chronic pain for at least 3 months duration that had substantial psychological factors that contributed to the pain. Forty-six patients participated (76% women and 91% Caucasian). Pain, pain-related disability, depression, general emotional distress, and satisfaction with life were assessed at baseline, post-treatment, and a 3-month follow-up. Stressful life events and emotion regulation ability were also assessed at baseline. The 4-session group treatment uses readings, writing about emotions, meditation, and other techniques to help people identify, understand, and verbalize emotions related to stressful life events or emotional conflict. Results indicated significant improvements for pain, pain-related disability and acceptance, depression, general emotional distress, and satisfaction with life. Effect sizes were generally medium or large and reliable change analyses indicated that approximately half of the patients showed at least a moderate effect across all the outcome domains. Increased levels of baseline depression and stress generally predicted improved treatment outcomes, whereas poorer baseline emotion regulation predicted inconsistent results. The baseline emotional assessment had no significant effect on the outcome measures. This study suggests that this emotion-focused treatment led to substantial improvements in pain, pain-related functioning, and emotional symptoms. Further research should seek to clarify the predictors of treatment outcome and the process by which it works

Evaluating the Concurrent Validity of Three Web-based IQ Tests and the Reynolds Intellectual Assessment Scales (RIAS)

In a double-blind study, 60 General Psychology students, selected in low, average, and high ACT ranges, were administered the Reynolds Intellectual Assessment Scales (RIAS). On a separate occasion, the students also completed web-based internet IQ tests from tickle.com, queendom.com, and iqtest.com. MANOVA results showed that ACT level had a significant effect on all four IQ scores combined (Wilk’s Lambda = .451,

Effectiveness of cognitive remediation in depression:a meta-analysis

Background Preliminary evidence suggests beneficial effects of cognitive remediation in depression. An update of the current evidence is needed. The aim was to systematically assess the effectiveness of cognitive remediation in depression on three outcomes. Methods The meta-analysis was pre-registered on PROSPERO (CRD42019124316). PubMed, PsycINFO, Embase and Cochrane Library were searched on 2 February 2019 and 8 November 2020 for peer-reviewed published articles. We included randomized and non-randomized clinical trials comparing cognitive remediation to control conditions in adults with primary depression. Random-effects models were used to calculate Hedges' g, and moderators were assessed using mixed-effects subgroup analyses and meta-regression. Main outcome categories were post-treatment depressive symptomatology (DS), cognitive functioning (CF) and daily functioning (DF). Results We identified 5221 records and included 21 studies reporting on 24 comparisons, with 438 depressed patients receiving cognitive remediation and 540 patients in a control condition. We found a small effect on DS (g = 0.28, 95% CI 0.09-0.46, I2 40%), a medium effect on CF (g = 0.60, 95% CI 0.37-0.83, I2 44%) and a small effect on DF (g = 0.22, 95% CI 0.06-0.39, I2 3%). There were no significant effects at follow-up. Confounding bias analyses indicated possible overestimation of the DS and DF effects in the original studies. Conclusions Cognitive remediation in depression improves CF in the short term. The effects on DS and DF may have been overestimated. Baseline depressive symptom severity should be considered when administering cognitive remediation

Augmenting neurocognitive remediation therapy to Preventive Cognitive Therapy for partially remitted depressed patients:protocol of a pragmatic multicentre randomised controlled trial

Introduction Major depressive disorder (MDD) affects 163 million people globally every year. Individuals who experience subsyndromal depressive symptoms during remission (ie, partial remission of MDD) are especially at risk for a return to a depressive episode within an average of 4 months. Simultaneously, partial remission of MDD is associated with work and (psycho)social impairment and a lower quality of life. Brief psychological interventions such as preventive cognitive therapy (PCT) can reduce depressive symptoms or relapse for patients in partial remission, although achieving full remission with treatment is still a clinical challenge. Treatment might be more effective if cognitive functioning of patients is targeted as well since cognitive problems are the most persisting symptom in partial remission and predict poor treatment response and worse functioning. Studies show that cognitive functioning of patients with (remitted) MDD can be improved by online neurocognitive remediation therapy (oNCRT). Augmenting oNCRT to PCT might improve treatment effects for these patients by strengthening their cognitive functioning alongside a psychological intervention. Methods and analysis This study will examine the effectiveness of augmenting oNCRT to PCT in a pragmatic national multicentre superiority randomised controlled trial. We will include 115 adults partially remitted from MDD with subsyndromal depressive symptoms defined as a Hamilton Depression Rating Scale score between 8 and 15. Participants will be randomly allocated to PCT with oNCRT, or PCT only. Primary outcome measure is the effect on depressive symptomatology over 1 year. Secondary outcomes include time to relapse, cognitive functioning, quality of life and healthcare costs. This first dual approach study of augmenting oNCRT to PCT might facilitate full remission in partially remitted individuals as well as prevent relapse over time. Ethics and dissemination Ethical approval was obtained by Academic Medical Center, Amsterdam. Outcomes will be made publicly available

Exploring Glucose Dysregulation in Migraine: Insights from Continuous Glucose Monitoring

Despite being associated with hypoglycemia for nearly a century, a definitive relationship between migraines and glucose dysregulation remains elusive. Accumulating evidence suggests that migraines are in part due to a metabolic mismatch between cerebral demand and available energy. Research analyzing plasma glucose levels and migraine activity may further elucidate this interface between metabolic dysregulation and migraine pathophysiology and may potentially open avenues for therapeutic interventions targeting holistic metabolism for migraine management

Development of a Protocol for Obtaining Biological Samples for Genetic Testing from Remote Individuals

Pharmacogenomic sequencing allows individuals to learn more about how they will respond to certain medications but requires shipping of a biological sample. One complication of sending biological samples to remote laboratories is stability. Blood generally yields sufficient quantities of high-quality DNA but requires a clinic visit. Saliva and buccal swabs are routinely used for DNA extractions, but the DNA quality is notoriously low due to the presence of bacteria in the mouth. Additionally, elderly individuals have difficulty producing enough saliva for testing, and the tubes contain several milliliters of liquid and shipping requires special considerations. Dried blood spot cards, which serve as an alternative to saliva and buccal swabs, yield high-quality DNA and ship easily, but may produce a lower yield. This project aims to determine which biological sample methods can reasonably be obtained from remote individuals

Age and sex influence marmot antipredator behavior during periods of heightened risk

Animals adjust their antipredator behavior according to environmental variation in risk, and to account for their ability to respond to threats. Intrinsic factors that influence an animal’s ability to respond to predators (e.g., age, body condition) should explain variation in antipredator behavior. For example, a juvenile might allocate more time to vigilance than an adult because mortality as a result of predation is often high for this age class; however, the relationship between age/vulnerability and antipredator behavior is not always clear or as predicted. We explored the influence of intrinsic factors on yellow-bellied marmot (Marmota flaviventris) antipredator behavior using data pooled from 4 years of experiments. We hypothesized that inherently vulnerable animals (e.g., young, males, and individuals in poor condition) would exhibit more antipredator behavior prior to and immediately following conspecific alarm calls. As expected, males and yearlings suppressed foraging more than females and adults following alarm call playbacks. In contrast to predictions, animals in better condition respond more than animals in below average condition. Interestingly, these intrinsic properties did not influence baseline time budgets; animals of all ages, sexes, and condition levels devoted comparable amounts of time to foraging prior to alarm calls. Our results support the hypothesis that inherent differences in vulnerability influence antipredator behavior; furthermore, it appears that a crucial, but poorly acknowledged, interaction exists between risk and state-dependence. Elevated risk may be required to reveal the workings of state-dependent behavior, and studies of antipredator behavior in a single context may draw incomplete conclusions about age- or sex-specific strategies

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy