31 research outputs found
Behavior therapy for pediatric trichotillomania: Exploring the effects of age on treatment outcome
<p>Abstract</p> <p>Background</p> <p>A randomized controlled trial examining the efficacy of behavior therapy for pediatric trichotillomania was recently completed with 24 participants ranging in age from 7 - 17. The broad age range raised a question about whether young children, older children, and adolescents would respond similarly to intervention. In particular, it is unclear whether the younger children have the cognitive capacity to understand concepts like "urges" and whether they are able to introspect enough to be able to benefit from awareness training, which is a key aspect of behavior therapy for trichotillomania.</p> <p>Methods</p> <p>Participants were randomly assigned to receive either behavior therapy (N = 12) or minimal attention control (N = 12), which was included to control for repeated assessments and the passage of time. Primary outcome measures were the independent evaluator-rated NIMH-Trichotillomania Severity Scale, a semi-structured interview often used in trichotillomania treatment trials, and a post-treatment clinical global impression improvement rating (CGI-I).</p> <p>Results</p> <p>The correlation between age and change in symptom severity for all patients treated in the trial was small and not statistically significant. A 2 (group: behavioral therapy, minimal attention control) × 2 (time: week 0, 8) × 2 (children < 9 yrs., children > 10) ANOVA with independent evaluator-rated symptom severity scores as the continuous dependent variable also detected no main effects for age or for any interactions involving age. In light of the small sample size, the mean symptom severity scores at weeks 0 and 8 for younger and older patients randomized to behavioral therapy were also plotted. Visual inspection of these data indicated that although the groups appeared to have started at similar levels of severity for children ≤ 9 vs. children ≥ 10; the week 8 data show that the three younger children did at least as well as if not slightly better than the nine older children and adolescents.</p> <p>Conclusions</p> <p>Behavior therapy for pediatric trichotillomania appears to be efficacious even in young children. The developmental and clinical implications of these findings will be discussed.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov NCT00043563.</p
The developmental effects of media-ideal internalization and self-objectification processes on adolescents’ negative body-feelings, dietary restraint, and binge eating
Despite accumulated experimental evidence of the negative effects of exposure to media-idealized images, the degree to which body image, and eating related disturbances are caused by media portrayals of gendered beauty ideals remains controversial. On the basis of the most up-to-date meta-analysis of experimental studies indicating that media-idealized images have the most harmful and substantial impact on vulnerable individuals regardless of gender (i.e., “internalizers” and “self-objectifiers”), the current longitudinal study examined the direct and mediated links posited in objectification theory among media-ideal internalization, self-objectification, shame and anxiety surrounding the body and appearance, dietary restraint, and binge eating. Data collected from 685 adolescents aged between 14 and 15 at baseline (47 % males), who were interviewed and completed standardized measures annually over a 3-year period, were analyzed using a structural equation modeling approach. Results indicated that media-ideal internalization predicted later thinking and scrutinizing of one’s body from an external observer’s standpoint (or self-objectification), which then predicted later negative emotional experiences related to one’s body and appearance. In turn, these negative emotional experiences predicted subsequent dietary restraint and binge eating, and each of these core features of eating disorders influenced each other. Differences in the strength of these associations across gender were not observed, and all indirect effects were significant. The study provides valuable information about how the cultural values embodied by gendered beauty ideals negatively influence adolescents’ feelings, thoughts and behaviors regarding their own body, and on the complex processes involved in disordered eating. Practical implications are discussed
Defining the Differences Between Episodic Migraine and Chronic Migraine
Chronic migraine (CM) and episodic migraine (EM) are part of the spectrum of migraine disorders, but they are distinct clinical entities. Population-based studies have shown that those with CM demonstrate higher individual and societal burden because they are significantly more disabled than those with EM and have greater impaired quality of life both inside and outside the home. Proper diagnosis of both conditions requires clearly defined clinical criteria. Diagnosis enables the initiation of appropriate treatments and risk-factor modification, which ultimately improve functional status and quality of life for persons with migraine. Recognizing that both disorders are on the spectrum of migraine, this review serves as a guide to define the disease state of CM as distinct from EM in terms of clinical, epidemiological, sociodemographic, and comorbidity profiles
Fortnightly changes in water transport direction across the mouth of a narrow estuary
This research investigates the dynamics of the axial
tidal flow and residual circulation at the lower Guadiana
Estuary, south Portugal, a narrow mesotidal estuary with low
freshwater inputs. Current data were collected near the deepest
part of the channel for 21 months and across the channel
during two (spring and neap) tidal cycles. Results indicate
that at the deep channel, depth-averaged currents are stronger
and longer during the ebb at spring and during the flood at
neap, resulting in opposite water transport directions at a
fortnightly time scale. The net water transport across the entire
channel is up-estuary at spring and down-estuary at neap, i.e.,
opposite to the one at the deep channel. At spring tide, when
the estuary is considered to be well mixed, the observed
pattern of circulation (outflow in the deep channel, inflow
over the shoals) results from the combination of the Stokes
transport and compensating return flow, which varies laterally
with the bathymetry. At neap tide (in particular for those of
lowest amplitude each month), inflows at the deep channel are
consistently associated with the development of gravitational
circulation. Comparisons with previous studies suggest that
the baroclinic pressure gradient (rather than internal tidal
asymmetries) is the main driver of the residual water transport.
Our observations also indicate that the flushing out of the
water accumulated up-estuary (at spring) may also produce
strong unidirectional barotropic outflow across the entire
channel around neap tide.info:eu-repo/semantics/publishedVersio
Managing Cancer And Living Meaningfully: study protocol for a randomized controlled trial
Circulation and suspended sediment dynamics in a tropical estuary under different morphological setting
Antibiotic prophylaxis for surgical site infections as a risk factor for infection with Clostridium difficile
The adhesion properties of natural rubber pressure-sensitive adhesives using palm kernel oil-based alkyd resins as a tackifier
Process contribution to the time-varying residual circulation in tidally dominated estuarine environments
In tide dominated environments residual circulation is the comparatively weak net flow in addition to the oscillatory tidal current. Understanding the 3D structure of this circulation is of importance for coastal management as it impacts the net (longer-term and event-scale) transport of suspended particles and the advection of tracer quantities. The Dee Estuary, northwest Britain, is used to understand which physical processes have an important contribution to the time-varying residual circulation. Model simulations are used to extract the time-varying contributions of tidal, riverine (baroclinicity and discharge), meteorological, external and wave processes, along with their interactions. Under hypertidal conditions strong semi-diurnal interaction within the residual makes it difficult to clearly see the affect of a process without filtering. An approach to separate the residual into the isolated process contribution and the contribution due to interaction is described. Applying this method to two hypertidal estuarine channels, one tide-dominant and one baroclinic-dominant, reveals that process interaction can be as important as the sub-tidal residual process contributions themselves. The time-variation of the residual circulation highlights the impact of different physical process components at the event-scale of tidal conditions (neap and spring cycles) and offshore storms (wind, wave and surge influence). This gives insight into short-term deviation from the typical estuarine residual. Both channels are found to react differently to the same local conditions, with different short-term change in process dominance during events of high and low energy