786 research outputs found

    Implications of therapist effects for the design and analysis of comparative studies of psychotherapies.

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    Empirically supported individual and group psychological treatments for adult mental disorders.

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    TGFβ/BMP immune signaling affects abundance and function of C. elegans gut commensals.

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    The gut microbiota contributes to host health and fitness, and imbalances in its composition are associated with pathology. However, what shapes microbiota composition is not clear, in particular the role of genetic factors. Previous work in Caenorhabditis elegans defined a characteristic worm gut microbiota significantly influenced by host genetics. The current work explores the role of central regulators of host immunity and stress resistance, employing qPCR and CFU counts to measure abundance of core microbiota taxa in mutants raised on synthetic communities of previously-isolated worm gut commensals. This revealed a bloom, specifically of Enterobacter species, in immune-compromised TGFβ/BMP mutants. Imaging of fluorescently labeled Enterobacter showed that TGFβ/BMP-exerted control operated primarily in the anterior gut and depended on multi-tissue contributions. Enterobacter commensals are common in the worm gut, contributing to infection resistance. However, disruption of TGFβ/BMP signaling turned a normally beneficial Enterobacter commensal to pathogenic. These results demonstrate specificity in gene-microbe interactions underlying gut microbial homeostasis and highlight the pathogenic potential of their disruption

    Empirically supported individual and group psychological treatments for adult mental disorders.

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    Psychoanalytic and psychodynamic therapies for depression. The evidence base.

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    David Taylor, a consultant psychotherapist at the Tavistock & Portman NHS Foundation Trust (120 Belsize Lane, London NW3 5BA, UK. Email: [email protected]), is the clinical lead of the Tavistock Adult Depression Study (a randomised controlled trial of 60 sessions of weekly psychoanalytic psychotherapy v. treatment as usual for patients with chronic, refractory depression). He is a training and supervising psychoanalyst at the Institute of Psychoanalysis. This article argues that the current approach to guideline development for the treatment of depression is not supported by the evidence: clearly depression is not a disease for which treatment efficacy is best determined by short-term randomised controlled trials. As a result, important findings have been marginalised. Different principles of evidence-gathering are described. When a wider range of the available evidence is critically considered the case for dynamic approaches to the treatment of depression can be seen to be stronger than is often thought. Broadly, the benefits of short-term psychodynamic therapies are equivalent in size to the effects of antidepressants and cognitive–behavioural therapy (CBT). The benefits of CBT may occur more quickly, but those of short-term psychodynamic therapies may continue to increase after treatment. There may be a ceiling on the effects of short-term treatments of whatever type. Longer-term psychodynamic treatments may improve associated social, work and personal dysfunctions as well as reductions in depressive symptoms

    Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

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    The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed

    Relationships between Clinician-Level Attributes and Fidelity-Consistent and Fidelity-Inconsistent Modifications to an Evidence-Based Psychotherapy

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    Background: Clinicians often modify evidence-based psychotherapies (EBPs) when delivering them in routine care settings. There has been little study of factors associated with or implications of modifications to EBP protocols. This paper differentiates between fidelity-consistent and fidelity-inconsistent modifications and it examines the potential influence of two clinician characteristics, training outcomes, and attitudes toward EBPs on fidelity-consistent and fidelity-inconsistent modifications of cognitive behavioral therapy in a sample of clinicians who had been trained to deliver these treatments for children or adults. Methods: Survey and coded interview data collected 2 years after completion of training programs in cognitive behavioral therapy were used to examine associations between successful or unsuccessful completion of training, clinician attitudes, and modifications. Modifications endorsed by clinicians were categorized as fidelity-consistent or fidelity-inconsistent and entered as outcomes into separate regression models, with training success and attitudes entered as independent variables. Results: Successful completion of a training program was associated with subsequent fidelity-inconsistent modifications but not fidelity-consistent modifications. Therapists who reported greater openness to using EBPs prior to training reported more fidelity-consistent modifications at follow-up, and those who reported greater willingness to adopt EBPs if they found them appealing were more likely to make fidelity-inconsistent modifications. Conclusions: Implications of these findings for training, implementation, EBP sustainment, and future studies are discussed. Research on contextual and protocol-related factors that may impact decisions to modify EBPs will be an important future direction of study to complement to this research

    A benchmark for microRNA quantification algorithms using the OpenArray platform

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    miRcompData R package source. The source code for the miRcompData R package, also available at: http://bioconductor.org/packages/miRcompData/ . (GZ 8765 kb
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