954 research outputs found

    Effects of a Transdiagnostic Group Treatment for Anxiety on Secondary Depression

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    Researchers have recently explored transdiagnostic anxiety treatments based on models of anxiety emphasizing a single common pathway across diagnostic categories. Results from a previous study (Norton and Hope, in press) indicated that a transdiagnostic approach was effective for both targeted and untargeted anxiety disorders. Consistent with the tripartite model, the transdiagnostic treatment should also influence symptoms of a broader pathology such as negative affectivity. This follow-up to Norton and Hope found significant decreases in depressed mood for clients undergoing transdiagnostic treatment for anxiety when compared to wait-list control participants. Although not statistically established, severity of depressive diagnoses seemed to generally decrease across treatment, whereas no change in severity occurred for those not receiving treatment

    The Pattern of Subjective Anxiety during In-session Exposures across Therapy for Clients with Social Anxiety Disorder

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    Exposure-based therapies have been considered the most efficacious treatments for social anxiety disorder (i.e., Gould et al., 1997). The majority of the theory behind exposure-based treatments rely on Foa and colleagues’s (Foa, Huppert, & Cahill, 2005; Foa & Kozak, 1986) emotional processing theory. However, there has been less research examining the way that emotional processing occurs across actual treatment sessions for clients with social anxiety disorder. This study utilized longitudinal data analytic methods to examine the changes in subjective anxiety during the first three exposure sessions in group and individual cognitive-behavioral therapy for social anxiety disorder. The results of this study provide preliminary evidence that while anxiety generally decreases across each exposure, some individuals experience considerable fluctuations in anxiety during a single exposure. Additionally, early exposures may be experienced differently than later exposures. Overall, this study highlights the importance of more fine-grained analyses to better understand the mechanisms underlying exposure-based therapy

    Effects of a Transdiagnostic Group Treatment for Anxiety on Secondary Depression

    Get PDF
    Researchers have recently explored transdiagnostic anxiety treatments based on models of anxiety emphasizing a single common pathway across diagnostic categories. Results from a previous study (Norton and Hope, in press) indicated that a transdiagnostic approach was effective for both targeted and untargeted anxiety disorders. Consistent with the tripartite model, the transdiagnostic treatment should also influence symptoms of a broader pathology such as negative affectivity. This follow-up to Norton and Hope found significant decreases in depressed mood for clients undergoing transdiagnostic treatment for anxiety when compared to wait-list control participants. Although not statistically established, severity of depressive diagnoses seemed to generally decrease across treatment, whereas no change in severity occurred for those not receiving treatment

    Working Alliance for Clients with Social Anxiety Disorder: Relationship with Session Helpfulness and Within-Session Habituation

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    It has been suggested that a strong working alliance encourages clients to take risks during therapy (Raue, Castonguay, & Goldfried, 1993). This encouragement may be important for clients who fear negative evaluations as they engage in risk-taking elements of therapy. This study examined the relationship between working alliance, session helpfulness, and measures of emotional processing in 18 clients undergoing cognitive behavior therapy (CBT) for social anxiety disorder. Results indicate a positive correlation between client-rated, but not observer-rated, working alliance and session helpfulness. Moderate levels of working alliance were associated with higher initial anxiety and deeper within-session habituation. Overall, a strong alliance was associated with clients engaging with the session and finding the session helpful. Implications for the use of CBT for social anxiety are discussed

    Being an Early-Career CMS Academic in the Context of Insecurity and ‘Excellence’: The Dialectics of Resistance and Compliance

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    Drawing on a dialectical approach to resistance, we conceptualise the latter as a multifaceted, pervasive and contradictory phenomenon. This enables us to examine the predicament in which early-career Critical Management Studies academics find themselves in the current times of academic insecurity and ‘excellence’, as gleaned through this group’s understandings of themselves as resisters and participants in the complex and contradictory forces constituting their field. We draw on 24 semi-structured interviews to map our participants’ accounts of themselves as resisters in terms of different approaches to tensions and contradictions between, on the one hand, the interviewees’ Critical Management Studies alignment and, on the other, the ethos of business school neoliberalism. Emerging from this analysis are three contingent and interlinked narratives of resistance and identity – diplomatic, combative and idealistic – each of which encapsulates a particular mode (negotiation, struggle, and laying one’s own path) of engaging with the relationship between Critical Management Studies and the business school ethos. The three narratives show how early-career Critical Management Studies academics not only use existing tensions, contradictions, overlaps and alliances between these positions to resist and comply with selected forces within each, but also contribute to the (re-)making of such overlaps, alliances, tensions and contradictions. Through this reworking of what it means to be both Critical Management Studies scholars and business school academics, we argue, early-career Critical Management Studies academics can be seen as active resisters and re-constituters of their complex field

    Stochastic modelling of African swine fever in wild boar and domestic pigs: epidemic forecasting and comparison of disease management strategies

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    African swine fever (ASF), caused by the African swine fever virus (ASFV), is highly virulent in domestic pigs and wild boar (Sus scrofa), causing up to 100% mortality. The recent epidemic of ASF in Europe has had a serious economic impact and poses a threat to global food security. Unfortunately, there is no effective treatment or vaccine against ASFV, limiting the available disease management strategies. Mathematical models allow us to further our understanding of infectious disease dynamics and evaluate the efficacy of disease management strategies. The ASF Challenge, organised by the French National Research Institute for Agriculture, Food, and the Environment, aimed to expand the development of ASF transmission models to inform policy makers in a timely manner. Here, we present the model and associated projections produced by our team during the challenge. We developed a stochastic model combining transmission between wild boar and domestic pigs, which was calibrated to synthetic data corresponding to different phases describing the epidemic progression. The model was then used to produce forward projections describing the likely temporal evolution of the epidemic under various disease management scenarios. Despite the interventions implemented, long-term projections forecasted persistence of ASFV in wild boar, and hence repeated outbreaks in domestic pigs. A key finding was that it is important to consider the timescale over which different measures are evaluated: interventions that have only limited effectiveness in the short term may yield substantial long-term benefits. Our model has several limitations, partly because it was developed in real-time. Nonetheless, it can inform understanding of the likely development of ASF epidemics and the efficacy of disease management strategies, should the virus continue its spread in Europe

    Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

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    Frequent assessment during therapy can improve treatments and provide accountability. However, clinicians often do not monitor progress because of the time it takes to administer and score assessments. In response, the Social Anxiety Session Change Index (SASCI) was developed. The SASCI is a short, easily administered rating of subjective improvement that asks clients with social anxiety disorder how much they have changed since the beginning of therapy. Change on the SASCI was related to change in fear of negative evaluation, a core aspect of social anxiety, and to clinician-rated improvement, but not to ratings of anxiety sensitivity or depression. Because it is brief and easily interpretable, the SASCI can be used in a variety of clinical settings to monitor change across therapy. The SASCI is presented along with examples of how the information gathered from frequent administration can inform clinical practice

    Automatic Thoughts and Cognitive Restructuring in Cognitive Behavioral Group Therapy for Social Anxiety Disorder

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    The goal in (Heimberg, R. G. [1991]. A manual for conducting Cognitive Behavior Group Therapy for social phobia (2nd ed.), unpublished manuscript) cognitive behavioral group therapy (CBGT) for social anxiety disorder (social phobia) is to challenge irrational automatic thoughts and create exposures to provide disconfirming evidence for these irrational thoughts as well as habituation to fearful stimuli. Yet little is known about the types of thoughts reported by socially anxious individuals in therapy or which thoughts therapists select for cognitive restructuring in CBGT sessions. The present study analyzed the semantic content of automatic thoughts reported in CBGT and found that the most common thoughts related to poor social performance, negative labels by others, and the anticipation of negative outcomes in feared situations. Principle components analyses indicated the automatic thoughts reflected three underlying themes: Experiencing Anxiety, Negative Self-Evaluation, and Fear of Negative Evaluation. The paper also describes exploratory analyses of which thoughts became the focus of cognitive restructuring exercises and their relationship to treatment outcome. Implications for cognitive therapy are also discussed

    Increase in West Nile Neuroinvasive Disease after Hurricane Katrina

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    After Hurricane Katrina, the number of reported cases of West Nile neuroinvasive disease (WNND) sharply increased in the hurricane-affected regions of Louisiana and Mississippi. In 2006, a >2-fold increase in WNND incidence was observed in the hurricane-affected areas than in previous years

    Limited Systemic Sclerosis Patients with Pulmonary Arterial Hypertension Show Biomarkers of Inflammation and Vascular Injury

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    Pulmonary arterial hypertension (PAH) is a common complication for individuals with limited systemic sclerosis (lSSc). The identification and characterization of biomarkers for lSSc-PAH should lead to less invasive screening, a better understanding of pathogenesis, and improved treatment.Forty-nine PBMC samples were obtained from 21 lSSc subjects without PAH (lSSc-noPAH), 15 lSSc subjects with PAH (lSSc-PAH), and 10 healthy controls; three subjects provided PBMCs one year later. Genome-wide gene expression was measured for each sample. The levels of 89 cytokines were measured in serum from a subset of subjects by Multi-Analyte Profiling (MAP) immunoassays. Gene expression clearly distinguished lSSc samples from healthy controls, and separated lSSc-PAH from lSSc-NoPAH patients. Real-time quantitative PCR confirmed increased expression of 9 genes (ICAM1, IFNGR1, IL1B, IL13Ra1, JAK2, AIF1, CCR1, ALAS2, TIMP2) in lSSc-PAH patients. Increased circulating cytokine levels of inflammatory mediators such as TNF-alpha, IL1-beta, ICAM-1, and IL-6, and markers of vascular injury such as VCAM-1, VEGF, and von Willebrand Factor were found in lSSc-PAH subjects.The gene expression and cytokine profiles of lSSc-PAH patients suggest the presence of activated monocytes, and show markers of vascular injury and inflammation. These genes and factors could serve as biomarkers of PAH involvement in lSSc
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