The potential of behavioural activation for the treatment of chronic pain: An exploratory review

Background: A substantial proportion of the population have a persistent pain condition. In addition to considerable personal suffering, these conditions have a massive economic cost at a society level in terms of health expenditure and lost productivity. To address this immense public health problem, treatment approaches are needed that are based on scientifically supported theories and that are easy to disseminate and scalable. Method: An exploratory qualitative review of literature concerning the operant model of chronic pain, related psychological interventions, and a synopsis of existing intervention studies with a behavioural activation (BA) approach was undertaken. Results: Current treatments for chronic pain are multimodal, however early research showed promising results for operant-based behavioural intervention alone. Although originally developed for depression, BA is a good theoretical match for operant conceptions of chronic pain. Further, because of its relative simplicity, BA is appealing in terms of its potential ease of dissemination. Two case studies have used BA for individuals suffering from fibromyalgia and produced promising treatment outcomes. Conclusions: Further research investigating the efficacy of BA for chronic pain is justified. Such work should begin with more single subject experimental designs to explore how BA might be best applied and the generalisability of the approach

Anger problems and posttraumatic stress disorder in male and female National Guard and Reserve Service members

Anger is a common problem among veterans and has been associated with posttraumatic stress disorder (PTSD). This study aimed to improve understanding of how anger and PTSD co-occur by examining gender differences and differences by whether the triggering traumatic event is deployment-related vs. civilian-related in current service members. A representative cohort of Reserve and National Guard service personnel (n = 1293) were interviewed to assess for deployment- or civilian-related traumas, PTSD, and anger. The prevalence of self-reported anger problems was estimated among male (n = 1036) and female (n = 257) service members. Log Poisson regression models with robust standard errors were used to estimate the associations of problems with anger with PTSD and PTSD symptom severity for men and women. Self-reported anger problems were common among male (53.0%) and female (51.3%) service members. Adjusted prevalence ratios (PR) showed associations between anger and PTSD connected to both civilian- and deployment-related traumas (PR were 1.77 (95% CI 1.52–2.05) and 1.85 (95% CI 1.62–2.12), respectively). PTSD symptom severity was also associated with anger. This study was cross-sectional and so a causal relationship between PTSD and anger cannot be established. Problems with anger are common among male and female current Guard and Reserve members. These findings suggest that anger treatment should be made available to current service members and that clinicians should assess anger problems irrespective of gender. Future research should examine the effectiveness of anger treatment protocols by gender

Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context

Ertl V, Saile R, Neuner F, Catani C. Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry. 2016;16(1): 202.Background It is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology. Methods A cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians’ socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression. Results Symptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men’s alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure. Conclusions The gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts

Job Functions, Roles and Views of Training of Learning Disability and Remedial Reading Personnel

140 p.Thesis (Educat.D.)--University of Illinois at Urbana-Champaign, 1973.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD