The relationship between obsessive-compulsive disorder and religious faith: Clinical characteristics and implications for treatment

This paper explores the relationship between religion and obsessive–compulsive dis- order (OCD), with particular interest in religion’s possible influence in the development of OCD and its impact on treatment outcome. The paper begins with a review of theoretical and research literatures concerning religious involvement, research evidence linking religious involvement and physical and mental health, and theoretical linkages supporting both positive and negative religious effects on health. Following this, we provide a general overview and description of OCD and information concerning the prevalence and incidence of religiously based OCD. Next, extant research linking religion and OCD is presented. Information relevant to the clinical treatment of OCD with religious content is discussed. Finally, practice implications for clinicians and clergy are provided.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107413/1/2011-11166-001.pdfDescription of 2011-11166-001.pdf : Main articl

ACT-Enhanced Behavior Therapy in Group Format for Trichotillomania: An Effectiveness Study

Background This study sought to investigate the effectiveness of group treatment for trichotillomania (TTM) in ordinary clinical settings. Treatment consisted of a combination of habit reversal training (HRT) and acceptance and commitment treatment (ACT). Both short- and long-term effects were explored, as well as individual change trajectories. Methods The sample consist of fifty-three patients with TTM. Treatment outcomes were evaluated at post-treatment and at one-year follow-up using self-report questionnaires (Massachusetts General Hospital Hair Pulling Scale, MGH-HS), structured clinical interviews (National Institute of Mental Health Trichotillomania Severity Scale, NIMH-TSS), and the Clinical Global Impression scale for TTM (CGI-TTM). Results Analyses by mixed models for repeated measurements yielded a statistically significant effect of time (p Conclusions ACT-enhanced behavior therapy in a group format seems efficient for reducing symptoms of trichotillomania

Alcohol abuse and the anxiety disorders: Evidence from the epidemiologic catchment area survey

This study examined the prevalence of alcohol abuse and/or dependence in a sample of patients with anxiety disorders gathered from the Epidemiologic Catchment Area Study. Prior research had indicated that anxiety disorders are prevalent among alcoholics and also that alcoholism is prevalent among samples of anxiety disorder patients. The sample included 2471 individuals who met a lifetime diagnosis of agoraphobia, panic disorder, agoraphobia with panic attacks, social phobia, simple phobia, or obsessive-compulsive disorder. About 12% of these individuals met criteria for a lifetime history of alcohol abuse and/or dependence. Relative odds ratios were calculated for the risk of alcohol use disorder, correcting for the effects of site, age, race, and gender. Among those individuals with a history of both anxiety and alcoholism disorders, the highest risk of alcohol use disorder was found in the agoraphobia with panic group. Lowest risk was found among those with a single diagnosis of simple phobia or agoraphobia without panic attacks. Clinical implications of these results are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29581/1/0000670.pd

A standardized behavioral group treatment program for obsessive-compulsive disorder: preliminary outcomes

This paper provides outcome data about the efficacy of a behavioral group therapy program for obsessive-compulsive disorder (OCD). Thirty-six patients completed a 7-week outpatient treatment program which provides: (1) education about OCD and its treatment, (2) instruction in a cognitive and behavioral approach to the self-treatment of OCD and (3) guided behavioral treatment. Significant improvement in obsession, compulsion, and depression scores were observed at completion of the group and at 3 month follow-up. Significant improvement in obsessions and compulsions was observed for both patients taking anti-obsessional medications and those who did not.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29633/1/0000722.pd

Simple phobia: Evidence for heterogeneity

Although simple phobia is a residual category in DSM-III, clinical experience suggests at least four subtypes of this group. To test the validity of the subtypes, the authors compared patients with one of four simple phobias subtypes (n: ANIMAL-INSECT = 25, BLOOD-INJURY = 9, SITUATIONAL = 46, CHOKING-VOMIT = 8). Significant sex differences were observed; all animal and insect phobics and seven of eight choking-vomit phobics were female, while the other two groups showed approximately equal numbers of males and females. Mean age of onset was significantly older for situational phobics than animal-insect or blood-injury phobics; choking-vomit probands were intermediate. Frequency of situational phobias differed significantly among relatives of the four proband groups, with highest frequency being found among situational probands. Thus, these clinical and epidemiological variables support the separation of simple phobia into at least these four diagnostic groups.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27973/1/0000405.pd

Adaptive School-based Implementation of CBT (ASIC): clustered-SMART for building an optimized adaptive implementation intervention to improve uptake of mental health interventions in schools

Abstract Background Depressive and anxiety disorders affect 20–30% of school-age youth, most of whom do not receive adequate services, contributing to poor developmental and academic outcomes. Evidence-based practices (EBPs) such as cognitive behavioral therapy (CBT) can improve outcomes, but numerous barriers limit access among affected youth. Many youth try to access mental health services in schools, but school professionals (SPs: counselors, psychologists, social workers) are rarely trained adequately in CBT methods. Further, SPs face organizational barriers to providing CBT, such as lack of administrative support. Three promising implementation strategies to address barriers to school-based CBT delivery include (1) Replicating Effective Programs (REP), which deploys customized CBT packaging, didactic training in CBT, and technical assistance; (2) coaching, which extends training via live supervision to improve SP competence in CBT delivery; and (3) facilitation, which employs an organizational expert who mentors SPs in strategic thinking to promote self-efficacy in garnering administrative support. REP is a relatively low-intensity/low-cost strategy, whereas coaching and facilitation require additional resources. However, not all schools will require all three strategies. The primary aim of this study is to compare the effectiveness of a school-level adaptive implementation intervention involving REP, coaching, and facilitation versus REP alone on the frequency of CBT delivered to students by SPs and student mental health outcomes. Secondary and exploratory aims examine cost-effectiveness, moderators, and mechanisms of implementation strategies. Methods Using a clustered, sequential multiple-assignment, randomized trial (SMART) design, ≥ 200 SPs from 100 schools across Michigan will be randomized initially to receive REP vs. REP+coaching. After 8 weeks, schools that do not meet a pre-specified implementation benchmark are re-randomized to continue with the initial strategy or to augment with facilitation. Discussion EBPs need to be implemented successfully and efficiently in settings where individuals are most likely to seek care in order to gain large-scale impact on public health. Adaptive implementation interventions hold the promise of providing cost-effective implementation support. This is the first study to test an adaptive implementation of CBT for school-age youth, at a statewide level, delivered by school staff, taking an EBP to large populations with limited mental health care access. Trial registration NCT03541317 —Registered on 29 May 2018 on ClinicalTrials.gov PRShttps://deepblue.lib.umich.edu/bitstream/2027.42/145606/1/13012_2018_Article_808.pd

A comparison of panic disorder and agoraphobia with panic attacks

The validity of distinguishing between the diagnoses of panic disorder and agoraphobia with panic attacks was examined in a study of 20 patients with each disorder. Comparison of demographic, psychometric, and clinical features of the two groups revealed few differences. Agoraphobics scored higher on ratings of interpersonal sensitivity, phobic anxiety, paranoid ideation, and alcohol use. Panic disorder patients more frequently reported periods of remissions from anxiety symptomatology. These results support the validity of conceptualizing agoraphobia with panic attacks and panic disorder as subcategories of a core endogenous anxiety disorder.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/25747/1/0000307.pd

Alcohol abuse among clinically anxious patients

Of 156 patients meeting DSM-III criteria for either agoraphobia with panic attacks, panic disorder, simple or social phobia, or generalized anxiety disorder, 27 (17.3%) were found to score in the alcoholic range ([ges] 5) on the Michigan Alcoholism Screening Test. This pattern of alcohol abuse was primarily associated with the diagnosis of agoraphobia. Agoraphobic patients with a concurrent affective disorder were especially prone to abuse alcohol.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26404/1/0000491.pd

Terapia cognitiva : aplicações de uma técnica para qualidade de vida e saúde

Esta pesquisa teve por objetivo geral aplicar e avaliar uma técnica específica de terapia cognitiva - organizada em 12 sessões grupais e denominada Tomada de Decisão e Qualidade de Vida -, destinada a promover saúde e incrementar qualidade de vida. No total, participaram 18 servidores de uma instituição pública de ensino superior. Nas etapas de admissão e de encerramento, aplicaram-se : Questionário de Qualidade de Vida, Inventário Beck de Ansiedade e Inventário Beck de Depressão. Foram identificadas melhoras significativas nos domínios físico, psicológico, meio ambiente, geral e saúde, relacionados à qualidade de vida. Não se verificaram alterações significantes nos escores de ansiedade (p=0,26). Em contrapartida, os escores de depressão indicaram melhora (p=0,02). Os resultados sugerem que a técnica pode ser empregada para promover saúde e qualidade de vida.In this study we implemented and assessed a specific cognitive therapy technique - Decision Making and Quality of Life, which is used to promote health and improve quality of life. Eighteen employees from a higher education institution participated in the study, which was organized into 12 group sessions. At the admission and concluding phases, we asked participants to complete the World Health Organization Quality of Life - Bref Questionnaire, the Beck Anxiety Inventory and the Beck Depression Inventory. Results showed significant improvement in five of the domains that measure quality of life: physical, psychological, environmental, general, and health. There were no significant changes (p=0.26) in anxiety scores. In contrast, the depression scores got significantly better (p=0.02). The results suggest that the proposed technique is conducive to health promotion and quality of life

Effects of Alcohol on the Acquisition and Expression of Fear Potentiated Startle in Mouse Lines Selectively Bred for High and Low Alcohol Preference

Rationale: Anxiety disorders and alcohol-use disorders frequently co-occur in humans perhaps because alcohol relieves anxiety. Studies in humans and rats indicate that alcohol may have greater anxiolytic effects in organisms with increased genetic propensity for high alcohol consumption. Objectives and Methods: The purpose of this study was to investigate the effects of moderate doses of alcohol (0.5, 1.0, 1.5 g/kg) on the acquisition and expression of anxiety-related behavior using a fear-potentiated startle (FPS) procedure. Experiments were conducted in two replicate pairs of mouse lines selectively bred for high- (HAP1 and HAP2) and low- (LAP1 and LAP2) alcohol preference; these lines have previously shown a genetic correlation between alcohol preference and FPS (HAP\u3eLAP; Barrenha and Chester 2007). In a control experiment, the effect of diazepam (4.0 mg/kg) on the expression of FPS was tested in HAP2 and LAP2 mice. Results: The 1.5 g/kg alcohol dose moderately decreased the expression of FPS in both HAP lines but not LAP lines. Alcohol had no effect on the acquisition of FPS in any line. Diazepam reduced FPS to a similar extent in both HAP2 and LAP2 mice. Conclusions: HAP mice may be more sensitive to the anxiolytic effects of alcohol than LAP mice when alcohol is given prior to the expression of FPS. These data collected in two pairs of HAP/LAP mouse lines suggest that the anxiolytic response to alcohol in HAP mice may be genetically correlated with their propensity toward high alcohol preference and robust FPS