Acceptance and commitment therapy delivered in a dyad after a severe traumatic brain injury: a feasibility study

Objective: There is a high prevalence of complex psychological distress after a traumatic brain injury but limited evidence of effective interventions. We examined the feasibility of Acceptance and Commitment Therapy after a severe traumatic brain injury using the criteria, investigating a therapeutic effect, and reviewing the acceptability of measures, treatment protocol, and delivery method (in a dyad of two clients and a therapist). Method: Two male outpatients with severe traumatic brain injury and associated psychological distress jointly engaged in a seven session treatment program based on Acceptance and Commitment Therapy principles. Pre- and post-treatment measures of mood, psychological flexibility, and participation were taken in addition to weekly measures. Results: The intervention showed a therapeutic effect with one participant, and appeared to be acceptable for both participants with regard to program content, measures, and delivery mode by in a dyad. One participant showed both significant clinical and reliable change across several outcome measures including measures of mood and psychological flexibility. The second participant did not show a reduction in psychological inflexibility, but did show a significant drop in negative affect. Significant changes pre- to post-treatment for measures of participation were not indicated. Qualitatively, both participants engaged in committed action set in accordance with their values. Conclusions: This study suggests that Acceptance and Commitment Therapy may be feasible to be delivered in a dyad with individuals who have a severe traumatic brain injury. A further test of its potential efficacy in a phase II clinical trial is recommended

Investigation of the Barriers and Facilitators to Making Healthy Choices at Work

This project aims to examine how workplace barriers and facilitators can affect an employee’s healthy choices. Barriers are factors that prevent the employee from making a healthy choice, whereas facilitators are factors that encourage the employee to make a healthy choice. It is imperative to understand how these barriers and facilitators affect the employee’s ability to make healthy choices in order to understand the importance of their presence within the workplace. The results of this study will further support previous research findings related to this topic, as well as support future attempts aimed to improve the overall well-being of employees in the workplace

Can Acceptance and Commitment Therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomised controlled trial

This study i⁠nvestigated if an Acceptance and Commitment Therapy (ACT) intervention (ACT-Adjust) can facilitate psychological adjustment and reduce psychological distress following severe traumatic brain injury (TBI). The study design comprised a single centre, two-armed, Phase II pilot randomized controlled trial. Nineteen individuals with severe TBI (PTA ≥7 days) who met a clinical threshold for psychological distress (Depression Anxiety Stress Scales-21; DASS > 9) were randomly allocated to either ACT-Adjust (n = 10) or an active control, Befriending Therapy (n = 9), in conjunction with a holistic rehabilitation programme. Primary (psychological flexibility, rehabilitation participation) and secondary (depression, anxiety & stress) outcomes were measured at three-time points (pre, post and follow up). Significant decreases were found for DASS-depression (group by time interaction, F1,17 = 5.35, p = .03) and DASS-stress (group by time interaction, F1,17 = 5.69, p = .03) in comparison to the Befriending group, but not for the primary outcome measures. The reduction in stress post-treatment was classed as clinically significant, however interaction differences for stress and depression were not maintained at one month follow up. Preliminary investigations indicate potential for ACT in decreasing psychological distress for individuals with a severe TBI with further sessions required to maintain treatment gains. The pilot results suggest further investigation is warranted in a larger scale clinical trial

Joseph D. Bates Jr. Correspondence

Entries include a typed letter of presentation for Bates, from the publisher Little, Brown & Compan

Lensed Quasar Hosts

Gravitational lensing assists in the detection of quasar hosts by amplifying and distorting the host light away from the unresolved quasar core images. We present the results of HST observations of 30 quasar hosts at redshifts 1 < z < 4.5. The hosts are small in size (r_e <~ 6 kpc), and span a range of morphologies consistent with early-types (though smaller in mass) to disky/late-type. The ratio of the black hole mass (MBH, from the virial technique) to the bulge mass (M_bulge, from the stellar luminosity) at 1<z<1.7 is broadly consistent with the local value; while MBH/M_bulge at z>1.7 is a factor of 3--6 higher than the local value. But, depending on the stellar content the ratio may decline at z>4 (if E/S0-like), flatten off to 6--10 times the local value (if Sbc-like), or continue to rise (if Im-like). We infer that galaxy bulge masses must have grown by a factor of 3--6 over the redshift range 3>z>1, and then changed little since z~1. This suggests that the peak epoch of galaxy formation for massive galaxies is above z~1. We also estimate the duty cycle of luminous AGNs at z>1 to be ~1%, or 10^7 yrs, with sizable scatter.Comment: 8 pages, 6 figures, review article with C. Impey at the conference on "QSO Host Galaxies: Evolution and Environment", Aug. 29-Sep. 2, 2005, Lorentz Center, Leiden, The Netherland

Joseph Cummings Chase Correspondence

Entries include the typed biographical account of a portrait artist during and after a world war on personal stationery and letters of correspondence from the Maine State Library

Joseph E. Coyne Correspondence

Entries include brief biographical information and a typed biographical letter

Paluel J. Flagg Correspondence

Entries include an envelope from the President of SPAD (Society for the Prevention of Asphyxial Death) with copies of academic newspaper biography clippings presenting courses and information on progress in the field with the photographic images of Flagg and his wife, a publisher advertisement, and typed letters on personal stationery

Resilience and psychiatric epidemiology: Implications for a conceptual framework

Kalisch and colleagues present a conceptual framework for the study of resilience, using a neurobiological approach. The present commentary examines issues arising for the study of resilience from epidemiological data, which suggest that resilience is most likely a normative function that may operate as a kind of psychological immune system. The implications of the epidemiological data on the development of a neurobiological theory of resilience are discussed