Energy transfer from an individual quantum dot to a carbon nanotube

A detailed understanding of energy transduction is crucial for achieving precise control of energy flow in complex, integrated systems. In this context, carbon nanotubes (CNTs) are intriguing model systems due to their rich, chirality-dependent electronic and optical properties. Here, we study the quenching of fluorescence from isolated quantum dots (QDs) upon approach of individual CNTs attached to atomic force microscope probes. Precision measurements of many different CNT/QD pairs reveal behavior consistent with resonant energy transfer between QD and CNT excitons via a Fohrster-like dipole-dipole coupling. The data reveal large variations in energy transfer length scales even though peak efficiencies are narrowly distributed around 96%. This saturation of efficiency is maintained even when energy transfer must compete with elevated intrinsic non-radiative relaxation rates during QD aging. These observations suggest that excitons can be created at different locations along the CNT length, thereby resulting in self-limiting behavior.Comment: 8 pages, 8 figures, with supplementary informatio

Developing a protocol to address co-occurring mental health conditions in the treatment of eating disorders

OBJECTIVE: While co-occurring mental health conditions are the norm in eating disorders, no testable protocol addresses management of these in psychotherapy. METHOD: The literature on managing mental health conditions that co-occur with eating disorders is outlined and reviewed. RESULTS: In the absence of clear evidence to inform managing co-occurring mental health conditions, we advocate for use of an iterative, session-by-session measurement to guide practice and research. We identify three data-driven treatment approaches (focus solely on the eating disorder; multiple sequential interventions either before or after the eating disorder is addressed; integrated interventions), and the indications for their use. Where a co-occurring mental health condition/s impede effective treatment of the eating disorder, and an integrated intervention is required, we outline a four-step protocol for three broad intervention approaches (alternate, modular, transdiagnostic). A research program is suggested to test the usefulness of the protocol. DISCUSSION: Guidelines that provide a starting point to improving outcomes for people with eating disorders that can be evaluated/researched are offered in the current paper. These guidelines require further elaboration with reference to: (1) whether any difference in approach is required where the co-occurring mental health condition is a comorbid symptom or condition; (2) the place of biological treatments within these guidelines; (3) precise guidelines for selecting among the three broad intervention approaches when adapting care for co-occurring conditions; (4) optimal approaches to involving consumer input into identifying the most relevant co-occurring conditions; (5) detailed specification on how to determine which adjuncts to add. PUBLIC SIGNIFICANCE: Most people with an eating disorder also have another diagnosis or an underlying trait (e.g., perfectionism). Currently no clear guidelines exist to guide treatment in this situation, which often results in a drift away from evidence-based techniques. This paper outlines data-driven strategies for treating eating disorders and the accompanying comorbid conditions and a research program that can test the usefulness of the different approaches suggested

El proceso transdiagnóstico del perfeccionismo

The transdiagnostic approach to theory and treatment of psychological disorders is gainingincreasing interest. A transdiagnostic process is one that occurs across disorders and explainstheir onset or maintenance. The purpose of this review is to provide evidence that perfectionism isa transdiagnostic process that it is elevated in anxiety disorders, eating disorders, depression, obsessivecompulsive personality disorder and somatoform disorders. Data are also reviewed to showthat perfectionism can explain aetiology as it is a prospective predictor of depression and eatingdisorders. Perfectionism is also demonstrated to predict poorer outcome to treatment for anxietydisorders, eating disorders and depression, suggesting the need for specific treatment of perfectionism.Evidence is provided to demonstrate that perfectionism can be successfully treated with cognitivebehavioural therapy which results in reduction in psychopathologies. Clinical guidelines areoutlined to assist in treatment planning for individuals with elevated perfectionism.Abstract: The transdiagnostic approach to theory and treatment of psychological disorders is gainingincreasing interest. A transdiagnostic process is one that occurs across disorders and explainstheir onset or maintenance. The purpose of this review is to provide evidence that perfectionism isa transdiagnostic process that it is elevated in anxiety disorders, eating disorders, depression, obsessivecompulsive personality disorder and somatoform disorders. Data are also reviewed to showthat perfectionism can explain aetiology as it is a prospective predictor of depression and eatingdisorders. Perfectionism is also demonstrated to predict poorer outcome to treatment for anxietydisorders, eating disorders and depression, suggesting the need for specific treatment of perfectionism.Evidence is provided to demonstrate that perfectionism can be successfully treated with cognitivebehavioural therapy which results in reduction in psychopathologies. Clinical guidelines areoutlined to assist in treatment planning for individuals with elevated perfectionism.Resumen: El enfoque transdiagnóstico sobre la teoría y el tratamiento de los trastornos psicológicosestá generando un interés creciente en la literatura. Un proceso transdiagnóstico es aquel quese da a través de los trastornos y explica su inicio o mantenimiento. El objetivo de esta revisiónconsiste en aportar evidencia sobre el perfeccionismo como un proceso transdiagnóstico que seencuentra elevado en los trastornos de ansiedad, los trastornos alimentarios, la depresión, el trastornode personalidad obsesivo-compulsivo y los trastornos somatoformes. Revisamos la evidenciaempírica para mostrar que el perfeccionismo puede explicar la etiología como predictor prospectivode la depresión y los trastornos alimentarios. También se ha demostrado que el perfeccionismopredice un peor resultado terapéutico del tratamiento de los trastornos de ansiedad, los trastornosalimentarios y la depresión, sugiriendo la necesidad de un tratamiento específico del perfeccionismo.Proporcionamos evidencia para demostrar que el perfeccionismo puede ser tratado con éxitomediante terapia cognitivo conductual y que el tratamiento del perfeccionismo produce reduccionesen un rango amplio de psicopatologías. Se describen directrices clínicas para asistir en la planificacióndel tratamiento en individuos con elevados niveles de perfeccionismo

What factors influence healthcare professionals to refer children and families to paediatric psychology?

Objectives: This study aimed to investigate factors influencing referral of children with physical illness to paediatric psychology. Due to high rates of mental health problems within this population, studies have shown that referral to paediatric psychology should be increased. However, few studies have examined factors shaping healthcare professionals’ referral behaviour. Methods: The current study used the theory of planned behaviour to develop a questionnaire which explores factors influencing the referral of children and families to paediatric psychology. Psychometric properties of the questionnaire were examined. Results: The questionnaire was found to have good reliability and validity. The main constructs of the theory of planned behaviour were useful in predicting intention to refer to paediatric psychology. Specific beliefs about referral were shown to influence intention to refer. Conclusions: Findings suggest that individual attitudes and beliefs can impact healthcare professionals’ referral behaviour, indicating that multidisciplinary interventions and inter-professional education relating to the psychological aspects of illness are required

The Efficacy of Parent Training Interventions for Disruptive Behavior Disorders in Treating Untargeted Comorbid Internalizing Symptoms in Children and Adolescents: A Systematic Review

Disruptive behavior disorders (DBDs) are among the primary reasons for child and youth referrals to mental health services and are linked to poor adult outcomes including antisocial behavior disorder. Research indicates a high incidence of internalizing problems in those with DBDs and those who have DBDs with cooccurring internalizing problems may have more severe later outcomes. Interventions targeted at internalizing symptoms have been found to also reduce comorbid externalizing problems. The impact of treatments for DBDs on comorbid internalizing disorders is not known. Databases PsycINFO, EMBASE and MEDLINE were systematically searched based on the Cochrane guidelines for systematic reviews. Records were independently reviewed by two reviewers. 12 papers were deemed eligible. A quality assessment of the selected studies was conducted independently by both reviewers. The 12 studies included 1334 young people with a mean age of 5 years. The parent training interventions assessed were the Incredible Years (6/12 studies), Triple-P (5/12) and Tuning In To Kids (1/12). 11 of the 12 studies reported significant reductions in primary externalizing behavior problems and DBDs. 7 studies reported significant reductions in internalizing symptoms. Mechanisms of change, clinical implications and directions for future research are discussed

Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism

It has been 21 years since the publication of the cognitive behavioural model of clinical perfectionism that underpins cognitive behaviour therapy (CBT) for perfectionism. The notion of clinical perfectionism and CBT for perfectionism has been controversial. Despite 15 randomised controlled trials which have demonstrated the efficacy of CBT for perfectionism in reducing perfectionism and symptoms of anxiety, depression and eating disorders, strong responses to this work continue to appear in the literature. In this article, we examine the evolution and controversy surrounding clinical perfectionism, the efficacy of CBT for perfectionism, and future directions for the concept of perfectionism and its treatment. Future research should aim to provide independent evaluations of treatment efficacy, compare CBT for perfectionism to active treatments, conduct dismantling trials to examine the effective components of treatment, and examine the causal processes involved in perfectionism. We provide recommendations for future pathways to support innovation in theory, understanding, and treatment of perfectionism with a view towards improving clinical outcomes

The Influence of Comorbidity and Perceived Complexity on Outcomes of Referrals to Children and Young Person Mental Health Services (UK): A Mixed Methods Vignette Study

Children and young people (CYP) with long-term physical conditions (LTCs) are four times more likely to develop mental health disorders yet many cannot access Children and Young People's Mental Health Services (CYPMHS) or evidence-based interventions. This study aimed to understand the reasons for this; presence of an LTC neurodevelopmental disorder, or service requirements. 79 CYP mental health practitioners were randomly assigned to read vignettes depicting a hypothetical referral letter for a child with a mental health condition alone (n = 27), mental health condition and LTC (n = 25), or mental health condition and neurodevelopmental disorder (Autism Spectrum Disorder-ASD) (n = 27), answering questions about their likelihood of accepting the referral and proposed treatment plan. There were no significant differences between accessing CYPMHS or being offered first line evidence-based interventions in those with a LTC or ASD compared to those without. However, additional perceived complexity was frequently provided as a reason for rejecting referrals and not offering evidence-based intervention, with clinicians' predicted success of intervention significantly lower for these CYP. Clinicians were significantly more likely to suggest adapting the intervention in the LTC and the ASD groups to account for additional perceived complexity. The research suggests a need for additional services for CYP with LTCs and those with neurodevelopmental disorders, as well as training/awareness for clinicians

The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis

Perfectionism is a transdiagnostic process across anxiety, depression, and eating disorders. The aim of this systematic review was to examine the efficacy of self-help and face to face CBT for perfectionism in reducing perfectionism and anxiety, depression, and eating disorders. A total of 15 randomised controlled trials of CBT for perfectionism were identified (N = 912 participants; mean pooled age = 23 years) which met inclusion criteria. There were medium or large effect sizes found on perfectionism measures; personal standards (g = 0.57, 95% CI = 0.43–0.72), concern over mistakes (g = 0.89, 95% CI = 0.71–1.08) and clinical perfectionism (g = 0.87, 95% CI = 0.70–1.04). There were medium effects for symptoms of eating disorders (g = 0.61, 95% CI = 0.36–0.87) and depression (g = 0.60, 95% CI = 0.28–0.91), and a small-medium effect on anxiety (g = 0.42, 95% CI = 0.21–0.62). There was no publication bias found. Limitations included the small number of trials included and lack of active treatment comparisons. Results suggested that CBT for perfectionism is efficacious in reducing perfectionism and symptoms of depression, anxiety and eating disorders. Future research should examine comparisons of CBT for perfectionism with other psychological treatments

Design Considerations for the Integrated Delivery of Cognitive Behavioral Therapy for Depression: A User-Centered Design Study

Background: Adherence to computerized cognitive behavioral therapy (cCBT) programs in real-world settings can be poor, and in the absence of therapist support, effects are modest and short term. Moreover, because cCBT systems tend toward limited support and thus low-intensity treatment, they are typically most appropriate for people experiencing mild to moderate mental health difficulties. Blended therapy, that is, combining direct therapist contact with cCBT or psychoeducational materials, has been identified as one possible approach to address these limitations and widen access to individual CBT for depression. Building on the initial success of blended therapy, we explore an integrated approach that seeks to seamlessly combine face-to-face contact, electronic contact, and between-session activities. Integration also considers how the technology can support therapists’ workflow and integrate with broader health care systems. The ultimate aim is to provide a structure within which therapists can deliver high-intensity treatments, while also greatly reducing face-to-face contact. Objective: The research aimed to explore patients’ and therapists’ views on using a system for the delivery of individual treatment for depression that integrates face-to-face therapist contact with access to online resources and with synchronous online therapy sessions that allow collaborative exercises, and to establish design requirements and thus key design considerations for integrated systems that more seamlessly combine different modes of communication. Methods: We conducted a series of four user-centered design studies. This included four design workshops and seven prototype testing sessions with 18 people who had received CBT for depression in the past, and 11 qualitative interviews and three role-play sessions with 12 CBT therapists experienced in the treatment of depression. Studies took place between July and December 2017 in Bristol, United Kingdom. Results: Workshops and prototyping sessions with people who had received CBT identified three important requirements for integrated platforms delivering CBT therapy for depression as follows: (1) features that help to overcome depression-related barriers, (2) features that support engagement, and (3) features that reinforce learning and support the development of new skills. Research with therapists highlighted the importance of the therapist and client working together, the impact of technology on therapists’ workflow and workload, challenges and opportunities related to the use of online resources, and the potential of technology to support patient engagement. We use these findings to inform 12 design considerations for developing integrated therapy systems. Conclusions: To meet clients’ and therapists’ needs, integrated systems need to help retain the personal connection, support both therapist- and patient-led activities, and provide access to materials and the ability to monitor progress. However, developers of such systems should be mindful of their capacity to disrupt current work practices and increase therapists’ workload. Future research should evaluate the impact of integrated systems on patients and therapists in a real-world context