TAKE ME BACK TO MOVE ME FORWARD: RE-ENACTMENT OF THE FAMILY SYSTEM AS A PATHWAY TO BETTER QUALITY OF LIFE FOR ALEXITHYMIC PATIENTS IN GROUP THERAPY

Background: Despite much attention in the clinical literature, research on alexithymia in the treatment setting has only recently gained traction. While several reports indicate limited benefit from therapy amongst patients with high alexithymia, this seems to be less so in the context of group therapy. This study considers a specific aspect of the group therapy process - family re-enactment - in facilitating improvement in overall quality of life for patients with high levels of alexithymia. Subjects and methods: Family re-enactment was examined as a potential mediator of the relationship between alexithymia and change in quality of life among 50 patients who completed treatment in an intensive, integrative group therapy programme. Patients completed three self-report measures: Toronto Alexithymia Scale-20 (baseline), Quality of Life Inventory (baseline, post-therapy), and Therapeutic Factors Inventory-Short Form (week 8). Regression with mediation analysis was employed using the change score for the QOLI as the dependent variable, alexithymia scores as the independent variable, and the family re-enactment score as the mediator; baseline quality of life was included in the model as a control variable. Results: Family re-enactment emerged as a significant mediator of the relationship between alexithymia and treatment outcome, implicating it as a contributing mechanism of change for alexithymic patients who participate in group therapy. Conclusion: Patients with higher levels of alexithymia (in particular, difficulty identifying and describing feelings) were more likely to positively endorse aspects of family re-enactment during group therapy, which in turn were significantly associated with greater improvement in patients’ overall quality of life

Optimistic Planning for Markov Decision Processes

International audienceThe reinforcement learning community has recently intensified its interest in online planning methods, due to their relative independence on the state space size. However, tight near-optimality guarantees are not yet available for the general case of stochastic Markov decision processes and closed-loop, state-dependent planning policies. We therefore consider an algorithm related to AO* that optimistically explores a tree representation of the space of closed-loop policies, and we analyze the near-optimality of the action it returns after n tree node expansions. While this optimistic planning requires a finite number of actions and possible next states for each transition, its asymptotic performance does not depend directly on these numbers, but only on the subset of nodes that significantly impact near-optimal policies. We characterize this set by introducing a novel measure of problem complexity, called the near-optimality exponent. Specializing the exponent and performance bound for some interesting classes of MDPs illustrates the algorithm works better when there are fewer near-optimal policies and less uniform transition probabilities

TAKE ME BACK TO MOVE ME FORWARD: RE-ENACTMENT OF THE FAMILY SYSTEM AS A PATHWAY TO BETTER QUALITY OF LIFE FOR ALEXITHYMIC PATIENTS IN GROUP THERAPY

Background: Despite much attention in the clinical literature, research on alexithymia in the treatment setting has only recently gained traction. While several reports indicate limited benefit from therapy amongst patients with high alexithymia, this seems to be less so in the context of group therapy. This study considers a specific aspect of the group therapy process - family re-enactment - in facilitating improvement in overall quality of life for patients with high levels of alexithymia. Subjects and methods: Family re-enactment was examined as a potential mediator of the relationship between alexithymia and change in quality of life among 50 patients who completed treatment in an intensive, integrative group therapy programme. Patients completed three self-report measures: Toronto Alexithymia Scale-20 (baseline), Quality of Life Inventory (baseline, post-therapy), and Therapeutic Factors Inventory-Short Form (week 8). Regression with mediation analysis was employed using the change score for the QOLI as the dependent variable, alexithymia scores as the independent variable, and the family re-enactment score as the mediator; baseline quality of life was included in the model as a control variable. Results: Family re-enactment emerged as a significant mediator of the relationship between alexithymia and treatment outcome, implicating it as a contributing mechanism of change for alexithymic patients who participate in group therapy. Conclusion: Patients with higher levels of alexithymia (in particular, difficulty identifying and describing feelings) were more likely to positively endorse aspects of family re-enactment during group therapy, which in turn were significantly associated with greater improvement in patients’ overall quality of life

Development and initial validation of the obsessive belief questionnaire-child version (OBQ-CV)

Cognitive models of obsessive-compulsive disorder (OCD) propose that beliefs are important in the etiology and maintenance of OCD and that these beliefs develop during childhood [Neal et al., 1991: Psychol Bull 109:400-410; Rachman, 1997: Behav Res Ther 35:793-802; Cronbach, 1951: Psychometrika 16:297-334]. However, the ability to test these predictions has been hampered by the lack of a standardized measure of OCD-related beliefs for youth. Therefore, this article presents initial data on a youth version of the widely used Obsessive Belief Questionnaire (OBQ) [Bonett, 2002: J Educ Behav Stat 27:335-340]. Data examining the psychometric properties of the Obsessive Belief Questionnaire-Child Version (OBQ-CV) are presented from two pediatric OCD samples: a North American (n=29, aged 9-17 years) and a Dutch sample (n=48, aged 8-18 years). Preliminary findings from both samples support the internal consistency, retest reliability, and convergent validity of the OBQ-CV. Results of this study suggest that the OBQ-CV is a promising tool for examining the role of cognitions in pediatric OCD. Development of the OBQ-CV to augment the existing adult version of the scale creates unique opportunities for investigating the role of cognitions in OCD across the lifespa

Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory

In 1995 the Obsessive Compulsive Cognitions Working Group initiated a collective process to develop two measures of cognition relevant to current cognitive-behavioural models of OCD. An earlier report (Behav. Res. Therapy, 35 (1997) 667) describes the original process of defining relevant domains. This article describes the subsequent steps of the development and validation process: item generation, scale reduction, and initial examination of reliability and validity. Two scales were developed. The Obsessive Beliefs Questionnaire consists of 87 items representing dysfunctional assumptions covering six domains: overestimation of threat, tolerance of uncertainty, importance of thoughts, control of thoughts, responsibility, and perfectionism. The Interpretation of Intrusions Inventory consists of 31 items that refer to interpretations of intrusions that have occurred recently. Three of the above domains are represented: importance of thoughts, control of thoughts, and responsibility. The item reduction and validation analyses were conducted on clinical and non-clinical samples from multiple sites. Initial examination of reliability and validity indicates excellent internal consistency and stability and encouraging evidence of validity. However, high correlations indicating overlap between some of the scales, particularly importance of thoughts, control of thoughts, and responsibility will need to be addressed in subsequent empirical and theoretical investigations

The FreeMABSys project and the BLAD libraries

International audienceNo abstrac