Brief Consultation to Families of Treatment Refusers with Symptoms of Obsessive Compulsive Disorder: Does It Impact Family Accommodation and Quality of Life?

Family members are often directly and significantly impacted by the restrictive demands of OCD, a frequently disabling disorder. Family accommodation behaviors (i.e., doing things for or because of the OCD sufferer that a person would not normally do) are associated with dysfunction, including poorer treatment responses in OCD sufferers and greater distress in family members. Although evidence suggests family-based intervention can reduce symptoms in OCD sufferers who participate in treatment, there is a lack of research documenting the impact of interventions designed for the families of OCD treatment refusers (TR). Brief Family Consultation (BFC) was developed by our clinical team to help families refocus their efforts on the things that they can realistically control and change (e.g., participation in compulsions). In this crossover study, twenty families related to an individual who exhibited OCD symptoms but had refused treatment were assigned to five phone sessions of either BFC or a psychoeducation condition. Compared to this credible, attention-placebo control group (Brief Educational Support; BES), BFC (but not BES) resulted in reductions in family accommodation behavior, yet neither BFC nor BES resulted in improved quality of life for family members of treatment refusers. BFC is one of the first interventions to be evaluated for its ability to help families when their loved ones with obsessive compulsive symptoms refuse treatment. This pilot study provides new insights for clinicians and researchers to better address the needs of these neglected families

Working Alliance for Clients with Social Anxiety Disorder: Relationship with Session Helpfulness and Within-Session Habituation

It has been suggested that a strong working alliance encourages clients to take risks during therapy (Raue, Castonguay, & Goldfried, 1993). This encouragement may be important for clients who fear negative evaluations as they engage in risk-taking elements of therapy. This study examined the relationship between working alliance, session helpfulness, and measures of emotional processing in 18 clients undergoing cognitive behavior therapy (CBT) for social anxiety disorder. Results indicate a positive correlation between client-rated, but not observer-rated, working alliance and session helpfulness. Moderate levels of working alliance were associated with higher initial anxiety and deeper within-session habituation. Overall, a strong alliance was associated with clients engaging with the session and finding the session helpful. Implications for the use of CBT for social anxiety are discussed

Efficacy of a Manualized and Workbook-Driven Individual Treatment for Social Anxiety Disorder

Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska–Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed

Discriminating between Cognitive and Supportive Group Therapies for Chronic Mental Illness

This descriptive and comparative study employed a Q-sort process to describe common factors of therapy in two group therapies for inpatients with chronic mental illness. While pharmacological treatments for chronic mental illness are prominent, there is growing evidence that cognitive therapy is also efficacious. Groups examined were part of a larger study comparing the added benefits of cognitive versus supportive group therapy to the treatment milieu. In general, items described the therapist’s attitudes and behaviors, the participants’ attitudes and behaviors, or the group interactions. Results present items that were most and least characteristic of each therapy and items that discriminate between the two modalities. Therapists in both groups demonstrated good therapy skills. However, the cognitive group was described as being more motivated and active than the supportive group, indicating that the groups differed in terms of common as well as specific factors of treatment

Contribution of working alliance to manual -based treatment of social anxiety disorder

This study examined the contribution of working alliance and other treatment variables to manual-based CBT for social anxiety disorder. Alliance, a common therapy factor, has been discussed in traditional psychotherapy literature and has recently received attention due to its correlation with outcome across different therapy methods. The broad circulation of treatment manuals raised concerns that the emphasis on specific techniques may impede the therapeutic relationship. The rationale for choosing social anxiety disorder included the serious nature of the disorder, the availability of an effective treatment protocol, and the cognitive biases and interpersonal difficulties inherent to the disorder. This study examined the utility of pre-treatment depression, treatment credibility and expectancy, and homework compliance as factors associated with outcome. Both a clinician-rated severity measure of distress and functional impairment and a self-report fear of negative evaluation scale were used to assess treatment gains. This study was conducted in the context of a wait-list controlled trial of individual cognitive-behavioral social anxiety disorder treatment. Results indicated that treatment significantly reduced symptom severity, fear of negative evaluation, and depressive symptomatology. Despite cognitive biases and interpersonal difficulties, participants had alliance ratings equivalent to general outpatient samples. After controlling for pre-treatment severity, working alliance after the final session was related to the post-treatment clinician-rated severity measure. This relationship suggested that working alliance developed in the context of improving in treatment, refuting a causal role for alliance. After controlling for pre-treatment scores, initial depression severity significantly contributed to post-treatment fear of negative evaluation model in the intent to treat sample. This relationship suggested the importance of considering comorbid depressive symptoms in treatment. However, initial levels of depression were not associated with outcome in individuals who completed treatment. Treatment implications, study limitations, and future directions were discussed

Public (RE devel)

Publicly shared information about this project, including Registered study protocol versions, etc

Efficacy of a Manualized and Workbook-Driven Individual Treatment for Social Anxiety Disorder

Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska–Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed

Discriminating between Cognitive and Supportive Group Therapies for Chronic Mental Illness

This descriptive and comparative study employed a Q-sort process to describe common factors of therapy in two group therapies for inpatients with chronic mental illness. While pharmacological treatments for chronic mental illness are prominent, there is growing evidence that cognitive therapy is also efficacious. Groups examined were part of a larger study comparing the added benefits of cognitive versus supportive group therapy to the treatment milieu. In general, items described the therapist’s attitudes and behaviors, the participants’ attitudes and behaviors, or the group interactions. Results present items that were most and least characteristic of each therapy and items that discriminate between the two modalities. Therapists in both groups demonstrated good therapy skills. However, the cognitive group was described as being more motivated and active than the supportive group, indicating that the groups differed in terms of common as well as specific factors of treatment

Plant derived MINA-05 inhibits human prostate cancer proliferation in vitro and lymph node spread in vivo

Few treatment options exist for metastatic prostate cancer (PC) that becomes hormone refractory (HRPC). In vitro, plant-derived MINA-05 caused dose-dependent decreases in cell numbers in HRPC cell lines LNCaPC4-2B and PC-3, and in androgen-sensitive LNCaP-FGC, DuCaP, and LAPC-4, by WST-1 assay. MINA-05 pretreatment significantly decreased clonogenic survival in agar and on plastic at 1 x and 2 x IC₅₀ for PC-3 (P < .05 and P < .001, respectively), and at 1/2 x, 1 x, and 2 x IC₅₀ for LNCaP-FGC cells (P < .001). MINA-05 also induced G₂M arrest of LNCaP-FGC and PC-3 cells (by flow cytometry) and caused some apoptosis in LNCaP-FGC (sub-G 1 peak on flow, expression of activated caspase-3) but not in PC-3 cells. Western blotting indicated that these cell cycle changes were associated with decreased levels of regulatory proteins cyclin B1 and cdc25C. MINA-05 given daily by gavage for 39 days did not diminish primary orthotopic PC-3 growth in nude mice, but decreased the extent of lymph node invasion at higher doses. We conclude that MINA-05 induces G₂M arrest, inhibits cell growth, reduces PC cell regrowth in vitro, and reduces lymph node invasion after orthotopic PC-3 cell implantation in vivo. It has potential as an adjuvant treatment for patients with PC.10 page(s