Cognitive-Behavioral Therapy and Neuroscience: Towards Closer Integration

The aim of this review article is to provide an integrative perspective by combining basic assumptions of cognitive behavioral therapy (CBT) with neuroscience research results. In recent years, interdisciplinary research in the field of neuroscience has expanded our knowledge about neurobiological correlates of mental processes and changes occurring in the brain due to therapeutic interventions. The studies are largely based on non-invasive brain imaging techniques, such as functional neuroimaging technologies of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The neuroscientific investigations of basic CBT hypotheses have shown that (i) functional and non-functional behavior and experiences may be learned through lifelong learning, due to brain neuroplasticity that continues across the entire lifespan; (ii) cognitive activity contributes to dysfunctional behavior and emotional experience through focusing, selective perception, memory and recall, and characteristic cognitive distortion; on a neurobiological level, there is a relationship between top-down and bottom-up regulation of unpleasant emotional states; and (iii) cognitive activity may be changed, as shown by therapeutic success achieved by metacognitive and mindfulness techniques, which also have their neurobiological correlates in the changes occurring in the cortical and subcortical structures and endocrine and immune systems. The empirical research also shows that neurobiological changes occur after CBT in patients with arachnophobia, obsessive-compulsive disorder, panic disorder, social phobia, major depressive disorder and chronic fatigue syndrome.disorder and chronic fatigue syndrome

Cognitive-Behavioral Therapy and Neuroscience: Towards Closer Integration

The aim of this review article is to provide an integrative perspective by combining basic assumptions of cognitive behavioral therapy (CBT) with neuroscience research results. In recent years, interdisciplinary research in the field of neuroscience has expanded our knowledge about neurobiological correlates of mental processes and changes occurring in the brain due to therapeutic interventions. The studies are largely based on non-invasive brain imaging techniques, such as functional neuroimaging technologies of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The neuroscientific investigations of basic CBT hypotheses have shown that (i) functional and non-functional behavior and experiences may be learned through lifelong learning, due to brain neuroplasticity that continues across the entire lifespan; (ii) cognitive activity contributes to dysfunctional behavior and emotional experience through focusing, selective perception, memory and recall, and characteristic cognitive distortion; on a neurobiological level, there is a relationship between top-down and bottom-up regulation of unpleasant emotional states; and (iii) cognitive activity may be changed, as shown by therapeutic success achieved by metacognitive and mindfulness techniques, which also have their neurobiological correlates in the changes occurring in the cortical and subcortical structures and endocrine and immune systems. The empirical research also shows that neurobiological changes occur after CBT in patients with arachnophobia, obsessive-compulsive disorder, panic disorder, social phobia, major depressive disorder and chronic fatigue syndrome.disorder and chronic fatigue syndrome

Use of YP-CORE Questionnaire in the Assessment of Mental Health of Children with Intellectual Difficulties

Kod djece i mladih s intelektualnim teškoćama u prvom je redu karakteristična snižena razina intelektualnog, a potom i emocionalnog i socijalnog funkcioniranja. Takve osobe zaostaju u usvajanju akademskih znanja, učenju i usvajanju socijalnih vještina. Poznavajući aspekte funkcioniranja djece i mladih s intelektualnim teškoćama moguće je predvidjeti faktore rizika za razvoj teškoća ponašanja te narušavanje mentalnog zdravlja. Međutim, teško je utvrditi razinu ili barem postojanje mentalnih teškoća zbog nepostojanja standardiziranih testova za procjenu mentalnog zdravlja kod djece i mladih s intelektualnim teškoćama, iako stručnjaci koji rade s takvim osobama upozoravaju na njihovo često narušeno mentalno zdravlje. Cilj istraživanja bio je utvrditi primjenjivost YP-CORE upitnika za procjenu psihičke uznemirenosti kod djece i mladih s intelektualnim teškoćama. Ispitivanje je provedeno s učenicima Centra za odgoj i obrazovanje Rijeka, na uzorku 59 djece i mladih dobi od 7 do 21 godine. Dobiveni rezultati sukladni su prethodnim istraživanjima koja su pokazala kako 30 % djece i mladih s intelektualnim teškoćama imaju izražene psihičke teškoće. Iako naši rezultati odgovaraju onima dobivenim u drugim istraživanjima, postoje teškoće u primjeni upitnika, prije svega kod osoba s umjerenim intelektualnim teškoćama. No, rezultati su ohrabrujući u smislu valjanosti, koju svakako treba provjeriti u budućim istraživanjima.Children and young people with intellectual disabilities are primarily characterized by a reduced level of intellectual as well as emotional and social functioning. Persons with intellectual disabilities lag behind in the acquisition of academic knowledge, learning and the acquisition of social skills. Knowing the aspects of cognitive functioning of children with intellectual disabilities, it is possible to predict risk factors for the development of behavioural difficulties and mental health disorders. However, it is difficult to determine the level or, at least, the presence of mental disabilities due to the lack of standardized tests to assess mental health in children and young people with intellectual disabilities. Experts who work with persons with intellectual disabilities warn of their often impaired mental health. The aim of the research was to determine the applicability of the YP-CORE questionnaire for assessing psychological distress in children and young people with intellectual disabilities. The survey was conducted with students of the Centre for Education and Teaching in Rijeka on a sample of 59 children and young people aged 7 to 21 years. The obtained results are in line with previous research indicating that 30% of children and young people with intellectual disabilities have severe mental disabilities. Although our results correspond to those obtained in other studies, there are difficulties in applying the questionnaire, especially in people with moderate intellectual disabilities. However, the results are encouraging in terms of validity, which should be the subject of further research in the future

Health Information Seeking on the Internet - Implications for Health Anxiety in the Elderly

Pretraživanje o zdravlju na internetu postalo je vrlo rašireno. Kako starije osobe imaju više zdravstvenih problema, mogle bi postati sve veći konzumenti digitalnih zdravstvenih sadržaja. No, budući da imaju slabije računalne vještine te da nisu naviknute na ulogu „osnaženog pacijenta“, mogle bi doživjeti pretjeranu zabrinutost dok pretražuju o svojim simptomima. Istraživanja sugeriraju da je pretraživanje o zdravlju na internetu potencijalni rizični faktor za patološku zdravstvenu anksioznost, a možda na poseban način djeluje upravo na starije osobe. Istraživanja o pretraživanju kod starijih malobrojna su i uglavnom provedena bez jasnog teorijskog okvira što otežava smislenu interpretaciju i integraciju njihovih nalaza. Stoga je cilj ovoga preglednog rada ponuditi takav teorijski okvir (Leventhalov model zdravorazumske regulacije) te dati pregled nalaza dosadašnjih istraživanja u području integrirajući ih u predloženi model. Ovaj model predviđa da dob i dobne promjene u doživljaju sebe rezultiraju promjenama u zdravstvenim kognicijama i ponašanjima. Pretraživanje o zdravlju na internetu može se konceptualizirati kao strategija suočavanja i sa zdravstvenom prijetnjom i emocionalnom neugodom, a koja ima posljedice na kognitivne reprezentacije bolesti (identitet, uzrok, posljedice, mogućnost kontrole i vremensku dimenziju), zdravstvena ponašanja i ishode. Polazeći od pretpostavki modela, raspravljeno je kako pretraživanje može rezultirati zdravstvenom anksioznošću. Na kraju su pružene smjernice za buduća istraživanja i razmotrene njihove praktične implikacije.Health information seeking on the Internet has become widespread. Since the elderly experience more health issues, they might become more frequent users of digital health content. But, since their computer skills are less advanced and since they are not used to the role of the „empowered patient“, researching their symptoms online might result in excessive anxiety. Research suggests that health information seeking might be a risk factor for pathological health anxiety, yet it may have a specific effect on the elderly. Studies on health information seeking in older adults are sparse and mostly conducted without a clear theoretical framework which complicates meaningful interpretation and integration of their findings. Therefore, the aim of this review paper is to propose such theoretical framework; Leventhal’s Common-sense model of self-regulation, and to review findings of previous studies in the area integrating them in the proposed model. According to this model, ageing and age-related changes in the self, affect health-related cognitions and behaviours. Health information seeking may be conceptualized as a coping response to both health threat and emotional discomfort, which has consequences on illness representations (identity, cause, consequences, control, and timeline), health behaviours and outcomes. Special emphasis was placed to a way in which health information seeking online can result in health anxiety according to the proposed model. Finally, avenues for future research are provided and their practical implications considered

Cultural Adaptation of Cognitive-Bihevioral Therapy – a Contribution to Efficacy

Kognitivno-bihevioralna terapija (KBT) prva je linija tretmana indicirana za široki raspon poremećaja mentalnog zdravlja. Navedeni pristup reflektira europsko-američke vrijednosti, a potrebno je uvažiti kako i kultura pojedinca oblikuje percepciju zdravlja, uvjerenja o uzrocima tegoba te pristup njihovu liječenju. Upravo se stoga preporučuje kulturološka prilagodba psiholoških tretmana. Unatoč tome empirijski nalazi o učinkovitosti takvih tretmana još su skromni. Cilj ovog sustavnog preglednog rada bio je sintetizirati dokaze o učinkovitosti kulturološki prilagođene kognitivno-bihevioralne terapije u usporedbi s neprilagođenom formom u izvanbolničkom kontekstu te ocijeniti kvalitetu tih studija. Istraživanje je provedeno u skladu sa smjernicama PRISMA-P, a prikazana su randomizirana kontrolirana istraživanja objavljena na engleskom jeziku. Uključene su studije koje su ispitivale učinkovitost kulturološki adaptirane i standardne forme KBT-a, bez obzira na modalitet provedbe i vrstu teškoća. U pretraživanje su uključene elektronske bibliografske znanstvene baze, psychINFO i PubMed, registri primarnih studija, Cochrane knjižnica CENTRAL i Gov. Trial baza te izvori sive literature, www.opengrey.eu, DART. U pretraživanje je uključen i Web of Science. Unatoč malom broju studija koje su ispunile kriterij za uključivanje te evidentiranim metodološkim nedostatcima, nalazi ovog istraživanja idu u prilog učinkovitosti kulturološki adaptirane u odnosu na standardnu formu KBT tretmana.Cognitive-behavioral therapy (CBT) is the first line of treatment indicated for a wide range of mental health disorders. This approach reflects Western values, and it is necessary to take into account the fact that the culture of every person also shapes the perception of health, beliefs about the causes of difficulties and the access to the treatment thereof. For that reason, cultural adaptation of psychological treatments is recommended. Despite this, empirical analyses on the effectiveness of such treatments are still scarce. The aim of this review paper is to synthesize evidence on the effectiveness of culturally adapted cognitive-behavioral therapy in comparison to standard form in an outpatient context as well as to evaluate the quality of these studies. The study was conducted in accordance with PRISMA-P guidelines and presents randomised controlled trials published in English. We have included studies that examined the effectiveness of culturally adapted and standard forms of CBT, regardless of the implementation modality or the type of difficulty. To identify studies, the electronic bibliographic databases psychINFO and PubMed, primary study registers, Cochrane Library CENTRAL and Gov.Trial database, and selected grey literature sources www.opengrey.eu and DART were screened. Web of Science was also included in the screening process. Despite a limited number of studies that met the inclusion criteria and methodological deficiencies, the findings of this study support the effectiveness of culturally adapted CBT treatment in comparison with the standard one

Psychophysical Characteristics of the Premenstrual Period

Aim of this study was to investigate psychophysical characteristics of the premenstrual period in regard to the period following menstruation. Psychophysical characteristics are defined as assessments of the physical state (fatigue, breast tenderness, bloating and lack of sleep), emotional state (happiness, anger, sadness, irritability, anxiety and distraction) and general assessments of physical attractiveness and satisfaction with oneself. Diary of psychophysical characteristics was designed for this study as well as a socio-demographic questionnaire and a menstrual cycle calendar. 51 healthy, non-help-seeking women, aged 21–46 kept a diary of psychophysical characteristics a week before menstruation and four days one week after the onset of menstruation, during two menstrual cycles. The premenstrual period is characterized by the intensification of negative emotional states, the decline of positive emotional states, and the worsening of the general self-image through the decline of the perception of physical attractiveness and satisfaction with oneself. In conclusion, the premenstrual period is not marked only by the mood-swings but also by the changes in the cognitive representation of self