Mat á árangri hugrænnar atferlismeðferðar í hóp við félagsfælni

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenÁ geðsviði Landspítala-háskólasjúkrahúss hefur undanfarin ár verið veitt hugræn atferlismeðferð í hóp við félagsfælni. Árangur af þessari meðferð, sem veitt var sex hópum við endurhæfingarsvið frá árinu 2002 til 2005, var borinn saman við biðlistamælingar. Alls hófu 54 manns hópmeðferðina og luku 45, eða 83,3% þátttakenda, meðferðinni. Þátttakendur lækkuðu töluvert á mælingum á einkennum félagsfælni á meðferðartímanum en einkennin stóðu í stað meðan þátttakendur voru á biðlista. Þátttakendur forðuðust félagslegar aðstæður síður undir lok hópmeðferðar, fundu minna fyrir líkamlegum kvíðaeinkennum, höfðu minni áhyggjur af kvíðaeinkennum og minna af neikvæðum hugsunum. Þeir mældust minna þunglyndir, beittu síður öryggishegðun og mátu félagslega færni sína meiri en þeir höfðu gert við upphaf hópmeðferðar. Þessar breytingar áttu sér ekki stað meðan þátttakendur voru á biðlista. Þrátt fyrir töluverða lækkun á mælingum á einkennum félagsfælni mældist hins vegar félagsfælni þátttakenda enn talsverð undir lok hópmeðferðar. Í ljósi þessa er nauðsynlegt að skoða hvort breyta þurfi fyrirkomulagi meðferðar og jafnvel lengja hana til að enn frekari árangur náist.Cognitive behaviour group therapy for social phobia has been given at Landspitali University Hospital, Department of Psychiatry, since 2002. The efficacy of this group therapy was evaluated in this study using single-group design with a baseline period before treatment. Participants were 54 between 2002 and 2005. 45 completed the treatment, or 83,3%. Towards the end of the treatment, participants reported fewer symptoms of social anxiety, were less likely to misinterpret these symptoms and had fewer negative thoughts. They also scored lower on measures of depression and estimated their social competence to be better than they had while they were on a waitinglist. In spite of significant reductions in symptoms of social anxiety, participants still experienced social anxiety at the end of the group therapy. A longer duration of group therapy is indicated, in order to reach even better results

Therapists' beliefs about excessive reassurance seeking and helping manage it : Does experience play a role?

Publisher Copyright: © The Author(s), 2023. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies.Excessive reassurance seeking (ERS) is believed to play an important role in maintaining mental health problems, in particular anxiety disorders such as obsessive-compulsive disorder and health anxiety. Despite this, therapists commonly give into patients' requests for reassurance in clinical settings and are generally unsure how to handle the issue both in therapy itself and concerning advice to the patient's loved ones. In order to increase our understanding of therapists' perception of ERS and how interventions for ERS are managed, we examined therapists' perception and understanding of ERS, including its function, which emotional problems therapists associate it with, and what treatment interventions they consider important for managing ERS. Qualified therapists (n=197) were benchmarked against international expert consensus (n=20) drawn from leading clinical researchers. There was evidence that clinical experience right up to the expert level may result in less reassurance giving within treatment settings. Still, there were enough inconsistencies between the experts and other clinicians to suggest that ERS remains poorly understood and is not consistently dealt with clinically. Results are discussed in terms of how current treatment interventions may be limited for treating ERS, highlighting the need to consider new approaches for dealing with this complicated interpersonal behaviour. Key learning aims (1) To describe the role of excessive reassurance seeking in checking behaviour, including its negative personal and interpersonal consequences. (2) To learn that therapists commonly report finding it difficult to manage reassurance seeking. (3) To learn that therapists' beliefs about excessive reassurance seeking may play a key role in helping us understand how to tackle this complicated behaviour. (4) To consider what therapeutic interventions may be appropriate and helpful for treating excessive reassurance seeking.Peer reviewe

Reassurance and its alternatives : Overview and cognitive behavioural conceptualisation

Funding Information: Excessive Reassurance Seeking (ERS) is an under-researched and poorly understood behaviour that maps onto the compulsive behaviours that are typically seen in obsessional problems. ERS can be complex, persistent, extensive, debilitating and may dominate the interactions of those involved. In this paper we review how ERS has been defined in the literature and put forward a new definition for this construct based on a cognitive behavioural theory. We also highlight the important role ERS may play in maintaining different anxiety problems and explore new ways of managing this behaviour clinically by helping patients to shift from seeking reassurance to seeking support.Peer reviewe

Therapist guided, parent-led cognitive behavioural therapy (CBT) for pre-adolescent children with obsessive compulsive disorder (OCD) : a non-concurrent multiple baseline case series

BACKGROUND: Cognitive behavioural therapy (CBT) including exposure and response prevention (ERP) is an effective treatment for preadolescent children with obsessive compulsive disorder (OCD); however, there is a need to increase access to this treatment for affected children. AIMS: This study is a preliminary evaluation of the efficacy and acceptability of a brief therapist-guided, parent-led CBT intervention for pre-adolescent children (5-12 years old) with OCD using a non-concurrent multiple baseline approach. METHOD: Parents of 10 children with OCD were randomly allocated to no-treatment baselines of 3, 4 or 5 weeks before receiving six to eight individual treatment sessions with a Psychological Wellbeing Practitioner. Diagnostic measures were completed prior to the baseline, 1-week post-treatment, and at a 1-month follow-up, and parents completed weekly measures of children's OCD symptoms/impairment. RESULTS: Seventy percent of children were 'responders' and/or 'remitters' on diagnostic measures at post-treatment, and 60% at the 1-month follow-up. At least 50% of children showed reliable improvements on parent-reported OCD symptoms/impairment from pre- to post-treatment, and from pre-treatment to 1-month follow-up. Crucially, the intervention was acceptable to parents. CONCLUSIONS: Brief therapist-guided, parent-led CBT has the potential to be an effective, acceptable and accessible first-line treatment for pre-adolescent children with OCD, subject to the findings of further evaluations.Peer reviewe

Genetics and epidemiology of mutational barcode-defined clonal hematopoiesis

Publisher Copyright: © 2023, The Author(s).Clonal hematopoiesis (CH) arises when a substantial proportion of mature blood cells is derived from a single hematopoietic stem cell lineage. Using whole-genome sequencing of 45,510 Icelandic and 130,709 UK Biobank participants combined with a mutational barcode method, we identified 16,306 people with CH. Prevalence approaches 50% in elderly participants. Smoking demonstrates a dosage-dependent impact on risk of CH. CH associates with several smoking-related diseases. Contrary to published claims, we find no evidence that CH is associated with cardiovascular disease. We provide evidence that CH is driven by genes that are commonly mutated in myeloid neoplasia and implicate several new driver genes. The presence and nature of a driver mutation alters the risk profile for hematological disorders. Nevertheless, most CH cases have no known driver mutations. A CH genome-wide association study identified 25 loci, including 19 not implicated previously in CH. Splicing, protein and expression quantitative trait loci were identified for CD164 and TCL1A.Peer reviewe

Organizational designs for managing incremental and radical innovation

This paper explores what types of organizational design mature firms in Iceland employ to host incremental and radical innovation. As innovation is generally recognized to be important for a firm’s competitive success, companies need to find the right balance between exploitation through incremental innovation and exploration through radical innovation. This paper draws on a case study by Tushman, Smith, Wood, Westerman, & O'Reilly (2004), which describes four different approaches of organizational design that organizations can employ in managing radical and incremental innovation: functional design, cross-functional teams, ambidextrous design and unsupported teams. A sample of six business units in Iceland, active in innovation and competing in a variety of industries, was explored for this research. Senior managers that were highly involved in innovation projects at their respective companies were interviewed. Each organization was mapped, based on whether it had high or low senior management integration, and high or low structural differentiation. Of the companies explored, three were found to employ a functional design, two cross-functional teams, and one employs an ambidextrous design. Despite efforts to find a case company that might employ unsupported teams, none of the case firms were found to employ that particular organizational design

Vísindakenningar og hversdagsleg gildi: Um áhrif hversdagslegra gilda á beitingu vísindakenninga og siðferðilegra ákvarðana

Í daglegri umræðu er oft gengið út frá því að vísindi færi okkar sannleikann um eðli hlutanna. Hins vegar geta vísindi aldrei greint rétt frá röngu með fullkominni vissu. Aðferðafræði vísinda gerir að verkum að vísindafólk þarf alltaf að „brúa“ bilið á milli reynslugagna og vísindakenninga. Vandinn sem blasir við er hvort og hvernig þetta er gert með skynsömum hætti. Þetta hefur meðal annars orðið til þess að margir vísindaheimspekingar telja vísindastarf vera undir áhrifum gilda með ýmsum hætti. Vísindaheimspekingurinn Heather Douglas hefur fært rök fyrir að hversdagsleg gildi (til dæmis siðferðileg gildi) vísindafólks hafi áhrif á hvort vísindakenningar séu samþykktar eða ekki þegar það hefði afleiðingar sem eru ekki þekkingarfræðilegar (til dæmis siðferðilegar afleiðingar). Skoðun Douglas er sú að vísindafólk á að beita hversdagslegum gildum sínum í slíku ferli. Í ritgerðinni er þessi afstaða Douglas tekin til skoðunar og niðurstaða mín er að það sé ekki í verkahring vísindafólks að taka slíkar ákvarðanir, heldur í verkahring stjórnmálafólks

Mat á árangri hugrænnar atferlismeðferðar í hóp við félagsfælni

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenÁ geðsviði Landspítala-háskólasjúkrahúss hefur undanfarin ár verið veitt hugræn atferlismeðferð í hóp við félagsfælni. Árangur af þessari meðferð, sem veitt var sex hópum við endurhæfingarsvið frá árinu 2002 til 2005, var borinn saman við biðlistamælingar. Alls hófu 54 manns hópmeðferðina og luku 45, eða 83,3% þátttakenda, meðferðinni. Þátttakendur lækkuðu töluvert á mælingum á einkennum félagsfælni á meðferðartímanum en einkennin stóðu í stað meðan þátttakendur voru á biðlista. Þátttakendur forðuðust félagslegar aðstæður síður undir lok hópmeðferðar, fundu minna fyrir líkamlegum kvíðaeinkennum, höfðu minni áhyggjur af kvíðaeinkennum og minna af neikvæðum hugsunum. Þeir mældust minna þunglyndir, beittu síður öryggishegðun og mátu félagslega færni sína meiri en þeir höfðu gert við upphaf hópmeðferðar. Þessar breytingar áttu sér ekki stað meðan þátttakendur voru á biðlista. Þrátt fyrir töluverða lækkun á mælingum á einkennum félagsfælni mældist hins vegar félagsfælni þátttakenda enn talsverð undir lok hópmeðferðar. Í ljósi þessa er nauðsynlegt að skoða hvort breyta þurfi fyrirkomulagi meðferðar og jafnvel lengja hana til að enn frekari árangur náist.Cognitive behaviour group therapy for social phobia has been given at Landspitali University Hospital, Department of Psychiatry, since 2002. The efficacy of this group therapy was evaluated in this study using single-group design with a baseline period before treatment. Participants were 54 between 2002 and 2005. 45 completed the treatment, or 83,3%. Towards the end of the treatment, participants reported fewer symptoms of social anxiety, were less likely to misinterpret these symptoms and had fewer negative thoughts. They also scored lower on measures of depression and estimated their social competence to be better than they had while they were on a waitinglist. In spite of significant reductions in symptoms of social anxiety, participants still experienced social anxiety at the end of the group therapy. A longer duration of group therapy is indicated, in order to reach even better results

Therapist guided, parent-led Cognitive Behavioural Therapy (CBT) for preadolescent children with Obsessive Compulsive Disorder (OCD): a non-concurrent multiple baseline case series

Background: Cognitive Behavioural Therapy (CBT) including Exposure and Response Prevention (ERP) is an effective treatment for preadolescent children with OCD, however, there is a need to increase access to this treatment for affected children. Aims: This study is a preliminary evaluation of the efficacy and acceptability of a brief therapist guided, parent-led CBT intervention for preadolescent children (5- to 12-years-old) with OCD using a non-concurrent multiple baseline approach. Method: Parents of 10 children with OCD were randomly allocated to no-treatment baselines of 3-, 4-, or 5-weeks before receiving 6-to-8- individual treatment sessions with a Psychological Wellbeing Practitioner. Diagnostic measures were completed prior to the baseline, one-week post-treatment, and at a one-month follow-up and parents completed weekly measures of children’s OCD symptoms/impairment. Results: Seventy percent of children were ‘responders’ and/or ‘remitters’ on diagnostic measures at post-treatment, and 60% at the one-month follow-up. At least 50% of children showed reliable improvements on parent-reported OCD symptoms/impairment from pre- to post-treatment, and from pre-treatment to one-month follow-up. Crucially, the intervention was acceptable to parents. Conclusions: Brief therapist guided, parent-led CBT has the potential to be an effective, acceptable, and accessible first-line treatment for preadolescent children with OCD, subject to the findings of further evaluations

Large-Scale Screening for Monogenic and Clinically Defined Familial Hypercholesterolemia in Iceland.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadObjective: Familial hypercholesterolemia (FH) is traditionally defined as a monogenic disease characterized by severely elevated LDL-C (low-density lipoprotein cholesterol) levels. In practice, FH is commonly a clinical diagnosis without confirmation of a causative mutation. In this study, we sought to characterize and compare monogenic and clinically defined FH in a large sample of Icelanders. Approach and Results: We whole-genome sequenced 49 962 Icelanders and imputed the identified variants into an overall sample of 166 281 chip-genotyped Icelanders. We identified 20 FH mutations in LDLR, APOB, and PCSK9 with combined prevalence of 1 in 836. Monogenic FH was associated with severely elevated LDL-C levels and increased risk of premature coronary disease, aortic valve stenosis, and high burden of coronary atherosclerosis. We used a modified version of the Dutch Lipid Clinic Network criteria to screen for the clinical FH phenotype among living adult participants (N=79 058). Clinical FH was found in 2.2% of participants, of whom only 5.2% had monogenic FH. Mutation-negative clinical FH has a strong polygenic basis. Both individuals with monogenic FH and individuals with mutation-negative clinical FH were markedly undertreated with cholesterol-lowering medications and only a minority attained an LDL-C target of <2.6 mmol/L (<100 mg/dL; 11.0% and 24.9%, respectively) or <1.8 mmol/L (<70 mg/dL; 0.0% and 5.2%, respectively), as recommended for primary prevention by European Society of Cardiology/European Atherosclerosis Society cholesterol guidelines. Conclusions: Clinically defined FH is a relatively common phenotype that is explained by monogenic FH in only a minority of cases. Both monogenic and clinical FH confer high cardiovascular risk but are markedly undertreated.Landspitali University Hospital Research Fun