ABSTRACT
Disorder-specific (DS-CBT) and transdiagnostic (TD-CBT) cognitive behaviour therapy have both been used to treat social anxiety disorder (SAD). This study compared internet-delivered DS-CBT and TD-CBT for SAD across clinician-guided (CG-CBT) and self-guided (SG-CBT) formats. Participants with SAD (n=233) were randomly allocated to receive internet-delivered TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of SAD (Cohen's d≥1.01; avg. reduction≥30%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d≥1.25; avg. reduction≥39%), generalised anxiety disorder (Cohen's d≥0.86; avg. reduction≥36%) and panic disorder (Cohen's d≥0.53; avg. reduction≥25%) were found immediately post-treatment and were maintained or further improved to 24-month follow-up. No marked differences were observed between TD-CBT and DS-CBT or CG-CBT and SG-CBT highlighting the potential of each for the treatment of SAD and comorbid disorders.
Subject(s)
Anxiety Disorders/therapy , Cognitive Behavioral Therapy/methods , Depressive Disorder/therapy , Internet , Phobia, Social/therapy , Self Care/methods , Therapy, Computer-Assisted , Adult , Anxiety Disorders/complications , Anxiety Disorders/psychology , Depressive Disorder/complications , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Phobia, Social/complications , Phobia, Social/psychology , Treatment Outcome , Young AdultABSTRACT
Transdiagnostic cognitive behaviour therapy (TD-CBT) aims to target the symptoms of multiple disorders whereas disorder-specific CBT (DS-CBT) targets the symptoms of principal disorders. This study compared the relative benefits of internet-delivered TD-CBT and DS-CBT when provided in clinician-guided (CG-CBT) and self-guided (SG-CBT) formats for people with a principal diagnosis of Panic Disorder (PD). Participants (n=145) were randomly allocated to receive TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of PD (Cohen's d ≥ 0.71; avg. reduction ≥ 36%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d ≥ 0.71; avg. reduction ≥ 33%), generalised anxiety disorder (Cohen's d ≥ 0.91; avg. reduction ≥ 34%) and social anxiety disorder (Cohen's d ≥ 0.50; avg. reduction ≥ 15%) were found over the 24-month follow-up period. Highlighting their efficacy and acceptability, no marked and consistent differences were observed between TD-CBT and DS-CBT or CG-CBT and DS-CBT.
Subject(s)
Anxiety Disorders/epidemiology , Anxiety Disorders/therapy , Internet , Panic Disorder/epidemiology , Panic Disorder/therapy , Therapy, Computer-Assisted , Adult , Cognitive Behavioral Therapy , Comorbidity , Depressive Disorder/therapy , Female , Follow-Up Studies , Humans , Male , Phobia, Social/therapy , Stress Disorders, Traumatic, Acute/therapy , Treatment OutcomeABSTRACT
Disorder-specific cognitive behavior therapy (DS-CBT) is effective at treating major depressive disorder (MDD) while transdiagnostic CBT (TD-CBT) addresses both principal and comorbid disorders by targeting underlying and common symptoms. The relative benefits of these two models of therapy have not been determined. Participants with MDD (n=290) were randomly allocated to receive an internet delivered TD-CBT or DS-CBT intervention delivered in either clinician-guided (CG-CBT) or self-guided (SG-CBT) formats. Large reductions in symptoms of MDD (Cohen's d≥1.44; avg. reduction≥45%) and moderate-to-large reductions in symptoms of comorbid generalised anxiety disorder (Cohen's d≥1.08; avg. reduction≥43%), social anxiety disorder (Cohen's d≥0.65; avg. reduction≥29%) and panic disorder (Cohen's d≥0.45; avg. reduction≥31%) were found. No marked or consistent differences were observed across the four conditions, highlighting the efficacy of different forms of CBT at treating MDD and comorbid disorders.
Subject(s)
Anxiety Disorders/therapy , Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/therapy , Adolescent , Adult , Anxiety Disorders/complications , Depressive Disorder, Major/complications , Female , Humans , Internet , Male , Middle Aged , Panic Disorder/complications , Panic Disorder/therapy , Patient Satisfaction , Phobic Disorders/complications , Phobic Disorders/therapy , Remote Consultation/methods , Self Care/methods , Treatment Outcome , Young AdultABSTRACT
Generalized anxiety disorder (GAD) can be treated effectively with either disorder-specific cognitive behavior therapy (DS-CBT) or transdiagnostic CBT (TD-CBT). The relative benefits of DS-CBT and TD-CBT for GAD and the relative benefits of delivering treatment in clinician guided (CG-CBT) and self-guided (SG-CBT) formats have not been examined. Participants with GAD (n=338) were randomly allocated to receive an internet-delivered TD-CBT or DS-CBT intervention delivered in either CG-CBT or SG-CBT formats. Large reductions in symptoms of GAD (Cohen's d ≥ 1.48; avg. reduction ≥ 50%) and comorbid major depressive disorder (Cohen's d ≥ 1.64; avg. reduction ≥ 45%), social anxiety disorder (Cohen's d ≥ 0.80; avg. reduction ≥ 29%) and panic disorder (Cohen's d ≥ 0.55; avg. reduction ≥ 33%) were found across the conditions. No substantive differences were observed between DS-CBT and TD-CBT or CG-CBT and SG-CBT, highlighting the public health potential of carefully developed TD-CBT and SG-CBT.
Subject(s)
Anxiety Disorders/therapy , Cognitive Behavioral Therapy/methods , Internet , Adolescent , Adult , Anxiety Disorders/psychology , Comorbidity , Depressive Disorder, Major/therapy , Female , Humans , Male , Middle Aged , Panic Disorder/therapy , Phobic Disorders/therapy , Self Care/methods , Stress Disorders, Traumatic, Acute/therapy , Treatment Outcome , Young AdultABSTRACT
Aims. To date, very few studies have examined the bi-directional associations between mood disorders (MDs), anxiety disorders (ADs) and substance use disorders (SUDs), simultaneously. The aims of the current study were to determine the rates and patterns of comorbidity of the common MDs, ADs and SUDs and describe the onset and temporal sequencing of these classes of disorder, by sex. Methods. Data came from the 2007 Australian National Survey of Mental Health and Wellbeing, a nationally representative household survey with 8841 (60% response rate) community residents aged 16-85. Results. Pre-existing mental disorders increase the risk of subsequent mental disorders in males and females regardless of the class of disorder. Pre-existing SUDs increase the risk of subsequent MDs and ADs differentially for males and females. Pre-existing MDs increase the risk of subsequent ADs differentially for males and females. Conclusions. Comorbidity remains a significant public health issue and current findings point to the potential need for sex-specific prevention and treatment responses.
ABSTRACT
Initially, rats were trained to walk on a treadmill to avoid footshock. Subsequently, rats given additional practice while pentobarbital-intoxicated became cross-tolerant to ethanol. However, rats given equivalent doses of pentobarbital after practice did not become cross-tolerant, nor did saline-vehicle controls. These results challenge the theories of cross-tolerance which are based exclusively upon cellular adaptations to pharmacological stimulation of drug-responsive neurons. That all of the cross-tolerance measured was attributable to the intoxicated practice suggests that this observed cross-tolerance was mediated by some form of learning.
Subject(s)
Conditioning, Classical , Conditioning, Operant , Ethanol/pharmacology , Pentobarbital/pharmacology , Animals , Avoidance Learning , Drug Tolerance , Electroshock , Male , Models, Psychological , RatsABSTRACT
The introduction of CPDA-1, as opposed to CPD, has allowed blood banks to store red blood cells for up to 35 days. The Missouri-Illinois Regional Blood Services studied the impact of CPDA-1 in three areas: reduction in blood outdating, change in distribution pattern, and the potential increase in the age of the products transfused. Our eighteen month study showed a reduction in blood outdating from 7.9 per cent to 3.9 per cent. Additionally, each unit of blood was distributed less frequently (from an average of 1.21 to 1.08 times from collection to transfusion). At the same time there was only a small increase in the mean age of the products transfused. It is our conclusion that the benefits of CPDA-1 can be attained with limited impact on the age of the products transfused.
