ABSTRACT
OBJECTIVE: We examined whether motivation and treatment credibility predicted alliance in a 10-session cognitive behavioral treatment delivered in community clinics for youth anxiety disorders. METHOD: Ninety-one clinic-referred youths (meanage = 11.4 years, standard deviation = 2.1, range 8-15 years, 49.5% boys) with anxiety disorders-rated treatment motivation at pretreatment and perceived treatment credibility after session 1. Youths and therapists (YT) rated alliance after session 3 (early) and session 7 (late). Hierarchical linear models were applied to examine whether motivation and treatment credibility predicted YT early alliance, YT alliance change, and YT alliance agreement. RESULTS: Motivation predicted high early YT alliance, but not YT alliance change or alliance agreement. Youth-rated treatment credibility predicted high early youth alliance and high YT positive alliance change, but not early therapist alliance or alliance agreement. CONCLUSION: Conclusion Efforts to enhance youth motivation and treatment credibility early in treatment could facilitate the formation of a strong YT alliance.
Subject(s)
Anxiety Disorders/therapy , Cognitive Behavioral Therapy/methods , Community Mental Health Centers , Motivation/physiology , Patient Acceptance of Health Care , Therapeutic Alliance , Adolescent , Anxiety/therapy , Child , Female , Humans , MaleABSTRACT
A previously healthy, 21-year-old female presented with acute dermatomyositis. Chest X-ray revealed bilateral hilar adenopathy, and mediastinal lymph node biopsy demonstrated noncaseating granulomata compatible with sarcoidosis. The patient improved spontaneously. The significance of bilateral hilar adenopathy in association with dermatomyositis and implications for management are discussed.
Subject(s)
Dermatomyositis/etiology , Granuloma/complications , Lymphatic Diseases/complications , Muscular Diseases/complications , Sarcoidosis/complications , Adult , Female , Granuloma/pathology , Humans , Lymph Nodes , Lymphatic Diseases/diagnostic imaging , Lymphatic Diseases/pathology , Mediastinum , Muscular Diseases/pathology , RadiographyABSTRACT
Reactive arthritis of one or more peripheral joints developed after an enteric infection with Clostridium difficile in 2 adult patients. Other reactive signs such as conjunctivitis, mucous membrane lesions and urethritis were absent. One patient had the HLA-B27 antigen. Short term followup showed a benign course of the arthritis. Three other cases of arthritis associated with C. difficile were reviewed.
