Group cognitive-behavioral therapy for patients with epilepsy and comorbid depression and anxiety.

Clinical Practice Guidelines for depression and anxiety recommend cognitive-behavioral therapy (CBT) as an equivalent and sometimes more effective treatment than medication. The limited research investigating CBT for anxiety and depression in epilepsy demonstrates mixed results. Described here is a pilot project using an existing group CBT intervention for symptoms of depression and/or anxiety, CBT Basics II, in patients with epilepsy. Eighteen patients with epilepsy, referred by neurologists to address depression and/or anxiety symptoms, completed the 10-week group. Results demonstrated improvements in depression, anxiety, negative automatic thoughts, and cognitive therapy knowledge and skills. The group was generally acceptable to patients as indicated by good attendance rates and only one dropout. This pilot project demonstrates that group CBT is a feasible, acceptable, and promising intervention for patients with epilepsy and comorbid depression and anxiety symptoms.

Subject characteristics and long term post-program smoking cessation.

In order to identify predictors of long-term post-treatment smoking abstinence, 333 adult smokers who volunteered to participate in a smoking cessation program were asked to complete a set of questionnaires which measured self-efficacy, motivation, reasons for smoking, and smoking history variables. Subjects were then randomly assigned to one of four smoking cessation interventions. Nine variables predicted abstinance up to and including one year following treatment. The importance of self-efficacy beliefs in quitting smoking was underscored.

The interactional model of anxiety: an evaluation of the differential hypothesis.

The interactional model of anxiety states that individuals who score high on trait anxiety measure for a specific situation dimension will respond with elevated state anxiety only in reaction to encounters with congruent situations. We tested this model by presenting subjects who scored high or low on ego threat, physical danger, novelty ambiguity, and daily routine trait measures with stressors representative of the four situation dimensions. The interactional model was partially supported for ego threat trait anxiety. However, results generally supported the influence of situation rather than the trait or interaction on anxiety response. The lack of trait factor independence for the novelty ambiguity and daily routine trait dimensions is discussed as a potential reason for the nonsupport of the interactional model. Finally, we suggest that the experimental design used in this study is a more accurate and vigorous test of the differential hypothesis than past research.

A randomized trial of three approaches to smoking cessation.

Three hundred and sixty-six patients volunteered for a smoking cessation trial and were randomly allocated to a control group or to three interventions: a single counselling visit to a physician, eight sessions of group health education or eight sessions of group behavior modification. Progress was assessed by smoking diaries, supported by saliva thiocyanate tests, before and after the intervention and six and 12 months later. Only the two group approaches showed a significant improvement compared to the control group immediately after the intervention; these differences were no longer statistically significant six or 12 months later. The group methods proved to be more cost-effective than the physician intervention. However, when different sub-groups were examined, such as heavy or light smokers, a different pattern of results emerged. For very heavy smokers, the physician-led intervention proved almost as successful as the group approaches. Overall quitting results were disappointing, but the programs appear to be more successful at helping people reduce smoking.

The diagnosis and conservative treatment of myofascial pain dysfunction syndrome.

The findings in 194 cases of myofascial pain dysfunction syndrome are summarized and the differential diagnosis of the condition is discussed. Conservative methods of treatment were used in all cases, and follow-up revealed complete or almost complete recovery in 75 per cent of the patients; this percentage was increased still further when relaxation and coping skills training were used. Those patients who had been involved in accidents with direct or indirect trauma to one or both joints showed a significantly higher proportion of nonresponse to therapy.