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1.
J Affect Disord ; 360: 376-386, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38823593

RESUMO

Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and âˆ¼2.5h and âˆ¼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention.


Assuntos
Depressão , Avaliação Momentânea Ecológica , Solidão , Interação Social , Humanos , Solidão/psicologia , Feminino , Masculino , Adulto , Depressão/psicologia , Pessoa de Meia-Idade , Adulto Jovem
2.
Cogn Behav Pract ; 28(2): 127-146, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-38371740

RESUMO

Efforts to integrate cultural competence and evidence-based treatments (EBTs) typically take the form of cultural adaptations of EBTs, characterized by modifications to the existing treatment based on presumed cultural notions of a given race or ethnic group. Much less attention has been given to ways EBTs can integrate a process model of cultural competence, which focuses on what clinicians do in-session to identify and integrate key cultural factors for a given individual in the treatment. Our objective is to consider how a process model of cultural competence (Shifting Cultural Lenses) can be integrated with an EBT (Behavioral Activation). We present a theoretical rationale for integrating the SCL model with BA and illustrate this integration, which clinician provides an additional approach to bringing culture to treatments and shows promise for identifying clinicians' in-session behaviors that reflect cultural competence.

3.
BMC Psychol ; 8(1): 111, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097084

RESUMO

BACKGROUND: Pierce's (The Black seventies: an extending horizon book, 1970) conception of "subtle and stunning" daily racial offenses, or microaggressions, remains salient even 50 years after it was introduced. Microaggressions were defined further by Sue and colleagues (Am Psychol 62:271, 2007), and this construct has found growing utility as the deleterious effects of microaggressions on the health of people of color continues to mount. Microaggressions are common on campuses and contribute to negative social, academic, and mental health outcomes. METHOD: This paper explores how Black college students' experiences correspond to or differ from the microaggression types originally proposed by Sue et al. (Am Psychol 62:271, 2007). Themes were identified from focus group data of students of color (N = 36) from predominately White institutions (PWIs) of higher learning (N = 3) using interpretative phenomenological analysis. RESULTS: We identified 15 categories of racial microaggressions, largely consistent with the original taxonomy of Sue et al. but expanded in several notable ways. New categories in our data and observed by other researchers, included categories termed Connecting via Stereotypes, Exoticization and Eroticization, and Avoidance and Distancing. Lesser studied categories identified included Sue et al.'s Denial of Individual Racism, and new categories termed Reverse Racism Hostility, Connecting via Stereotypes, and Environmental Attacks. DISCUSSION: While previous literature has either embraced the taxonomy developed by Sue and colleagues or proposed a novel taxonomy, this study synthesized the Sue framework in concert with our own focus group findings and the contributions of other researchers. Improving our understanding of microaggressions as they impact people of color may better allow for improved understanding and measurement of this important construct.


Assuntos
Agressão , Negro ou Afro-Americano/psicologia , Pesquisa Qualitativa , Racismo/estatística & dados numéricos , Universidades , População Branca/psicologia , Feminino , Humanos , Masculino , Adulto Jovem
4.
Int. j. psychol. psychol. ther. (Ed. impr.) ; 20(3): 373-394, oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200329

RESUMO

No disponible


Intimate relationships matter for both human's physical and psychological health. Although many theories have been developed to study this topic, there is no consensus about the underlying processes in human relationships. The Interpersonal Process Model, which has well-established empirical support, aims to address the development of intimate relationships describing them as observed behaviors. This has important implications in psychotherapy, especially for those approaches that understand the interpersonal patient-therapist relationship as a tool for change. That is the case of Functional Analytic Psychotherapy. In this paper we articulate a model of intimate relationships based on Interpersonal Process Model and the principles of Functional Behavioral Analysis, connecting it with previous results on the field of intimate relationships. Likewise, a discussion about its implications in psychotherapy and its utility to solve some Functional Analytic Psychotherapy's limitations is presented


Assuntos
Humanos , Relações Interpessoais , Codependência Psicológica , Psicoterapia/instrumentação , Terapia Cognitivo-Comportamental/métodos , Habilidades Sociais , Pesquisa Comportamental/métodos , Processos Psicoterapêuticos
5.
Clín. salud ; 31(2): 85-90, jul. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-191919

RESUMO

The predominant model of burnout posits three dimensions: emotional exhustion (EE), depersonalization (D), and (a lack of) personal accomplishment (PA). To date, contextual behavioral approaches have explored the role of psychological flexibility within this model of burnout but has not focused on the role of interpersonal variables, such as suggested by the Awareness, Courage, and Love (ACL) model of Functional Analytic Psychotherapy. In this study, 269 Spanish mental health workers completed a questionnaire study exploring the unique contribution of ACL, over and above psychological flexibility, to understanding burnout. Results indicated that psychological flexibility predicted all three dimensions of burnout. Regarding ACL, love was the strongest predictor of D over and above psychological flexibility and all three ACL dimensions contributed to PA prediction. We briefly present a contextual-behavioral model that integrates these findings with implications for improving interventions to reduce burnout in mental health practitioners


El modelo predominante del burnout asume tres dimensiones: agotamiento emocional (AE), despersonalización (D) y (falta de) logro personal (LP). Hasta la fecha, enfoques conductuales-contextuales han explorado el papel de la flexibilidad psicológica en el burnout, pero no el rol de variables interpersonales como las del modelo Consciencia, valentía y amor (ACL, por sus siglas en inglés) de la psicoterapia analítica funcional. En este estudio, 269 trabajadores españoles de salud mental cumplimentaron un formulario que exploraba la contribución del ACL, más allá de la flexibilidad psicológica, para comprender el burnout. Los resultados principales muestran que la flexibilidad psicológica predice las tres dimensiones del burnout. Con respecto al modelo ACL, el amor fue el predictor más fuerte de D, después de la flexibilidad psicológica; las tres dimensiones del ACL contribuyen a predecir el LP. En este trabajo se presenta brevemente un modelo conductual-contextual que integra estos hallazgos y sus implicaciones para mejorar las intervenciones para reducir el burnout en profesionales de salud mental


Assuntos
Humanos , Masculino , Feminino , Esgotamento Psicológico/psicologia , Pessoal de Saúde/psicologia , Saúde Mental , Amor
6.
BMC Med Educ ; 20(1): 88, 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32209082

RESUMO

BACKGROUND: Racial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters. METHODS: This paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention specifically aimed to decrease providers' likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially charged moments, such as when patients discuss past incidents of discrimination. Workshop exercises were informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provider emotional rapport and responsiveness during simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants. RESULTS: Greater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants. CONCLUSIONS: Medical providers may be more likely to exhibit bias with patients of color in specific racially charged moments during medical encounters. This small-sample pilot study suggests that interventions that directly intervene to help providers improve responding in these moments by incorporating mindfulness and interracial contact may be beneficial in reducing racial health disparities.


Assuntos
Agressão , Relações Profissional-Paciente , Racismo , Adulto , Feminino , Humanos , Masculino , Observação , Projetos Piloto , Autorrelato
7.
Qual Life Res ; 29(1): 127-139, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31535262

RESUMO

PURPOSE: Humans are fundamentally social beings, and the relationships we form with others are crucial for our well-being. Research across a variety of domains has established the association between a variety of interpersonal factors and health outcomes, including quality-of-life. However, there is a need for a more integrative, holistic analysis of these variables and how they relate to one another. METHODS: Undergraduate students (n = 1456) from four universities across the United States completed self-report measures of their quality-of-life and a variety of interpersonal factors identified as important predictors across the literature. We examined zero-order correlations between these measures and quality-of-life, estimated a path model to look at unique variance accounted for by each, and finally used network analysis to examine the network of direct and indirect associations among these variables and quality-of-life. RESULTS: Loneliness had the strongest association with quality-of-life across all analyses. When examining the unique association between quality-of-life and each interpersonal variable, six remained statistically significant: loneliness, social support, social connectedness, emotional intelligence, intimacy with one's romantic partner, and empathic concern. These results were supported by the network model, which found direct associations between quality-of-life and these six variables as well as indirect associations with all other interpersonal variables in the model. CONCLUSIONS: Results from this research suggest that interpersonal factors in general, and loneliness in particular, are strongly associated with quality-of-life. Future research is needed to establish the direction of these effects and examine for whom these findings are generalizable.


Assuntos
Relações Interpessoais , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudantes , Adulto Jovem
8.
Int J Ment Health Nurs ; 27(1): 276-286, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28220616

RESUMO

Mental health inpatient milieus have repeatedly been found to be associated with passivity, social disengagement, and low levels of interaction with staff. However, little is known about patients' experiences related to different ward activities. In the present study, we aimed to study the reports of activities and associated experiences of patients admitted to acute psychiatric inpatient wards. Disengaged, inactive, and solitary activities were hypothesized to be associated with less reward and more distress than their counterparts. We also aimed to investigate if such activities predicted distress, and if they were associated with clinical severity. Participants (n = 102) recorded their activities along with concurrent ratings of reward and distress in a structured 1-day diary, and nurses provided clinical severity ratings. On average, 3.74 of the 11 hours assessed (34%) were spent doing nothing, only 0.88 hours (8%) were spent with staff, and most of the time was spent in solitude. Doing nothing, being alone, and passivity were associated with the greatest levels of distress and lowest levels of reward, whereas informal socializing demonstrated the opposite pattern. Distress was not predicted by activity or reward when adjusting for baseline distress. Clinical severity was not associated with the amount of time spent alone or the experience of reward during activity. In conclusion, the risk for passivity and social disengagement during admission prevails. This activity pattern could have detrimental emotional consequences and warrants action, but more studies are needed to determine if activity actually precedes emotional experience.


Assuntos
Emoções , Prontuários Médicos , Transtornos Mentais/terapia , Unidade Hospitalar de Psiquiatria , Atividades Cotidianas/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
9.
J Racial Ethn Health Disparities ; 5(5): 919-927, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29098598

RESUMO

Prior research has demonstrated a clear relationship between experiences of racial microaggressions and various indicators of psychological unwellness. One concern with these findings is that the role of negative affectivity, considered a marker of neuroticism, has not been considered. Negative affectivity has previously been correlated to experiences of racial discrimination and psychological unwellness and has been suggested as a cause of the observed relationship between microaggressions and psychopathology. We examined the relationships between self-reported frequency of experiences of microaggressions and several mental health outcomes (i.e., anxiety [Beck Anxiety Inventory], stress [General Ethnic and Discrimination Scale], and trauma symptoms [Trauma Symptoms of Discrimination Scale]) in 177 African American and European American college students, controlling for negative affectivity (the Positive and Negative Affect Schedule) and gender. Results indicated that African Americans experience more racial discrimination than European Americans. Negative affectivity in African Americans appears to be significantly related to some but not all perceptions of the experience of discrimination. A strong relationship between racial mistreatment and symptoms of psychopathology was evident, even after controlling for negative affectivity. In summary, African Americans experience clinically measurable anxiety, stress, and trauma symptoms as a result of racial mistreatment, which cannot be wholly explained by individual differences in negative affectivity. Future work should examine additional factors in these relationships, and targeted interventions should be developed to help those suffering as a result of racial mistreatment and to reduce microaggressions.


Assuntos
Afeto , Ansiedade , Negro ou Afro-Americano , Trauma Psicológico , Racismo , Estresse Psicológico , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Ansiedade/epidemiologia , Ansiedade/psicologia , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Neuroticismo , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Racismo/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Estudantes , Brancos
10.
Clin Psychol Rev ; 58: 141-156, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29089146

RESUMO

Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991) is a transdiagnostic approach to outpatient psychotherapy that presented guidelines to instantiate the behavioral principle of natural, social reinforcement applied to idiographic behavioral targets within a genuine and authentic psychotherapy relationship. We present the first comprehensive review of research on FAP, including qualitative studies, uncontrolled and controlled single-case designs, group designs, and studies on training therapists in FAP. We conclude that current research support for FAP is promising but not sufficient to justify claims that FAP is research-supported for specific psychiatric disorders. There is stronger support for FAP's mechanism of therapist-as-social reinforcer: FAP techniques, when appropriately applied to idiographically defined behavioral problems-primarily in the realm of social functioning-produce positive change in those behaviors.


Assuntos
Terapia Comportamental/métodos , Transtornos Mentais/terapia , Avaliação de Resultados em Cuidados de Saúde , Reforço Psicológico , Humanos
11.
J Consult Clin Psychol ; 85(8): 814-825, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28726481

RESUMO

OBJECTIVE: This randomized-controlled trial assessed the efficacy of a trainer-led, active-learning, modular, online behavioral activation (BA) training program compared with a self-paced online BA training with the same modular content. METHOD: Seventy-seven graduate students (M = 30.3 years, SD = 6.09; 76.6% female) in mental health training programs were randomly assigned to receive either the trainer-led or self-paced BA training. Both trainings consisted of 4 weekly sessions covering 4 core BA strategies. Primary outcomes were changes in BA skills as measured by an objective role-play assessment and self-reported use of BA strategies. Assessments were conducted at pre-, post-, and 6-weeks after training. A series of longitudinal mixed effect models assessed changes in BA skills and a longitudinal model implemented with generalized estimating equations assessed BA use over time. RESULTS: Significantly greater increases in total BA skills were found in the trainer-led training condition. The trainer-led training condition also showed greater increases in all core BA skills either at posttraining, follow-up, or both. Reported use of BA strategies with actual clients increased significantly from pre- to posttraining and maintained at follow-up in both training conditions. CONCLUSIONS: This trial adds to the literature on the efficacy of online training as a method to disseminate BA. Online training with an active learning, modular approach may be a promising and accessible implementation strategy. Additional strategies may need to be paired with the online BA training to assure the long-term implementation and sustainability of BA in clinical practice. (PsycINFO Database Record


Assuntos
Terapia Comportamental/métodos , Transtorno Depressivo/terapia , Internet , Terapia Assistida por Computador/métodos , Adulto , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Estudantes , Resultado do Tratamento , Adulto Jovem
12.
Clin Psychol Psychother ; 24(4): 1014-1027, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28008691

RESUMO

Functional Analytic Psychotherapy (FAP) is a behavioral psychotherapy intervention that emphasizes the development of an intimate and intense therapeutic relationship as the vehicle of therapeutic change. Recently, research has provided preliminary support for a FAP therapist training (FAPTT) protocol in enhancing FAP competency. The present study aimed to expand on this research by examining the effects of FAPTT on FAP-specific skills and competencies and a set of broadly desirable therapist qualities (labelled awareness, courage and love in FAPTT) in a sample of therapist trainees in Singapore. The study also evaluated the feasibility and acceptability of FAP in the Singaporean context. Twenty-five students enrolled in a master's in clinical psychology program were recruited and randomly assigned to receive either eight weekly sessions of a FAPTT course or to a waitlist condition. All participants completed measures assessing empathy, compassionate love, trait mindfulness, authenticity and FAP-specific skills and competencies pre- and post-training, and at 2-month follow-up. A post-course evaluation was administered to obtain participants' qualitative feedback. Results indicated that compared with the waitlisted group, FAPTT participants reported significant increases in overall empathy, FAP skill and treatment acceptability from pre- to post-training. Improvements were observed on several outcome variables at 2-month follow-up. Participants reported finding the training to be both feasible and acceptable, although several raised issues related to the compatibility of the treatment with the local cultural context. Overall, the findings suggest that FAPTT is effective for improving specific FAP competencies and selected broadly desirable therapist qualities among therapist trainees. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Functional Analytic Therapy (FAP) therapist training protocol was effective in improving empathy and FAP skills among Singaporean therapist trainees. These improvements were maintained at 2-month follow-up. The training was found to be acceptable in the Singaporean context, although several adaptations were suggested to increase the compatibility between FAP principles and local cultural norms.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/métodos , Relações Profissional-Paciente , Terapia Psicanalítica/educação , Estudantes de Medicina/psicologia , Adulto , Empatia , Feminino , Humanos , Amor , Masculino , Atenção Plena , Singapura , Adulto Jovem
13.
J Behav Ther Exp Psychiatry ; 54: 93-100, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27423222

RESUMO

BACKGROUND AND OBJECTIVES: Our understanding of how Behavioral Activation (BA) for depression works is limited. BA is theorized to lead to changes in depression through changes in activation. While distal support for activation as a mechanism has been obtained, more research is needed before definitive conclusions can be drawn. Research on mechanism should consider the appropriate time-frame for examining changes in the theorized mechanism variable and whether the proposed mechanism is expected to exert causal influence in all BA cases. These issues were considered in the current study in which a post-hoc analysis was conducted to explore BA's mechanism using single-subject data obtained at each session during the course of treatment. METHODS: Activation and depression data were obtained from a randomized-controlled trial of BA for Latinos (BAL) compared to treatment-as-usual (TAU). Cross-lagged correlations were computed to test whether activation changes preceded, co-occurred with, or lagged behind changes in depression in a sample of 21 clients (BAL n = 14; TAU n = 7). Differences among participants based on activation-depression patterns were examined. RESULTS: For 79% of the BAL sample, changes in activation preceded or co-occurred with changes in depression, while no clients in the TAU sample evidenced this pattern. LIMITATIONS: Use of more proximal and objective measures of the constructs of interest and a higher dosage of BA may have served as a stronger test of the treatment's mechanism. CONCLUSIONS: More time-sensitive measurement of changes in variables of interest is needed.


Assuntos
Terapia Comportamental/métodos , Transtorno Depressivo/psicologia , Transtorno Depressivo/reabilitação , Hispânico ou Latino/psicologia , Resultado do Tratamento , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Psicometria
14.
15.
Scand J Psychol ; 57(1): 73-82, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26094553

RESUMO

Learning theory provides a foundation for understanding and deriving treatment principles for impacting a spectrum of functional processes relevant to the construct of depression. While behavioral interventions have been commonplace in the cognitive behavioral tradition, most often conceptualized within a cognitive theoretical framework, recent years have seen renewed interest in more purely behavioral models. These modern learning theory accounts of depression focus on the interchange between behavior and the environment, mainly in terms of lack of reinforcement, extinction of instrumental behavior, and excesses of aversive control, and include a conceptualization of relevant cognitive and emotional variables. These positions, drawn from extensive basic and applied research, cohere with biological theories on reduced reward learning and reward responsiveness and views of depression as a heterogeneous, complex set of disorders. Treatment techniques based on learning theory, often labeled Behavioral Activation (BA) focus on activating the individual in directions that increase contact with potential reinforcers, as defined ideographically with the client. BA is considered an empirically well-established treatment that generalizes well across diverse contexts and populations. The learning theory account is discussed in terms of being a parsimonious model and ground for treatments highly suitable for large scale dissemination.

16.
J Affect Disord ; 180: 190-9, 2015 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-25913804

RESUMO

BACKGROUND: Incorporating religious beliefs into mental health therapy is associated with positive treatment outcomes. However, evidence about faith-sensitive therapies for minority religious groups is limited. METHODS: Behavioural Activation (BA), an effective psychological therapy for depression emphasising client values, was adapted for Muslim patients using a robust process that retained core effective elements of BA. The adapted intervention built on evidence synthesised from a systematic review of the literature, qualitative interviews with 29 key informants and findings from a feasibility study involving 19 patients and 13 mental health practitioners. RESULTS: Core elements of the BA model were acceptable to Muslim patients. Religious teachings could potentially reinforce and enhance BA strategies and concepts were more familiar to patients and more valued than the standard approaches. Patients appreciated therapist professionalism and empathy more than shared religious identity but did expect therapist acceptance that Islamic teachings could be helpful. Patients were generally enthusiastic about the approach, which proved acceptable and feasible to most participants; however, therapists needed more support than anticipated to implement the intervention. LIMITATIONS: The study did not re-explore effectiveness of the intervention within this specific population. Strategies to address implementation issues highlighted require further research. CONCLUSIONS: The adapted intervention may be more appropriate for Muslim patients than standard therapies and is feasible in practice. Therapist comfort is an important issue for services wishing to introduce the adapted therapy. The fusion of conceptual frameworks within this approach provides increased choice to Muslim patients, in line with policy and research recommendations.


Assuntos
Terapia Comportamental/métodos , Depressão/etnologia , Depressão/terapia , Islamismo/psicologia , Relações Profissional-Paciente , Religião e Medicina , Características Culturais , Feminino , Humanos , Masculino , Resultado do Tratamento
17.
Behav Ther ; 46(2): 177-92, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25645167

RESUMO

Depression presents a significant public health burden for Latinos, the largest and fastest-growing minority group in the United States. The current study performed a randomized controlled trial of Behavioral Activation (BA) for Latinos (BAL, n=21), with relatively minor modifications, compared to treatment as usual (TAU, n=22) in a community mental health clinic setting with a sample of depressed, Spanish-speaking Latinos. TAU was a strong comparison condition, taking place at the same clinic, under the same guidelines and clinic protocols, with similar levels of ongoing consultation, and using the same pool of therapists as BAL. Results indicated that BAL performed well with respect to treatment engagement and retention. Regarding acute treatment outcomes, an interaction emerged between number of sessions attended and condition. Specifically, only BAL clients who were engaged in treatment and attended more sessions demonstrated significant reductions in depression and improvements in quality of life and mental health functioning. Results are discussed in terms of the balance of efficacy and effectiveness issues addressed in this trial.


Assuntos
Terapia Comportamental/métodos , Transtorno Depressivo Maior/terapia , Hispânico ou Latino/psicologia , Grupos Minoritários/psicologia , Cooperação do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Transtorno Depressivo Maior/etnologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/etnologia , Qualidade de Vida , Resultado do Tratamento , Estados Unidos , Wisconsin , Adulto Jovem
18.
J Behav Ther Exp Psychiatry ; 46: 170-81, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25460264

RESUMO

BACKGROUND AND OBJECTIVES: The present study employed a multiple baseline study design with repeated measures to explore clinical outcomes, therapy mechanisms, and feasibility of Behavioral Activation for persons admitted to inpatient psychiatry. METHODS: Six adult inpatients with depressive symptoms and different psychiatric disorders were randomized to different lengths of baseline standard inpatient treatment. Subsequently a 5-day, 10-session Behavioral Activation protocol was added. Daily self-report outcome and process measures were administered and supplemented with hourly self-reports and clinician assessments before and after each study phase. RESULTS: After a relatively stable baseline, at least four participants showed marked gradual improvements both in terms of outcome as well as activation and avoidance as Behavioral Activation was initiated. The temporal relation between process and outcome differed somewhat across metrics. In most instances however, change in activation and avoidance either coincided or preceded decreased depression. LIMITATIONS: We did not include some relatively common disorders, did not control for the effects of increased attention, did not investigate treatment integrity, and did not conduct follow-up after discharge. Raters were not blind and measures were mainly focused on depressive symptoms. All received concurrent medical treatment. CONCLUSIONS: This preliminary study further supports the promise of Behavioral Activation as an inpatient treatment for persons with a variety of psychiatric disorders. Results also lends preliminary support for the purported mechanisms of Behavioral Activation.


Assuntos
Sintomas Comportamentais , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Adulto , Sintomas Comportamentais/diagnóstico , Sintomas Comportamentais/etiologia , Sintomas Comportamentais/terapia , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Escalas de Graduação Psiquiátrica , Autorrelato , Inquéritos e Questionários
19.
J Nerv Ment Dis ; 202(7): 556-61, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24921418

RESUMO

Anecdotal reports of increased stigma toward mental illness among Orthodox Jews seems to conflict with an existing literature describing less stigmatization toward depression among Jewish individuals. This online survey study investigated stigma toward depression and treatment preference among Orthodox and non-Orthodox Jews (N = 391). All participants were presented with a depression vignette to assess for stigma and then randomized to a vignette depicting a treatment modality (behaviorally oriented or insight oriented) to assess for treatment preference across several delivery options (individual, group, or Internet). Results indicated elevated depression stigma among Orthodox Jews as expressed by elevated levels of secrecy, treatment-seeking stigma, family/marriage stigma, and stigmatizing experiences, but not attitudinal social distancing. No group differences were found with respect to overall treatment preference, treatment modality, or manner of delivery. Overall, participants preferred individual therapy more than group and Internet therapy and preferred group therapy more than Internet therapy. Clinical and research implications are discussed.


Assuntos
Depressão/etnologia , Judaísmo/psicologia , Preferência do Paciente/psicologia , Religião e Psicologia , Estigma Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Autorrevelação
20.
Artigo em Inglês | IBECS | ID: ibc-119268

RESUMO

The Behavioral Activation for Depression Scale (BADS), a four-factor (Activation, Aviodance/Rumination, Work/School impairment, and Social Impairment), 25-item scale, was to assess response contingent positive reinforcement (RCPR) that underlies the depression. So far, all the studies that examined its psychometric properties supported its usefulness in assessing RCPR in western culture. The purpose of the current study was to further evaluate psychometric properties of BADS that measures RCPR in a non-western culture. Based on a sample of 440 college participants from China, the results revealed that the four-factor of 25-item structure had a good fit to the data except for two items loaded differently from what was hypothesized. The data seemed to support BADS as a valid measure of RCPR and the results were discussed in the context of cultural differences (AU)


No disponible


Assuntos
Humanos , Depressão/psicologia , Psicometria/instrumentação , Escalas de Graduação Psiquiátrica Breve , Diversidade Cultural
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