Dysfunctional beliefs discriminate personality disorders.

This study examines whether specific sets of dysfunctional beliefs are differentially associated with five personality disorders (PDs) as predicted by cognitive theory. Seven hundred fifty-six psychiatric outpatients completed the Personality Belief Questionnaire (PBQ) at intake and were assessed for PDs using a standardized clinical interview conducted by assessors who were blind to patients' PBQ responses. Findings showed that patients with avoidant, dependent, obsessive-compulsive, narcissistic, and paranoid PDs preferentially endorsed PBQ beliefs theoretically linked to their specific disorders. The study results support the cognitive theory of personality disorders. Suggestions are made regarding the clinical utility of the PBQ with personality-disordered patients and future research on the PBQ.

A comparison of focused and standard cognitive therapy for panic disorder.

The relative efficacy of two psychotherapeutic approaches to panic disorder, namely, focused cognitive therapy (FCT) and standard cognitive therapy (SCT) was examined. FCT focused specifically on the "catastrophic misinterpretation" of physical and psychological sensations experienced during panic attacks induced in the office or occurring spontaneously between sessions. SCT focused primarily on the cognitions and beliefs relevant to interpersonal concerns involved in generalized anxiety. We hypothesized that FCT would be more effective than SCT since the latter did not include an induced panic exercise (exposure condition) specific to the patient's panicogenic cognitions. Forty patients diagnosed with panic disorder were randomly assigned to the SCT and FCT groups for approximately 12 to 18 sessions of treatment. Both groups reported significant decreases in the severity of the clinical measures at termination. Moreover, 89.5% of the SCT group and 84.2% of the FCT group were free of panic attacks at 1-year follow-up. Contrary to the predictions, the results for measures of panic attack frequency, anxiety, and depression did not reveal any significant differences between the two groups. Results suggest that in-office "exposure" is not necessary for improvement and that a primary focus on cognitions associated with generalized anxiety may be an effective intervention. However, since improvement in panic was correlated with normalizing of panic-related beliefs in both conditions, it is suggested that cognitive change may be a crucial ingredient of improvement in panic episodes.

Cognitive therapy of substance abuse: theoretical rationale.

In this chapter, the authors assert that drug-related beliefs are an important factor in drug abuse and its treatment. Three types of acute drug-related beliefs have been described that contribute to urges, cravings, and ultimate use of drugs: anticipatory beliefs, relief-oriented beliefs, and permissive beliefs, and various ways have been described to assess more general, long-term beliefs pertinent to drug use. The role of the cognitive therapist is to assess, examine, and test these beliefs with the patient in order to ultimately develop more adaptive beliefs. The active application of skills and homework that tap into the patient's adaptive beliefs helps the patient to become and remain drug-free.

Hopelessness, depression, suicidal ideation, and clinical diagnosis of depression.

The relevance of a clinical diagnosis of depression for explaining the discrepant relationships of hopelessness and depression with suicidal ideation was studied. The Beck Depression Inventory (BDI), Hopelessness Scale (BHS), and the Scale for Suicide Ideation (SSI) were administered to 1,306 (72.8%) patients with at least one DSM-III-R mood disorder and 488 (27.3%) patients without any mood disorders. A multiple regression analysis was conducted, and hopelessness was 1.3 times more important than depression was for explaining suicidal ideation. The interactions of the BDI and BHS with diagnostic group were not significant.

Nutritional support in HIV disease.

As the management of HIV disease enters the realm of life-long treatment, rather than treatment for a terminal disease, nutrition becomes an important part of the treatment plan. Studies have shown a clear relationship between good nutritional status and the longevity of the AIDS patient.

Nutrition-related backgrounds and counseling practices of doctors of chiropractic.

A questionnaire was designed and mailed to the entire membership (no. = 438) of the San Francisco Bay Area Chiropractic Society to determine their nutrition education backgrounds and counseling practices and the relationship of backgrounds and counseling practices and the relationship of backgrounds and information resources to counseling practices. Results, based on the 23% response rate, indicated that the hours of formal nutrition education in chiropractic college varied widely in the five categories of responses from zero to more than 120, with the median respondent falling in the median category (81 to 100 hours). Sixty percent of the respondents indicated that they provided nutrition information to their patients on a routine basis, and 38% provided information on request only. The major forms of nutrition information dissemination were counseling (87%) and written materials (74%). The majority of respondents reported that they diagnose osteoporosis, arthritis, and allergies and use nutrition treatments for those disorders as a part of overall therapy. Chiropractic journals and texts were the most frequently used sources of nutrition information. Awareness of the educational backgrounds of registered dietitians correlated positively with the use of dietitians as a resource for nutrition information (p less than .005). The survey results suggest a need for dietitians to become involved in the nutrition-related practices of chiropractors as sources for information and referral.