The self-complexity model (Linville, 1987) predicts that individuals who have numerous self-aspects with little overlap among them will be buffered against the effects of stressful life events and will experience less depression. Despite some evidence to this effect, many replication attempts have failed (cf. Rafaeli-Mor & Steinberg, 2002). The present studies reexamine the self-complexity model, incorporating recent theoretical and methodological critiques of its original formulation (e.g., Brown, Hammen, Wickens, & Craske, 1995; Rafaeli-Mor, Gotlib, & Revelle, 1999). Two prospective studies provide some support for a revised self-complexity hypothesis, which examines separately the effects of differentiation (number of self-aspects) and integration (overlap among them) and considers more carefully the role of stress.
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Adults’ recollections of how often they were teased as children are positively associated with their social anxiety symptoms. It has therefore been suggested that childhood teasing may play a role in the development of social anxiety disorder (SAD). However, existing studies have not determined whether adults with SAD were actually teased more as children or whether their current symptoms have distorted their memories of childhood events. This study examined reports of childhood teasing in adults with SAD before and after cognitive behavioral therapy (CBT). If recollections of childhood teasing are colored by SAD symptoms, then reported frequency of teasing might be more likely to decrease as symptoms improve after CBT. However, if individuals’ memories of teasing are unbiased, they should not substantially change with the reduction of symptoms after CBT. Ninety-one participants with SAD completed the Teasing Questionnaire-Revised (TQ-R) before and after 12 sessions of group CBT. CBT was effective in reducing SAD symptoms, whereas recollections of the frequency of childhood teasing did not change significantly after treatment. These results are consistent with the possibility that recollections of childhood teasing are not substantially biased by symptoms of SAD, and they lend support to previous studies which suggest that adults with SAD endured higher frequencies of teasing as children compared to controls.
- Go to article: Maternal Obesity and Breastfeeding A Review of the Evidence and Implications for Practice
A myriad of factors influence the sub-optimal breastfeeding rates in the U.S. Among these factors is maternal obesity (BMI > 30 kg/m2), which has been found to negatively impact breastfeeding initiation and duration for some women. Obesity increases women’s risk for various complications throughout the perinatal period, which may impact breastfeeding and the long-term health and well-being of women and their children. However, adequate lactation support that upholds a respectful consciousness regarding the potential breastfeeding challenges of women with obesity can assist these women to successfully meet their breastfeeding goals. This review summarizes the literature on the impact of maternal BMI on breastfeeding duration, and maternal and infant risk factors that may complicate lactation for women with obesity. Recommendations for assessing and supporting the needs of mothers with obesity to best achieve their breastfeeding goals are provided.Source:
Research has shown that the Flash Technique (FT) appears to reduce memory-related disturbance and may reduce symptoms of posttraumatic stress disorder. This paper discusses the connections between FT and eye movement desensitization and reprocessing (EMDR) therapy. In FT, clients remind themselves of a traumatic memory without dwelling on it and focus instead on a positive engaging focus and then blink their eyes when prompted. This paper summarizes numerous models describing how the brain processes traumatic material and presents a model for how FT may work in the brain. It proposes that during the blinking, the patient’s periaqueductal gray (PAG) may take over, sensing the reminder of the traumatic memory and reflexively triggering the amygdala. In Porges’s neuroception model, the PAG assesses danger without going through the conscious brain. Recent fMRI data show that for patients with posttraumatic stress disorder, there is enhanced connectivity from the amygdala to the left hippocampus. Thus, triggering the amygdala may, in turn, activate the left hippocampus, which may then provide a brief access to the traumatic memory. Given the brief access, there is insufficient time for the amygdala to go into overactivation. The client remains calm while accessing the traumatic memory, thus setting up the prediction error necessary for possible memory reconsolidation. This process is repeated during blinking in FT allowing memory reconsolidation to proceed. This model requires experimental confirmation.
- Go to article: Efforts to Improve the Accuracy of Information About Electroconvulsive Therapy Given to Patients and Families
Efforts to Improve the Accuracy of Information About Electroconvulsive Therapy Given to Patients and Families
Objective: Many thousands of people still receive electroconvulsive therapy (ECT) but it remains highly contested. A recent audit of the United Kingdom patient information leaflets found multiple inaccuracies and omissions, minimizing risks and exaggerating benefits (e.g., only six leaflets mentioned cardiovascular events). This study reports efforts to improve accuracy for patients and families. Methods: Letters were sent twice to managers of all 51 United Kingdom National Health Service Trusts, (regional bodies which deliver most healthcare) detailing the audit’s findings and the accuracy of their own Trust’s leaflet, also asking what changes would be undertaken. Results: Only nine Trusts responded and three committed to improvements. The Royal College of Psychiatrists released a slightly better but still highly misleading information sheet. Efforts to engage Government and all other relevant United Kingdom bodies failed. Conclusions: Trusts are unwilling to correct misinformation/ provide balanced information.
Mainstream psychiatry is unable to decide on its model of mental disorder. While the great bulk of research is biologically oriented, many practitioners prefer a more holistic model integrating biological, psychological, and social factors. The “biopsychosocial model” attributed to George Engel appears to offer theoretical support, but the evidence is that it does not exist in any form suitable for science. This puts psychiatry in an invidious position, exposed to allegations of misconduct with no obvious defense.
- Go to article: Randomized Controlled Assays and Randomized Controlled Trials: A Category Error With Consequences
In 1962, in the wake of the thalidomide crisis, a new Amendment to the Food and Drugs Act introduced Randomized Controlled Trials (RCTs) into the regulations governing the licensing of medicines. It was believed that requiring companies to demonstrate their products were effective through RCTs would contribute to safety. In 1962, RCTs were a little-understood technique. It was thought trials would produce generalizable knowledge with similar outcomes for successive trials. As a result, regulators adopted a criterion of two positive placebo-controlled trials for licensing medicine. For physicians keen to stall therapeutic bandwagons and eliminate ineffective treatments, a negative RCT result was a good outcome. When it made a gateway to the market, companies, in contrast, had an interest to transform RCTs from assessments that might throw up unexpected or negative results into Randomized Controlled Assays (RCAs) that efficiently generated approvable results. This article outlines the differences between RCTs and RCAs, the steps companies took to transform RCTs into RCAs, and the consequences of this transformation.
- Go to article: The TraumaClinic Model of EMDR Basic Training in Brazil: A Country Case Study for In-Person and Online Training
The TraumaClinic Model of EMDR Basic Training in Brazil: A Country Case Study for In-Person and Online Training
This article utilizes a country case study design to describe the implementation of eye movement desensitization and reprocessing (EMDR) therapy training in Brazil. The primary focus is on the methodology, adaptations, adjustments, and cultural considerations necessary to incorporate in-person and virtual training in this country. Additionally, the article will explore the impact of the Covid-19 pandemic to address National Government Guidance related to social distancing. This guidance required adjustments to training delivery, clinical and self-practice, clinical supervision, and consultation. Finally, the article outlines the advantages and disadvantages of implementing EMDR therapy training in Brazil, expanding to how models of good practice could be implemented in other countries, such as Angola and Mozambique, to include cultural adaptation, sensitivity, and replication.
Most mental health clinicians treating trauma survivors are exposed to repeated details of clients’ traumatic experiences, and some of these clinicians may experience symptoms of indirect trauma through vicarious traumatization (VT), which has the potential of negatively impacting professional quality of life (ProQOL). The ProQOL Scale was developed to measure both negative and positive effects of working with those who have experienced traumatic stress. The purpose of this study was to determine if clinicians who are trained in eye movement desensitization and reprocessing (EMDR) therapy, as compared to trauma-focused cognitive behavioral therapy (TF-CBT) and prolonged exposure (PE), would relate to aspects of their ProQOL differently. Second, it was hypothesized that the ProQOL model would predict VT in TF-CBT and PE clinicians, but not in EMDR therapy clinicians. Fifty-four trauma clinicians who reported their primary modality of treatment as EMDR, PE, and TF-CBT were studied. Participants completed a survey that included demographic information, the ProQOL Scale, and the Vicarious Trauma Scale (VTS). Hierarchical ordinary least squared regression revealed that the empirical ProQOL model did not predict VT scores in EMDR therapy clinicians as it did for non-EMDR therapy clinicians. This study implies that there could be aspects of the EMDR therapy methodology that may support a clinician’s healthy worldview when empathetically bonding with traumatized clients, thereby fostering longevity for both clients and clinicians.
- Go to article: The Effects of EMDR Therapy on Pregnant Clients With Substance Use Disorders: A Narrative, Scoping Literature Review
The Effects of EMDR Therapy on Pregnant Clients With Substance Use Disorders: A Narrative, Scoping Literature Review
This narrative scoping literature review explores a significant clinical population, pregnant women with co-occurring substance misuse, through the lens of adaptive information processing and the potential for eye movement desensitization and reprocessing (EMDR) therapy intervention. A data search in PubMed, PsychINFO, Web of Knowledge, Science Direct, Cochran, and Scopus databases focusing on literature published within the last 10 years. Due to the distinctiveness of the issue, 10 research articles met the required inclusion criteria. The results confirm that EMDR can deliver effective outcomes for women with co-occurring substance use disorder during pregnancy. However, the rationale for using EMDR as a “sole-treatment” intervention appears insufficient. Instead, there is an argument supporting the utilization of integrative approaches. This review highlights the limited research available for this essential population and discusses the need for further study and investigation.