The Efficacy of a Novel Video Game Intervention (MindLight) in Reducing Children's Anxiety

Anxiety disorders are the most prevalent form of psychopathology among children and adolescents. Because demand for treatment far exceeds availability, there is a need for alternative approaches that are engaging, accessible, cost-effective, and incorporate practice to reach as many youth as possible. One novel approach is a video game intervention called MindLight that uses two evidence-based strategies to target childhood anxiety problems. Using neurofeedback mechanics to train players to: (1) attend to positive rather than threatening stimuli and (2) down-regulate arousal during stressful situations, MindLight teaches children how to practice overcoming anxious thoughts and arousal in a fun and engaging context. The present study examined the effectiveness of MindLight versus online cognitive-behavioural therapy (CBT) based psychoeducation sessions as a comparison in reducing anxiety in a sample of 144 anxious children, which was measured in three ways: (1) anxiety symptoms, (2) state anxiety in response to stress, and (3) psychophysiological arousal in response to stress. Children between the ages of 8.05–17.78 years (M=13.61, SD=1.79) were randomly assigned to play MindLight or complete psychoeducation for five hours over three weeks. State anxiety and psychophysiological arousal were assessed in response to two stress tasks before and after exposure to MindLight or psychoeducation. Anxiety symptoms were also measured via a questionnaire. Overall, participants showed significant reductions in anxiety symptoms and state anxiety in response to stress, but not psychophysiological arousal in response to stress. Moreover, the magnitude of reductions in anxiety did not differ between interventions but by age and sex. Specifically, older participants showed a greater decrease in severity of state anxiety in response to a social stressor than younger participants and girls showed a greater decrease in severity of state anxiety in response to a cognitive stressor than boys. The present study suggests that playing MindLight results in similar reductions in anxiety as one of the more common means of delivering CBT principles to youth.

A Cognitive Behavioural Therapy approach to Suicide Assessment and Intervention

An evaluation of training delivered to undergraduate nursing students on the therapeutic benefits and efficacy of the application of a basic CBT model and the use of simple CBT techniques for the assessment and intervention of service users with suicidal intent.

O Efeito da Terapia Cognitivo Comportamental na Anorexia Nervosa: uma meta-análise

Introdução: A Anorexia Nervosa (AN) é a perturbação do comportamento alimentar (PCA) com a maior taxa de mortalidade de todos os transtornos psiquiátricos. Carateriza-se pela recusa em manter um peso corporal normal mínimo, pela distorção da imagem corporal e por um obsessivo medo de ganhar peso. Os comportamentos patológicos a ela associados podem levar a uma semi-inanição que necessita de cuidados médicos pluridisciplinares, muitas vezes, em regime de internamento. Vários ensais clínicos avaliaram a eficácia da Terapia Cognitivo- Comportamental (TCC), indicando que ela favorece a remissão ou a diminuição da frequência de episódios de compulsão alimentar, dos comportamentos purgativos e da restrição alimentar. Objetivo: Combinar os resultados da melhor evidência científica de forma a avaliar a eficácia da TCC em comparação com outras terapias utilizadas no tratamento da AN. Métodos: A pesquisa realizou-se nas bases de dados eletrónicas da MEDLINE, Psyc-Info, Embase, CCTR e de forma manual, incluindo ensaios clínicos controlados randomizados que comparam a TCC com qualquer outro tipo de intervenção no tratamento da AN. Resultados: Foram incluídos 10 estudos que envolveram 957 pacientes: dos quais 571 (59,7%) foram submetidos a tratamento com Terapia cognitivo comportamental e 556 (49,3%) a outras terapias. Não se registaram diferenças significativas nos resultados obtidos em diversos outcomes, exceto nas subescalas Restrições (z=3,03; p=0,02), Preocupações alimentares (z=2,98; p=0,002) e Preocupações com a forma (z=1,71; p=0,09) do EDE e nos scores da escala GAF (z=1,87; p=0,06). Registaram-se diferenças estatisticamente significativas no número de episódios bulímicos (z=2,61; p=0,009), número de episódios de indução de vómito (z=2,11; p=0,03) e no número de episódios de uso indevido de laxantes (z=3,04; p=0,002). Conclusão: A utilização da Terapia Cognitivo-Comportamental no tratamento de doentes com AN parece melhorar bastante os sintomas da doença, revelando-se particularmente eficaz nos resultados obtidos na Eating Disorder Examination Scale. A sua utilização parece levar a uma melhoria no scores da GAF, evidenciando uma melhoria geral do estado de saúde dos pacientes (redução dos episódios de vómito, bulimia e uso de laxantes). / Página | viii ABSTRACT Background: Anorexia Nervosa is an eating disorder with the highest mortality rate of all psychiatric disorders. It is characterized by refusal to maintain a minimally normal body weight, the distortion of body image and obsessive fear of gaining weight. The pathological behaviors associated with it can lead to semi-starvation, requiring medical treatment and multidisciplinary inpatient care. Several clinical trials evaluated the efficacy of Cognitive Behavioral Therapy (CBT) in lead to remission or reduction of the frequency of bingue eating episodes, purgative behaviors and food restriction. Objective: Combining the results of the best scientific evidence to assess the efficacy of CBT in comparison with other therapies used in the treatment of AN. Methods: The research was carried out in electronic databases of MEDLINE, Psyc- Info, Embase, CCTR and manually, including randomized controlled trials that compared CBT with any other type of intervention in the treatment of AN. Results: Of which 571 (59.7%) were treated with cognitive behavioral therapy and 556 (49.3%) to other therapies: 10 studies involving 957 patients were included. No significant differences in the results obtained in different outcomes, except subscales Restrictions (z = 3.03, p = 0.02), Eating Concerns (z = 2.98, p = 0.002) and Shape Concerns (z = 1.71, p = 0.09) in the scores of EDE and the GAF scale (z = 1.87, p = 0.06). There were statistically significant differences in the number of bulimic episodes (z = 2.61, p = 0.009), number of episodes of induced vomiting (z = 2.11, p = 0.03) and the number of occurrences of use misuse of laxatives (z = 3.04, p = 0.002). Conclusion: The use of cognitive-behavioral therapy in the treatment of patients with AN seems to greatly improve the symptoms of the disease, revealing particularly effective results in the Eating Disorder Examination Scale. Its use seems to lead to an improvement in the GAF scores, showing a general improvement of the health status of patients (reduction of episodes of vomiting, bulimia and laxative use).

Våldets onda cirklar : En explorativ undersökning av mäns barndomsupplevelser, maskuliniteter, känslor, våld samt terapeutiska interventioner mot våld

Avhandlingens överordnade syfte är att utforska möjligheterna för ett integrerat forskningsperspektiv på mäns våld samt exemplifiera hur sådan forskning kan bedrivas. Det konkreta syftet är att öka kunskapen om hur våldsamma mäns barndomsupplevelser, socialisation, maskulinitetskonstruktion och emotioner kan relateras till deras våld mot andra män, mot sig själva och mot kvinnor samt till hur terapeutiska interventioner mot våld kan analyseras och utvecklas i korrespondens med denna kunskap. Med vetenskapsteoretiska utgångspunkter hämtade från den kritiska realismen och ekologiska metoder relaterar studien forskning från olika skolbildningar till varandra; - psykologisk: om barndomserfarenheter och socialisation, socialpsykologisk: om emotioner och interaktion samt sociologisk: om social klass, könsmaktsstrukturer och hegemonisk maskulinitet. Detta genomförs för att kunna få tillgång till kunskap om hur olika faktorer samverkar vid mäns våld. I studie I och II studerades möjligheterna att undersöka de sociala banden mellan terapeut/terapi och klient inom terapeutiska behandlingar mot våld. I studie I operationaliserades indikatorer på emotionerna stolthet och skam och i studie II testades dessa på terapeuter inom en KBT-orienterad terapi. I studie IIIundersöktes män i olika maskulinitetspositioner, där urvalet för den ena gruppen hämtades ur populationen män dömda till terapi för våld och missbruk och den andra ur populationen män som organiserat arbetade för jämlikhet och mot våld mot kvinnor. I studien jämfördes de båda gruppernas förhållningssätt till faktorer som i tidigare forskning relaterats till våld och våld mot kvinnor. I studie IVundersöktes våldsdömda mäns karriärer fram till deras nuvarande position som våldsbejakande kriminella i avsikt att öka kunskapen om det samspel mellan faktorer som i olika situationer leder fram till deras våld mot andra män, sig själva och kvinnor. Samtliga empiriska studier använde kvalitativa metoder för datainsamling och analys. I studie IV användes individuella intervjuer och biografisk analys, I studie II ochIII användes gruppintervjuer samt deduktiv innehållsanalys. I studie I, den teoretiska reviewartikeln, utgjorde sociologisk, socialpsykologisk och psykologisk teoribildning empiri. Avhandlingen visar att det finns fler fördelar är nackdelar med ett nivåövergripande perspektiv. Nivåintegrerande studier försvåras av att de kräver en komplex metodologi för att kunna hantera samverkan mellan faktorer bakom våld på olika nivåer men ger å andra sidan en mer holistisk förståelse av fenomenet i fråga. Resultaten visar att integrerande perspektiv kan minska risken för ekologiska felslut och ökar förståelsen av komplex samverkan mellan faktorer bakom mäns våld, något som kan komma att bidra till kunskapsutvecklingen inom våldsterapiområdet. Den teoretiska reviewartikeln (studie I) exemplifierade hur teoretiskt och metodologiskt driven forskning om sociala band kan göras pragmatiskt tillämpbar av terapeuter inom våldbehandlingar. Den tillämpade studien av en KBT-terapi (studie II) gav exempel på hur operationaliserade indikatorer på stolthet och skam kan användas praktiskt för att bestämma kvalitén på det sociala bandet mellan terapeut och klient. Den studerade KBT-terapin innehöll som förväntat både skam- och stolthetskapande moment vilket utgör värdefulla utgångspunkter för vidare forskning. Jämförelsen mellan män i idealtypiskt motsatta maskulinitetspositioner (studie III) visade att både gruppen av män som arbetar mot våld mot kvinnor och männen dömda till behandling mot våld, bär på ambivalenta attityder gentemot våld och våld mot kvinnor. Jämförelsen visade vidare att gruppernas maskulinitetskonstruktioner och attityder till våld korresponderar med grupperingarnas olika tillgång till ekonomiska, sociala och kulturella resurser. Den biografiskt fokuserade kvalitativa studien av män i våldsbehandling (studie IV) undersökte explorativt hur karriären fram till våldskriminell kan se ut och hur barndomsupplevelser, socialisation, maskulinitet och emotioner hos enskilda våldsverkande män kan tänkas ha samverkat med varandra när våld äger rum. Resultaten visade att de män som vittnar om utsatthet för allvarligt våld i barndomen är mer skambenägna och vid kränkningar från andra tenderar att omedvetet och utan föregående känslor av skam direkt reagera med aggressioner och våld mot båda könen. Övriga män var visserligen skambenägna men beskrev en mer kontrollerad våldsreaktion. Två män som blivit brutalt fysiskt mobbade i grundskolan, berättade om ett mer kontrollerat våld. En preliminär hypotes är att männen kan ha lärt sig att kognitivt, för att undslippa fortsatt mobbing, ta kontrollen över processen där skamkänslor ersätts med aggressioner. Föräldrarnas personliga problem tillsammans med deras bristande sociala kontroll och omsorg antogs ha ett samband med flera av männens skolproblem, deras umgänge med avvikande ungdomar, deras senare svårigheter med att kunna försörja sig med konventionella medel samt deras våldskarriärer.

An Interdisciplinary Approach to the Management of Vocal Cord Dysfunction in an Elite Female Swimmer: a Case Study

Acute pulmonary disorders are commonplace within the athletic population, with exercise induced bronchoconstriction (EIB), and vocal cord dysfunction (VCD) common diagnoses. VCD is a condition that causes the adduction of the vocal folds during inhalation, causing obstruction at the larynx and thereby a severely impaired sporting performance. VCD can be brought on by laryngeal irritants, emotional and psychological stress and asthma. The gold standard of treatment for VCD centres on an interdisciplinary approach from specialists that often include a respiratory consultant, speech and language therapist (SLT) and a psychologist. The present case study details the interdisciplinary approach to the treatment of an elite female swimmer with VCD with an intervention programme that lasted nine weeks, instigated by a local general practitioner (G.P.) who chose to engage a Sport Psychology Consultant (SPC) due to the sport-specific nature of the psychological stress experienced by the individual. The steps involved in the design of the sport psychology interventions are outlined and the relationship of those interventions to the work of the other specialists is discussed. The 9 week intervention programme was aimed at reducing perfectionist tendencies and competitive state anxiety using a combination of cognitive behavioural therapy (CBT), goal-setting and imagery. Overall, the treatment programme was deemed a success as perfectionism and competitive state anxiety levels reduced over time along with the frequency of VCD occurrence. This case study demonstrates the breadth of roles that can be undertaken by a SPC and raises awareness of a complex respiratory disorder that is not yet fully understood.

Multicomponent cognitive-behavioral therapy for intermittent explosive disorder by videoconferencing: a case study

Cognitive-behavioral Therapy (CBT) for the treatment of Intermittent Explosive Disorder (IED) has proved to be effective, with moderate to large effect sizes both in individual and group interventions. Videoconferencing has been used effectively to treat different mental disorders but its use for IED patients is as yet unknown. The aim of this study is to provide preliminary evidence of the possibility of treating IED by videoconference. We present a case-study experiment of a Spanish male, aged 33 years, living and working in China. After the intervention, the patient's aggressive episodes decreased dramatically, as well as his negative affect. In contrast, he showed an important increment in positive emotions and self-esteem. There were also positive changes in some personality dimensions and facets measured by NEO-PI-R, specifically in neuroticism, extraversion, and agreeableness. The benefits were maintained at 3-, 8- and 18-month follow-ups. These preliminary results reveal that CBT by videoconference oriented to increasing emotion regulation skills was effective when implemented in a case study of a person suffering from IED.

Systematic review and meta-analysis of interventions relevant for young offenders with mood disorders, anxiety disorders, or self-harm

Background: Mood and anxiety disorders, and problems with self harm are significant and serious issues that are common in young people in the Criminal Justice System. Aims: To examine whether interventions relevant to young offenders with mood or anxiety disorders, or problems with self harm are effective. Method: Systematic review and meta-analysis of data from randomised controlled trials relevant to young offenders experiencing these problems. Results: An exhaustive search of the worldwide literature (published and unpublished)yielded 10 studies suitable for inclusion in this review. Meta-analysis of data from three studies (with a total population of 171 individuals) revealed that group-based Cognitive Behaviour Therapy (CBT) may help to reduce symptoms of depression in young offenders. Conclusions: These preliminary findings suggest that group-based CBT may be useful for young offenders with such mental health problems, but larger high quality RCTs are now needed to bolster the evidence-base.

Individual Child Cognitive Behavioral Treatment versus Child-Parent Cognitive Behavioral Treatments for Anxiety Disorders in Children and Adolescents: Comparative Outcomes

Anxiety disorders; such as separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia, are widespread in children and adolescents. Cognitive behavioral therapy (CBT) has been shown to be effective in reducing excessive fears and anxieties in children and adolescents. Research has produced equivocal findings that involving parents in treatment of child anxiety enhances effects over individual CBT (ICBT). The present dissertation study examined whether parental involvement can enhance individual treatment effect if the parent conditions are streamlined by targeting specific parental variables. The first parent condition, Parent Reinforcement Skills Training (RFST), involved increasing mothers’ use of positive reinforcement and decreasing use of negative reinforcement. The second parent condition, Parent Relationship Skill Training (RLST), involved increasing maternal child acceptance and decreasing maternal control (or increasing autonomy granting). Results of the present dissertation findings support the use of all three treatment conditions (ICBT, RLST, RFST) for child anxiety; that is, significant reductions in anxiety were found in each of the three treatment conditions. No significant differences were found between treatment conditions with respect to diagnostic recovery rate, clinician rating, and parent rating of child anxiety. Significant differences between conditions were found on child self rating of anxiety, with some evidence to support the superiority of RLST and RFST to ICBT. These findings support the efficacy of individual, as well as parent involved CBT, and provide mixed evidence with respect to the superiority of parent involved CBT over ICBT. The conceptual, empirical, and clinical implications of the findings are discussed.

Contributo para a caracterização morfométrica da raça de abelhas melíferas (Apis mellifera iberiensis) da região norte de Portugal

A necessidade de aprofundar o conhecimento sobre a morfologia da abelha melífera portuguesa (Apis mellifera iberiensis) originou o presente estudo. A amostragem definiu-se com base no banco de amostras existentes no Laboratório de Patologia Apícola da ESA-IPB, relativas ao ano de 2015. Cada amostra foi constituída por cinco obreiras adultas conservadas pelo frio (-18 °C). Foram analisadas 124 amostras distribuídas por 16 concelhos (aproximadamente oito por concelho) pertencentes aos distritos de Bragança e Vila Real. As medições efetuadas em cada uma das obreiras foram: peso (PA), comprimento (CA) e largura (LA) do corpo; comprimento (CAA) e largura (LAA) da asa anterior; comprimento (CAP) e largura da asa posterior (LAP); comprimento do fêmur (CF), da tíbia (CT), do basitarso (CBT), do tarso (CTA) e da probóscide (CP) e a largura do basitarso (LBT). Para avaliação destas medidas utilizou-se uma balança analítica de precisão (0,01g) e um paquímetro eletrónico digital (0-100mm±0,02mm). As diferentes variáveis estudadas compararam-se por análise de variância (ANOVA), sendo o teste de Tukey-Kramer HSD utilizado para a comparação múltipla de médias. O peso médio das obreiras do concelho de Vila Pouca de Aguiar (0,123±0,018 g) foi mais elevado (p<0,05) do que o das obreiras dos concelhos de Torre de Moncorvo e Ribeira de Pena (0,106±0,023 g em ambos os casos). Também, as obreiras do concelho de Vila Pouca de Aguiar apresentaram um comprimento médio do corpo (13,065±0,890 mm) superior (p<0,05) às obreiras do concelho de Boticas (12,228±0,958 mm) e uma largura média (4,565 ± 0,392 mm) superior às obreiras de Vila Flor (4,089 ±0,288 mm). Porém, o CAP (6,333±0,303 mm) e o CT (3,179±0,183mm) das obreiras de Vila Pouca de Aguiar foi mais baixo (p<0,05) ao observado nos concelhos de Torre de Moncorvo (6,616±0,361 mm) e Vila Flor (3,358±0,146 mm). As variáveis LAA, LAP, CF, CBT e CP não apresentaram diferenças significativas (p>0,05) entre os concelhos estudados.

Efeito da utilização do Kit Embrapa de Ordenha Manual para caprinos leiteiros na Contagem Total de Bactérias do leite.

2015

Progettazione innovativa di un dispositivo di ausilio al sonno

Il rapido sviluppo dell'economia e della tecnologia ha portato rapidi cambiamenti nella vita delle persone. Solo avendo un sonno di alta qualità possiamo dare il meglio ed essere veramente produttivi e produttivi.Invertire giorno e notte, procrastinare il sonno e stare alzati fino a tardi sono diventate abitudini comuni delle persone moderne. Queste cattive abitudini del sonno hanno un impatto sulla salute fisica, sull'efficienza del lavoro e dello studio e sulla vita delle persone. Miatal Tracker è un software di monitoraggio del sonno per i mercati europeo e americano e fornisce anche molti audio per dormire, corsi di meditazione e conoscenze relative al sonno. Durante il mio tirocinio, il team ha scoperto che i nostri prodotti sono meno differenziati da prodotti simili sul mercato. Per aiutare meglio gli utenti a risolvere i problemi di insonnia e migliorare la qualità del sonno, estraiamo metodi di terapia comportamentale dalla CBT-I migliorando così l'insonnia. Basato sulla progettazione della persuasione e della guida, migliora l'esecuzione dei comportamenti target e aiuta gli utenti a formare buone abitudini di sonno. Dal punto di vista del design, vengono studiate le ragioni di questi fenomeni e, combinate con le pertinenti conoscenze di psicologia e scienze comportamentali, viene esplorato come aiutare le abitudini di lavoro e di riposo delle persone. Prendendo questo come un'idea di design, la progettazione di prodotti e software applicativo si basa sulla progettazione del prodotto, integrata da applicazioni software, che combinano abitudini del sonno, prodotti e monitoraggio del sonno per formare un sistema di prodotti di promemoria, simboli e feedback, aiutando gli utenti a formare un buon sistema di prodotti Le abitudini del sonno, attraverso una guida non coercitiva, cambiano gli atteggiamenti e i comportamenti degli utenti verso l'obiettivo di ottenere un sonno di qualità.

La sicurezza alimentare nel latte crudo: la problematica Bacillus cereus

La crescente richiesta di sicurezza negli alimenti di origine animale, inclusa la filiera lattiero casearia ha spinto gli operatori del settore a porre maggiore attenzione ad un sempre più elevato numero di batteri patogeni. Negli ultimi si è posta l’attenzione, in modo crescente, sul monitoraggio del Bacillus cereus, per il quale lo stesso Reg. 2073/2005 ha definito criteri igienici di processo nel latte in polvere. Il presente studio si è pertanto focalizzato sul monitoraggio delle caratteristiche igienico sanitarie di diverse tipologie di latte crudo (BIO, BIO Fieno, Tracciato, Alta Qualità e Alta Qualità NO OGM), includendo il controllo del Bacillus cereus. In particolare oltre alla detection ed identificazione del Bacillus cereus si sono valutati diversi parametri quali pH, cellule somatiche, Conta Batterica Totale (CBT), Enterobacteriaceae, E. coli, Staphylococchi coagulasi positivi, Salmonella e Listeria monocytogenes. I risultati ottenuti hanno confermato ottimali condizioni igieniche in tutte le tipologie di latte con una media geometrica della Carica batterica totale pari a 13553 ufc/ml valore nettamente inferiore rispetto al limite stabilito dal Reg. 853/2004). L’assenza di Salmonella in tutti i campioni testati ed una positività solo alla detection per Listeria moncytogenes in 2/46 campioni testati dimostrano ottimali garanzie di sicurezza alimentare. Relativamente alla positività per Bacillus cereus il 23.9% dei campioni analizzati sono risultati positivi (dopo conferma in PCR). In conclusione si può affermare che l’azienda fornitrice dei campioni di latte alimentare applichi buone pratiche di igiene e di processo nelle fasi antecedenti la trasformazione del latte, nel rispetto delle normative di riferimento sia in ambito igienico che di sicurezza alimentare.