The adapted German version of the SRS-22 questionnaire can be used to assess the outcome of treatment for German-speaking patients with idiopathic scoliosis.
Increase in mastery and self-esteem experiences are associated with symptom decrease in obsessive-compulsive disorder (OCD) during cognitive-behavioural therapy (CBT). Initial score of mastery experiences and problem clarification predict symptom decrease in OCD during CBT. CBT therapists should focus on problem clarification in the very first sessions and try to boost self-esteem and self-efficacy throughout the treatment of OCD.
Interleukin-8 (IL-8) is an important mediator in neutrophil-mediated acute inflammation but has also a wide range of actions on various cells types. We demonstrated that infection of melanoma cells and fibroblasts with cell-associated varicella-zoster virus (VZV) and infection of a T cell line with cell-free VZV resulted in an induction of IL-8 secretion in vitro. The inhibition of the VZV replication with a drug interfering with its DNA replication had no effect on the IL-8 release. Since the IL-8 promoter contains binding sites for NF-kappaB and AP-1, melanoma cells and the T cell line were treated with inhibitors of NF-kappaB, JNK/SAPK or p38/MAPK prior to infection. In melanoma cells, the JNK/SAPK pathway was shown to be important for the IL-8 secretion during the VZV replication, whereas in the T cell line, not only the JNK/SAPK but also the p38/MAPK pathways were required for IL-8 secretion. The neutralisation of the IL-8 bioactivity had no significant consequence on the VZV replication, suggesting that IL-8 acts neither as a proviral nor as an antiviral cytokine during the VZV replication in vitro.
Background: To gain a better understanding about which aspects of the treatment work for obsessive-compulsive disorders (OCD), the investigation of possible change factors is essential. Psychological flexibility (PsyF) has been of interest in research on successful OCD therapy for some time. Exposure interventions and cognitive strategies in cognitive behavioural therapy (CBT) for OCD may enhance PsyF. To date, however, no process studies have been published that clarify the role of PsyF as a possible change factor for the reduction of OCD symptoms. Aims: This study investigates whether PsyF works as a mediator in successful CBT treatment of OCD. Method: The study recruited 112 adults diagnosed with OCD in a multi-modal in-patient treatment with specific CBT including exposure and response prevention (ERP). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to measure OCD symptoms and three self-constructed items to assess PsyF. PsyF was conceptualised as the capability of patients to accept stressful feelings and thoughts. Data were collected weekly. For statistical analysis at the process level, longitudinal multi-level models (MLMs) with random intercepts and linear growth curves were estimated to test for mediation of PsyF on Y-BOCS. Results: OCD symptoms decreased significantly and PsyF increased in patients throughout the course of therapy. MLM revealed that higher average values in PsyF were associated with lower Y-BOCS sum values, but only values between subjects significantly predicted the degree of obsessions and compulsions. Conclusions: Although research shows that PsyF is enhanced by CBT and also shows a connection with Y-BOCS values, its role as a mediator could not be confirmed.
Da bislang etwa ein Drittel der Patienten mit Zwangsstörungen nicht hinreichend von Expositionen mit Reaktionsmanagement (ERM) profitiert, erscheint eine genaue Analyse möglicher Wirkfaktoren für den Therapieerfolg angebracht. In der vorliegenden systematischen Übersichtsarbeit wird der derzeitige Forschungsstand zu Wirkfaktoren bei Zwangsstörungen zusammengefasst und diskutiert. Dazu wurde eine systematische Recherche zu Publikationen ab dem Jahr 2000 durchgeführt, von denen lediglich 8 Studien die geforderten Einschlusskriterien erfüllten (Psychotherapiestudie, erwachsene Zwangspatienten, potenzielle Mediatoren werden longitudinal unter Berücksichtigung des Zeitreihenkriteriums untersucht). Im Bereich kognitiver Wirkfaktoren, die am häufigsten untersucht wurden, scheinen dysfunktionale Annahmen über Zwänge, insbesondere Perfektionismus/Intoleranz für Unsicherheit, eine wichtige Rolle zu spielen. Die hier diskutierten Studien stuften zudem die Veränderung von Depressivität als Wirkfaktor ein. Die Ergebnisse widersprechen sich jedoch hinsichtlich der Richtung und des Ausmaßes ihrer Mediatorfunktion. Auch fanden sich Hinweise, dass die Adhärenz des Patienten hinsichtlich des therapeutischen Vorgehens eine Rolle als Mediator spielt. Die Variablen «Fallkonzeption» und «Vermeidungsverhalten» gingen nicht als Wirkfaktoren hervor. Bei der Untersuchung von Komplexität zeigte sich, dass sich bei den meisten Patienten eine rasche Veränderung der Symptome bereits vor einer Interventionsphase mit ERM vollzieht. Die überschaubare Anzahl an Studien mit teilweise widersprüchlichen Ergebnissen macht deutlich, dass großer Bedarf an elaborierten Längsschnittstudien zu Wirkfaktoren der Psychotherapie von Zwangsstörungen besteht.
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