Selfishness,understood as excessive focus on the self,appears to be a predominant feature of contemporary culture.While the degree of self-focus is adaptive for survival and decision-making,self-rigidity has been asso...Selfishness,understood as excessive focus on the self,appears to be a predominant feature of contemporary culture.While the degree of self-focus is adaptive for survival and decision-making,self-rigidity has been associated with significant psychological,interpersonal,and social costs.Throughout history,philosophers,religious leaders,and social activists have promoted a“hypo-egoic”way of being,characterized by reduced self-fixation and greater openness to others.However,a key question arises:How can one cultivate a more flexible and interdependent perspective on the self?Deconstructive meditations are a group of contemplative practices that aim to dismantle self-rigidity by exploring perception,cognition,and emotion.Their central mechanism is self-inquiry,an experiential process that involves directly observing patterns of the self,questioning the solidity of identity,and developing new ways to relate to experience.From the perspective of contemplative neuroscience,these practices have been shown to reduce selfnarrative identification and promote psychological flexibility.Despite their potential,empirical research on deconstructive meditations remains limited and requires further investigation.This article reviews the essential findings on practices,their connection to psychotherapy,and their potential therapeutic applications.Finally,their clinical implications are discussed along with future research directions to validate their impact on mental health.展开更多
Background Tele-cognitive behavioural therapy(t-CBT)is the most studied remote therapy,and evidence supports its efficacy in treating depression and anxiety symptoms.Aims To compare the effectiveness of tele-interpers...Background Tele-cognitive behavioural therapy(t-CBT)is the most studied remote therapy,and evidence supports its efficacy in treating depression and anxiety symptoms.Aims To compare the effectiveness of tele-interpersonal psychotherapy(t-IPT)to that of t-CBT.We hypothesise that t-IPT is as effective as t-CBT.Methods We conducted a randomised clinical trial with two parallel arms and equal randomisation.The allocation was on a 1∶1 ratio based on a computerised randomisation sequence of permuted blocks of 50.Interventions and assessments were done via a website designed specifically for the trial.Participants were community-based adults with symptoms of anxiety,depression or irritability who received four sessions of t-CBT or t-IPT.The main outcome measures were the Patient Health Questionnaire-9 for depressive symptoms,Generalised Anxiety Disorder-7 for anxiety symptoms and Affective Reactivity Index for irritability.Results 149 individuals with a mean(standard deviation)age of 32.51(10.73)years were randomised to receive t-CBT(n=73)or t-IPT(n=76).Seven participants withdrew from the interventions(t-CBT,n=4;t-IPT,n=3),and 20 participants completed the interventions but did not complete the follow-up questionnaires(t-CBT,n=9;t-IPT,n=11).Analysis was conducted by intention-to-treat.There was a significant overall reduction in symptoms of depression,anxiety and irritability(p<0.001)in both treatment arms;neither modality was superior to the other.Effectiveness analysis showed that the two interventions were equivalent.Conclusions In community adults,t-IPT is as effective as t-CBT in treating symptoms of anxiety,depression or irritability.展开更多
目的:探讨行为激活团体心理治疗改善非典型抑郁症青少年的脑网络特征的效果。方法:纳入2023年7月至2024年7月于我院诊断的非典型抑郁症青少年120例。通过双重差分模型(difference in difference,DID)验证治疗的净效果;分析脑网络拓扑指...目的:探讨行为激活团体心理治疗改善非典型抑郁症青少年的脑网络特征的效果。方法:纳入2023年7月至2024年7月于我院诊断的非典型抑郁症青少年120例。通过双重差分模型(difference in difference,DID)验证治疗的净效果;分析脑网络拓扑指标与生活质量评分、抑郁评分的关联。结果:DID分析显示治疗后研究组的生活质量综合评定问卷(generic quality of life inventory-74,GQOL-74)评分上升幅度及17项汉密尔顿抑郁量表(Hamilton depression scale-17 item,HAMD-17)评分下降幅度均优于对照组(P均<0.001);治疗后对照组脑网络拓扑指标显著高于研究组(P<0.05);不同脑网络拓扑指标对HAMD-17、GQOL-74评分均存在不同程度影响。结论:行为激活团体心理治疗能够显著改善非典型抑郁症青少年的抑郁症状,提升其生活质量,并对脑网络特征产生积极影响。同时脑网络结构与患者生活质量和抑郁程度密切相关。展开更多
Background: Posttraumatic stress disorder(PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy ...Background: Posttraumatic stress disorder(PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy of animal-based therapies in this disorder is unknown. The goal of equine-assisted psychotherapy(EAP) is to improve the social, emotional, and/or cognitive functions of individuals with PTSD.Objective: This study aims to explore the effects of EAP on PTSD symptoms. We hypothesized that veterans with PTSD who participate in a standardized EAP program for 1 h per week for 6 weeks would experience decreased PTSD symptoms and would demonstrate increased resilience as compared with individuals who do not receive EAP intervention.Design, setting, participants and interventions: We conducted a sequentially assigned, two-arm parallel group trial comparing 6 weeks of EAP with standard, previously established, ongoing PTSD therapy.Therapy was conducted at a community EAP facility in conjunction with an academic University Hospital. Twenty adult veterans with symptomatic PTSD completed the study. Ten adult veterans with previously diagnosed PTSD were assigned to EAP and received directed interaction with trained horses for one hour a week in groups of 3 or 4 individuals, while also continuing their previously established therapies. A certified therapist supervised the sessions, and a professional horse handler was also present.Results were compared with those from 10 adult veterans who only received their standard previously established PTSD care as prescribed by their provider.Main outcome measures: Changes in salivary cortisol, scores for the PTSD Check List-Military Version(PCL-M) and the Connor-Davidson Resilience Scale(CD-RISC) after 6 weeks of study were measured.Results: Of the 20 enrolled patients, 10 served in Afghanistan, 5 served in Iraq, and 3 served in Vietnam. Subjects were(47 ± 14) years old, were predominantly male, and had a body mass index of(29 ± 7) kg/m2. They had(9.2 ± 6.1) years of military service and carried 66% ± 37% service-connected disability. PCL-M scores declined significantly in both groups and CD-RISC scores increased significantly in the EAP group. There was no difference between the groups with respect to the magnitude of change.Conclusion: As compared to the control group, a 6-week EAP program did not produce a statistically significant difference with respect to PCL-M and CD-RISC scores, or salivary cortisol. However, our results suggest that EAP may work as well as standard therapy with respect to these parameters. This study supports further inquiry into EAP as a potentially efficacious alternative for veterans suffering from PTSD.Trial registration: ClinicalTrials.gov NCT #03039361.展开更多
BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different typ...BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different types of therapies has been questioned.AIM To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.METHODS Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were matched.Therapy regimens were applied according to care as usual/manualized including quality control and supervision as usual.Randomization to one of the groups was done after baseline assessment.During classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post analysis.The patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent raters.Therapeutic action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'characteristics.RESULTS During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD symptoms,while PDT to a decrease;for the long run,variance of observed change was higher in PSA than in PDT(SDPSA±9.29 vs SDPDT±7.94).Our assumption that transference interpretations,closely followed by affective changes in the patient,could be useful modes of interaction was reproducible in our findings,especially when looking at the descriptive findings in the long-term data.The analysis of repetitive interaction structures demonstrated a very specific"time-lag"between therapeutic intervention and a corresponding increase in positive affect in successful therapy cases.CONCLUSION Exploring the change processes in the patients'characteristics and linking these changes to specific treatment strategies is of clinical importance when starting treatment and for its long-term progress.展开更多
文摘Selfishness,understood as excessive focus on the self,appears to be a predominant feature of contemporary culture.While the degree of self-focus is adaptive for survival and decision-making,self-rigidity has been associated with significant psychological,interpersonal,and social costs.Throughout history,philosophers,religious leaders,and social activists have promoted a“hypo-egoic”way of being,characterized by reduced self-fixation and greater openness to others.However,a key question arises:How can one cultivate a more flexible and interdependent perspective on the self?Deconstructive meditations are a group of contemplative practices that aim to dismantle self-rigidity by exploring perception,cognition,and emotion.Their central mechanism is self-inquiry,an experiential process that involves directly observing patterns of the self,questioning the solidity of identity,and developing new ways to relate to experience.From the perspective of contemplative neuroscience,these practices have been shown to reduce selfnarrative identification and promote psychological flexibility.Despite their potential,empirical research on deconstructive meditations remains limited and requires further investigation.This article reviews the essential findings on practices,their connection to psychotherapy,and their potential therapeutic applications.Finally,their clinical implications are discussed along with future research directions to validate their impact on mental health.
基金funding from the Department for Innovation and Technology of the State of Rio Grande do Sul,Brazil,under Public Call Notice No.001/2020('Edital de Chamamento Público número 001/2020,vinculadoàs açöes do Programa INOVA-RS de apoio ao enfrentamento da Covid19)LSL received a master's scholarship('PROSUC Modalidade II')from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(CAPES),Brazil+1 种基金BMdA received a scholarship from Fundação de AmparoàPesquisa do Estado do Rio Grande do Sul(FAPERGS),BrazilACP receives a doctoral's scholarship from CAPES,Brazil,and a scholarship from Deutscher Akademischer Austauschdienst,Deutschland.FMS received a research grant from Fundação Vale do Taquari de Educação e Desenvolvimento Social(FUVATES),Brazil.
文摘Background Tele-cognitive behavioural therapy(t-CBT)is the most studied remote therapy,and evidence supports its efficacy in treating depression and anxiety symptoms.Aims To compare the effectiveness of tele-interpersonal psychotherapy(t-IPT)to that of t-CBT.We hypothesise that t-IPT is as effective as t-CBT.Methods We conducted a randomised clinical trial with two parallel arms and equal randomisation.The allocation was on a 1∶1 ratio based on a computerised randomisation sequence of permuted blocks of 50.Interventions and assessments were done via a website designed specifically for the trial.Participants were community-based adults with symptoms of anxiety,depression or irritability who received four sessions of t-CBT or t-IPT.The main outcome measures were the Patient Health Questionnaire-9 for depressive symptoms,Generalised Anxiety Disorder-7 for anxiety symptoms and Affective Reactivity Index for irritability.Results 149 individuals with a mean(standard deviation)age of 32.51(10.73)years were randomised to receive t-CBT(n=73)or t-IPT(n=76).Seven participants withdrew from the interventions(t-CBT,n=4;t-IPT,n=3),and 20 participants completed the interventions but did not complete the follow-up questionnaires(t-CBT,n=9;t-IPT,n=11).Analysis was conducted by intention-to-treat.There was a significant overall reduction in symptoms of depression,anxiety and irritability(p<0.001)in both treatment arms;neither modality was superior to the other.Effectiveness analysis showed that the two interventions were equivalent.Conclusions In community adults,t-IPT is as effective as t-CBT in treating symptoms of anxiety,depression or irritability.
文摘目的:探讨行为激活团体心理治疗改善非典型抑郁症青少年的脑网络特征的效果。方法:纳入2023年7月至2024年7月于我院诊断的非典型抑郁症青少年120例。通过双重差分模型(difference in difference,DID)验证治疗的净效果;分析脑网络拓扑指标与生活质量评分、抑郁评分的关联。结果:DID分析显示治疗后研究组的生活质量综合评定问卷(generic quality of life inventory-74,GQOL-74)评分上升幅度及17项汉密尔顿抑郁量表(Hamilton depression scale-17 item,HAMD-17)评分下降幅度均优于对照组(P均<0.001);治疗后对照组脑网络拓扑指标显著高于研究组(P<0.05);不同脑网络拓扑指标对HAMD-17、GQOL-74评分均存在不同程度影响。结论:行为激活团体心理治疗能够显著改善非典型抑郁症青少年的抑郁症状,提升其生活质量,并对脑网络特征产生积极影响。同时脑网络结构与患者生活质量和抑郁程度密切相关。
文摘Background: Posttraumatic stress disorder(PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy of animal-based therapies in this disorder is unknown. The goal of equine-assisted psychotherapy(EAP) is to improve the social, emotional, and/or cognitive functions of individuals with PTSD.Objective: This study aims to explore the effects of EAP on PTSD symptoms. We hypothesized that veterans with PTSD who participate in a standardized EAP program for 1 h per week for 6 weeks would experience decreased PTSD symptoms and would demonstrate increased resilience as compared with individuals who do not receive EAP intervention.Design, setting, participants and interventions: We conducted a sequentially assigned, two-arm parallel group trial comparing 6 weeks of EAP with standard, previously established, ongoing PTSD therapy.Therapy was conducted at a community EAP facility in conjunction with an academic University Hospital. Twenty adult veterans with symptomatic PTSD completed the study. Ten adult veterans with previously diagnosed PTSD were assigned to EAP and received directed interaction with trained horses for one hour a week in groups of 3 or 4 individuals, while also continuing their previously established therapies. A certified therapist supervised the sessions, and a professional horse handler was also present.Results were compared with those from 10 adult veterans who only received their standard previously established PTSD care as prescribed by their provider.Main outcome measures: Changes in salivary cortisol, scores for the PTSD Check List-Military Version(PCL-M) and the Connor-Davidson Resilience Scale(CD-RISC) after 6 weeks of study were measured.Results: Of the 20 enrolled patients, 10 served in Afghanistan, 5 served in Iraq, and 3 served in Vietnam. Subjects were(47 ± 14) years old, were predominantly male, and had a body mass index of(29 ± 7) kg/m2. They had(9.2 ± 6.1) years of military service and carried 66% ± 37% service-connected disability. PCL-M scores declined significantly in both groups and CD-RISC scores increased significantly in the EAP group. There was no difference between the groups with respect to the magnitude of change.Conclusion: As compared to the control group, a 6-week EAP program did not produce a statistically significant difference with respect to PCL-M and CD-RISC scores, or salivary cortisol. However, our results suggest that EAP may work as well as standard therapy with respect to these parameters. This study supports further inquiry into EAP as a potentially efficacious alternative for veterans suffering from PTSD.Trial registration: ClinicalTrials.gov NCT #03039361.
文摘BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different types of therapies has been questioned.AIM To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.METHODS Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were matched.Therapy regimens were applied according to care as usual/manualized including quality control and supervision as usual.Randomization to one of the groups was done after baseline assessment.During classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post analysis.The patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent raters.Therapeutic action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'characteristics.RESULTS During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD symptoms,while PDT to a decrease;for the long run,variance of observed change was higher in PSA than in PDT(SDPSA±9.29 vs SDPDT±7.94).Our assumption that transference interpretations,closely followed by affective changes in the patient,could be useful modes of interaction was reproducible in our findings,especially when looking at the descriptive findings in the long-term data.The analysis of repetitive interaction structures demonstrated a very specific"time-lag"between therapeutic intervention and a corresponding increase in positive affect in successful therapy cases.CONCLUSION Exploring the change processes in the patients'characteristics and linking these changes to specific treatment strategies is of clinical importance when starting treatment and for its long-term progress.
