PSYCHOTHERAPY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Psychotherapy: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84567-0 1. Psychotherapy-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on psychotherapy. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON PSYCHOTHERAPY ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Psychotherapy ............................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 63 The National Library of Medicine: PubMed ................................................................................ 64 CHAPTER 2. NUTRITION AND PSYCHOTHERAPY ............................................................................ 77 Overview...................................................................................................................................... 77 Finding Nutrition Studies on Psychotherapy.............................................................................. 77 Federal Resources on Nutrition ................................................................................................... 78 Additional Web Resources ........................................................................................................... 79 CHAPTER 3. ALTERNATIVE MEDICINE AND PSYCHOTHERAPY ...................................................... 81 Overview...................................................................................................................................... 81 The Combined Health Information Database............................................................................... 81 National Center for Complementary and Alternative Medicine.................................................. 82 Additional Web Resources ........................................................................................................... 83 General References ....................................................................................................................... 92 CHAPTER 4. DISSERTATIONS ON PSYCHOTHERAPY ........................................................................ 93 Overview...................................................................................................................................... 93 Dissertations on Psychotherapy................................................................................................... 93 Keeping Current ........................................................................................................................ 124 CHAPTER 5. CLINICAL TRIALS AND PSYCHOTHERAPY ................................................................ 125 Overview.................................................................................................................................... 125 Recent Trials on Psychotherapy................................................................................................. 125 Keeping Current on Clinical Trials ........................................................................................... 127 CHAPTER 6. PATENTS ON PSYCHOTHERAPY ................................................................................ 129 Overview.................................................................................................................................... 129 Patents on Psychotherapy .......................................................................................................... 129 Patent Applications on Psychotherapy ...................................................................................... 136 Keeping Current ........................................................................................................................ 138 CHAPTER 7. BOOKS ON PSYCHOTHERAPY .................................................................................... 139 Overview.................................................................................................................................... 139 Book Summaries: Federal Agencies............................................................................................ 139 Book Summaries: Online Booksellers......................................................................................... 141 Chapters on Psychotherapy........................................................................................................ 145 CHAPTER 8. MULTIMEDIA ON PSYCHOTHERAPY ......................................................................... 147 Overview.................................................................................................................................... 147 Video Recordings ....................................................................................................................... 147 Audio Recordings....................................................................................................................... 148 CHAPTER 9. PERIODICALS AND NEWS ON PSYCHOTHERAPY ...................................................... 151 Overview.................................................................................................................................... 151 News Services and Press Releases.............................................................................................. 151 Newsletters on Psychotherapy ................................................................................................... 153 Newsletter Articles .................................................................................................................... 154 Academic Periodicals covering Psychotherapy .......................................................................... 157 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 161 Overview.................................................................................................................................... 161 NIH Guidelines.......................................................................................................................... 161 NIH Databases........................................................................................................................... 163 Other Commercial Databases..................................................................................................... 165
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APPENDIX B. PATIENT RESOURCES ............................................................................................... 167 Overview.................................................................................................................................... 167 Patient Guideline Sources.......................................................................................................... 167 Finding Associations.................................................................................................................. 186 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 189 Overview.................................................................................................................................... 189 Preparation................................................................................................................................. 189 Finding a Local Medical Library................................................................................................ 189 Medical Libraries in the U.S. and Canada ................................................................................. 189 ONLINE GLOSSARIES................................................................................................................ 195 Online Dictionary Directories ................................................................................................... 195 PSYCHOTHERAPY DICTIONARY ........................................................................................... 197 INDEX .............................................................................................................................................. 241
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with psychotherapy is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about psychotherapy, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to psychotherapy, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on psychotherapy. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to psychotherapy, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on psychotherapy. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON PSYCHOTHERAPY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on psychotherapy.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and psychotherapy, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “psychotherapy” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Sign-Language Interpretation in Psychotherapy with Deaf Patients Source: American Journal of Psychotherapy. 53(2): 163-176. Spring 1999. Contact: Available from American Journal of Psychotherapy. Belfer Center, Room 405, 1300 Morris Park Avenue, Bronx, NY 10461. (718) 430-3503. Fax (718) 430-8907. Website: www.ajp.org. Summary: Sporadic encounters with deaf patients seeking psychotherapy present a challenge to general clinicians outside of specialized services for the deaf. Skills for working with people who do not share one's own language mode and culture are not routinely taught in most training programs, so clinicians may be unprepared when they first encounter a deaf patient. This article arose from one psychiatric resident's first experience of psychotherapy working with a sign language interpreter. The author
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summarizes the literature search that resulted from a quest for understanding of deaf culture and experience, of the unique characteristics of sign language, and of the effects on the therapeutic relationship made by the interpreter's presence. The author notes that while it would be ideal to be able to match deaf patients with therapists fluent in their preferred language mode, this is often not feasible in smaller centers. Working with a trained, professional sign language interpreter can be a productive alternative, as long as patient, therapist, and interpreter understand and are comfortable with the process. Peer reviewed literature on sign language interpretation in psychotherapy is sparse, but some practical guidelines can be gleaned from it and supplemented by information provided by the deaf community through the Internet. 27 references. •
Psychotherapy for Individuals With Alzheimer Disease Source: Alzheimer Disease and Associated Disorders: An International Journal. 8(Supplement 3): 75-81. 1994. Summary: This article discusses the emotional difficulties of patients with Alzheimer's disease (AD) as the disease progresses and the early- and late-stage use of psychotherapy as an intervention. The author states that individuals with AD often experience depression, anger, and other psychological symptoms. Various forms of psychotherapy have been attempted with these people, including insight-oriented therapy and less verbal therapies such as music therapy and art therapy. Although few data- based outcome studies support the effectiveness of these interventions, case studies and descriptive information suggest they may help alleviate negative emotions and minimize problematic behaviors. 25 references. (AA-M).
Federally Funded Research on Psychotherapy The U.S. Government supports a variety of research studies relating to psychotherapy. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to psychotherapy. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore psychotherapy. The following is typical of the type of information found when searching the CRISP database for psychotherapy: •
Project Title: A CONTROLLED TRIAL OF PSYCHODYNAMIC TREATMENT FOR PANIC Principal Investigator & Institution: Milrod, Barbara L.; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021
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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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Timing: Fiscal Year 2002; Project Start 15-FEB-2000; Project End 31-JAN-2005 Summary: This mentored patient-oriented treatment development award is designed to assist Barbara Milrod, M.D. to become an independent physician investigator. It will also further the development of the psychotherapy research program at Cornell by expanding it into the area of panic disorder. The award will free Dr. Milrod from much of her present clinical responsibility and enable her to obtain the training and experience necessary to become a well-rounded investigator. The training plan is built on specific educational experiences dedicated to achieve specific educational aims, with close tutoring by expert clinical research faculty. The specific aims of the research plan are to: 1) Conduct a randomized controlled trial of PFPP in comparison with relaxation treatment (ART) for patients with panic disorder. 2) Building upon previous research, to test a set of instruments that can reliably distinguish between the already-manualized Panic-Focused Psychodynamic Psychotherapy (PFPP) and applied relaxation training (ART). The plan develops a method of testing the efficacy of an accessible and commonly practiced treatment, psychodynamic psychotherapy, for a specific DSM Axis I disorder, panic disorder. Psychodynamic psychotherapy is a widely-practiced, understudied treatment that deserves careful assessment in clinical populations. Panic disorder is a significant public health problem, from which some treatment responders may relapse after receiving therapies that have been researched to date. Academic and research activities will take place throughout the award period. Upon completion of the award, Dr. Millrod will serve as principle investigator in psychotherapy research studies, and as mentor to residents, child and adolescent psychiatry fellows, medical students and colleagues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BEHAVIORAL INTERVENTION FOR DEPRESSION IN NURSING HOMES Principal Investigator & Institution: Meeks, Suzanne; Associate Professor; Psychology; University of Louisville University of Louisville Louisville, Ky 40292 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2005 Summary: (provided by applicant): The risk for depression is nearly twice as great among nursing home residents as it is for community-residing elders, with up to 50 percent of nursing home residents affected by significant depressive symptoms. Although we now have a good understanding of the epidemiology and manifestations of depression in late life, and are beginning to apply effective treatments to some groups of elders, the benefits of the past decade of research have yet to reach the frailest elders living in nursing homes. Depression in long-term care is a significant public health issue. The health and cognitive multiple comorbidity of this population makes treatment, and treatment research, extremely challenging. The broad goal of this proposal is to adapt an efficacious psychosocial intervention for depression to the nursing home setting, using the public health model of intervention research and the exploratory/development mechanism provided by NIMH for implementing such work. There are 3 specific aims: (1) To use a collaborative treatment development process involving nursing home staff to adapt a behavioral intervention for treating depression in elders with cognitive impairment to nursing home residents with a range of physical and cognitive abilities; (2) to conduct a pilot effectiveness study on the adapted intervention, using a replicated, single-subject design, in 2-3 nursing homes other than the one in which the initial treatment development process took place, and (3) as a part of the effectiveness study, to collect data on staff outcomes and cost effectiveness. The treatment has a behavioral theoretical basis, and focuses on increasing opportunity for
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pleasant events to increase levels of activity and positive affect. Treatment is implemented primarily by existing nursing facility staff, with supervision from a licensed psychologist, making ultimate dissemination of this treatment practical and affordable. Standardizing the treatment collaboratively with staff insures a high level of staff acceptance and maximizes feasibility in the nursing home setting. The treatment evaluation design employs a replicated, multiple-baselines-within-subjects design and Hierarchical Linear Modeling, optimizing features from single-case and group research. Each participant will be observed for a minimum of a two-week baseline, followed by six weeks of active intervention, four weeks of maintenance, and a three-month followup. Measures include comprehensive psychiatric evaluation and diagnosis, depression and mood rating scales, observed affect and activity participation, behavior problems, and staff burden. The end-product of the work will be a standardized treatment protocol ready for formal multi-site intervention trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOBEHAVIORAL EFFECTS OF EMOTIONAL EXPRESSION IN CANCER Principal Investigator & Institution: Cohen, Lorenzo; Associate Professor; Behavioral Science; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2002; Project Start 11-FEB-2002; Project End 31-JAN-2007 Summary: Models of cognitive processing suggest that once a traumatic event is appropriately understood and integrated the stress associated with the event will diminish. Thoughts and feelings surrounding a traumatic experience are often disorganized, yet when disclosed verbally or through writing, they can assume the form of an organized, coherent narrative resulting in improved health outcomes. This is illustrated by recent findings that indicated that a brief written emotional expression exercise was associated with improved physical health, psychological well-being, physiological functioning, and general functioning. This writing exercise was also associated with beneficial changes in immune function. The brief writing intervention is hypothesized to increase cognitive processing and foster adaptation to traumatic events. To date, however, most research examining this intervention has been conducted in healthy populations. The diagnosis and treatment of cancer are traumatic experiences associated with distress and the fear of cancer recurrence, progression, and death. The impact of stress on the immune system may be particularly detrimental to patients with renal cell cancer, as this cancer is immunogenic, meaning that the immune system regulates progression of the disease. Because emotional expression writing interventions have been shown to facilitate adaptation, reduce stress, improve psychological adjustment and QOL, and positively impact immune function, this type of intervention may be beneficial in patients with renal cancer. Pilot data from our laboratory suggest that it is feasible to conduct the emotional expression writing intervention in patients with renal cancer. Results from this study also provide initial evidence that the intervention increases cognitive processing and improves psychological well- being. The proposed study will assess the benefits of this written emotional expression exercise in patients with renal cell carcinoma. Patients in this study will be randomly assigned either to an emotional expression writing group or to a neutral writing group. This research will also evaluate the extent to which psychosocial factors mediate or moderate the effects of the intervention program and predict recovery and adjustment. The effects of the intervention should be evident throughout recovery and across indices of quality of life, mental health, subjective symptoms of stress, and immune function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BIOBEHAVIORAL MECHANISMS OF DEPRESSION IN WOMEN Principal Investigator & Institution: Cyranowski, Jill M.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 20-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): This Mentored Research Scientist Development Award (MRSDA) is designed to promote the Candidate's long-term goal of becoming a women's health researcher with expertise in the etiology and treatment of depression in women. The training and research activities described in this MRSDA will facilitate the Candidate's training in the methods of acute stress research and neurohormonal assessment techniques, and the integration of these techniques within her own background in depression intervention research. This interdisciplinary training will provide the Candidate with the skills and experience needed to pursue an independent program of research testing biobehavioral mechanisms of stress sensitivity, depression vulnerability, and ultimately, depression treatment outcomes in women. Post-pubertal females are twice as likely as males to experience a lifetime episode of major depression, and are particularly likely to become depressed when faced with stressful life events. This gender-linked health disparity persists throughout women's reproductive lives, carrying deleterious consequences for both the woman herself and the children under her care. We (Cyranowski et al., 2000) have theorized that women's sensitivity to interpersonal life stress is mediated, in part, by the hypothalamic neurohormone, oxytocin. Oxytocin is known to play a key role in female reproductive processes. A growing body of animal research indicates that oxytocin is critically regulated by female reproductive hormones, and that oxytocin serves to facilitate female affiliative behaviors and down-regulate the hypothalamic-pituitary-adrenal (HPA) stress axis. The proposed pilot study was designed to provide a preliminary examination of the role of oxytocin in women's stress sensitivity and depression vulnerability. Twenty-two normal cycling, depressed females aged 21-40 and 22 age-matched never-depressed controls will be recruited to participate in a 3-hour laboratory experiment designed to stimulate, measure and compare peripheral oxytocin release and basal oxytocin concentrations within and between groups, and to examine whether peripheral oxytocin release is associated with a down-regulation of the HPA stress axis following an acute stress task. Subjects will also complete self-report measures of depression, anxiety, interpersonal function, trauma history, and recent life stress. Subjects will then be retested with the laboratory paradigm at 18 weeks follow-up, or for depressed subjects, following a course of interpersonal psychotherapy (IPT). The skills, training, and pilot data obtained from this MRSDA will subsequently be used to support the Candidate's development of an R0l application in Years 03-05 of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BRIEF ALCOHOL INTERVENTION WITH DEPRESSED PATIENTS Principal Investigator & Institution: Ramsey, Susan E.; Rhode Island Hospital (Providence, Ri) Providence, Ri 029034923 Timing: Fiscal Year 2003; Project Start 05-SEP-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Heavy alcohol consumption is common among patients seeking treatment for depression. Heavy drinking is associated with a variety of medical and psychosocial problems. Heavy drinking is particularly problematic among depressed patients, increasing the likelihood of poor depression treatment outcomes. While methods for reducing alcohol use in this population have been unexplored to date, brief interventions to reduce heavy alcohol use have been well-validated in
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numerous patient populations and offer the promise to reduce heavy drinking among depressed patients and to improve depression treatment outcomes. We hypothesize that adding a brief alcohol intervention to standard psychiatric care, relative to standard psychiatric care alone, will reduce overall drinking volume and heavy drinking days among heavy-drinking depressed patients. Furthermore, we expect patients who receive the brief alcohol intervention to have better depression outcomes than patients receiving standard psychiatric care alone. We also expect that reduced alcohol consumption will mediate the effect of the brief alcohol intervention on depression outcomes. In addition, we will examine individual difference variables as predictors of change in alcohol use. The proposed study is a randomized, two-group design with repeated measures over time, comparing a brief, motivationally-focused alcohol intervention plus standard psychiatric care to standard psychiatric care alone. For this study, we will recruit a sample of 240 psychiatry clinic outpatients meeting structured diagnostic criteria for major depressive disorder who drink heavily but are not alcohol dependent. We expect that the results of this study will improve depression treatment outcomes for the significant sub-population of depressed patients who drink heavily and are likely to do poorly in depression treatment in the absence of a change in their drinking behavior. The intervention proposed in this study represents a novel approach to reducing heavy drinking among depressed patients that, if effective, can be readily integrated into depression treatment in a variety of treatment settings. In addition, this study will provide valuable information on the association between alcohol use and depression outcomes and on the mechanisms of change in alcohol use among heavy-drinking depressed patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHILD PSYCHIATRY INTERVENTION RESEARCH CENTER Principal Investigator & Institution: Shaffer, David S.; Irving Phillips Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 24-SEP-1999; Project End 31-MAY-2004 Summary: This is an application for a Child Psychiatry Intervention Research Center (CPIRC) at New York State Psychiatric Institute. The CPIRC comprises: 1) The Central (Administrative) Core (Director: David Shaffer, M.D.) will perform administrative functions for all Cores, distribute small grants, oversee protocols to insure consumersensitive practice, insure coordination between the locally based NIMH Research Unit for Pediatric Psychopharmacology (RUPP), the Ruane Early-Diagnosis Center, and if funded the Anxiety Disorders IRC, will maintain a local Area Network (LAN) to serve all CPIRC users; 2) a Clinical Core (PI: Rachel Klein, Ph.D.) will recruit and screen subjects for treatment studies and will provide post-protocol care; 3) a Psycho-therapy Core (PI: Myrna Weissman, Ph.D.) will provide training and archival materials for manualized psychotherapies; 4) a Biostatistics, Measurement, Effectiveness Evaluation Core (PI: Andrew Leon, Ph.D.) will provide consultation on biostatistics, and research design, that will advise investigators on planning and conducting of effectiveness studies that will advise and train research staff on measurement choice and will manage and customize entry into a uniform database; and 5) a Psychopharmacology Core (PI: Laurence Greenhill, M.D.) that will monitor safety parameters, provide manuals to standardize psychopharmacology studies, will provide training and will facilitate pharmacological and basic science studies related to treatment response. Over the past four years, there has been a Child Psychiatry CRC that performed some but not all the treatment related functions that will be carried out by the CPIC that CRC screened over 1,698 individuals and referred over 718 to treatment protocols, provided consultation on
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75 research projects, provided over 200 consultations related to publications and research-grant applications, and given courses whose combined audiences numbered in the hundreds. CRC users were productive: over a 4 year period wrote 367 publications that related to Center activities. This flourishing research environment, will be maintained by the CPIRC. The CPIRC will start life with a large number of experienced researchers and 28 funded treatment protocols. It will provide the infrastructure necessary for successful recruitment, sophisticated design badly needed in a field characterized by the widespread use of medical and psychotherapies of unproven value and safety for children and teens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHILD/ADOLESCENT ANXIETY MULTIMODAL TREATMENT STUDY Principal Investigator & Institution: Piacentini, John C.; Associate Professor; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-MAY-2006 Summary: (provided by applicant): With point prevalence estimates ranging from 12 percent to 20 percent, anxiety disorders are among the most common conditions affecting children and adolescents. The three most commonly impairing childhoodonset anxiety disorders are separation anxiety disorder, social phobia and generalized anxiety disorder. As a group, these disorders routinely co-occur and cause clinically significant distress and impairment affecting school, social, and family functioning. Left untreated, these disorders leave children at risk for anxiety disorders, major depression and, in some cases, substance abuse extending into late adolescence and adulthood. Hence, effective treatments for childhood-onset anxiety disorders promise to alleviate and perhaps to prevent long-term morbidity and even mortality. In randomized controlled trials, we have shown that two monotherapies, cognitive-behavioral therapy (CBT) and the selective serotonin reuptake inhibitor (SSRI), fluvoxamine (FLV), are effective treatments for separation anxiety, social phobia, and generalized anxiety disorders in children and adolescents. Even though the monotherapies are effective a substantial number of patients remain symptomatic following treatment and, might have benefited from combined treatment. There are as yet no systematic, controlled studies comparing CBT and an SSRI, alone or in combination, against a control condition in the same patient population. This revised application proposes a four-year, six site, randomized controlled efficacy trial comparing cognitive-behavioral (CBT) and pharmacological treatment for youth ages 7 to 16 years with anxiety disorders. Phase 1 is a 12-week, random assignment acute efficacy study comparing CBT, FLV, their combination (n=90, each condition), and pill placebo control (n=48) in 318 (53/site) youth with DSM-IV primary diagnoses of separation anxiety, social phobia, and/or generalized anxiety disorder. Phase II involves a 6-month treatment maintenance period for Phase I responders. All subjects regardless of response status will be evaluated at all scheduled assessment points. In addition to comprehensive parent, child, clinician, and teacher reports, the primary outcome variables will be assessed by blind independent evaluators. Manualized intervention and assessment protocols plus state-of-the-art quality assurance and adverse event monitoring procedures insure uniform cross-site administration of the study protocol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COGNITIVE THERAPY FOR PERSONALITY DISORDERS Principal Investigator & Institution: Hayes, Adele M.; Associate Professor; Psychology; University of Miami Coral Gables Box 248293 Coral Gables, Fl 33134 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2005 Summary: (provided by applicant): The Cluster C personality disorders (obsessivecompulsive, avoidant, and dependent) are the most prevalent personality disorders (PDs) in outpatient samples. These PDs are highly comorbid with mood and anxiety disorders. Patients with comorbid PD and Axis I disorders present with more severe and chronic symptom profiles, and they do not respond well to psychotherapy or pharmacotherapy. It is particularly difficult to establish a therapeutic alliance, a welldocumented predictor of treatment outcome, and treatment retention and compliance are often compromised. Given the prevalence of Cluster C PDs and their significant impact on psychosocial functioning, treatment response, and health care utilization, it is surprising that little attention has been paid to treatment development for this population. Cognitive therapy has been demonstrated to be an effective treatment across a number of Axis I disorders and recently has been extended to PDs. In a sample of patients with obsessive-compulsive (OCPD) and avoidant (AVPD) PDs, the first open trial of cognitive therapy for PDs (CT-PD) demonstrated significant improvements in personality symptoms, as well as in symptoms of depression and anxiety. Because the therapy is in early stages of development, general principles and guidelines for treatment of PDs are provided, but there are few specific details on how to treat OCPD and AVPD. This lack of specificity limits the extent to which the manual can be used to conduct larger scale clinical trials outside of the Center for Cognitive Therapy, where the manual was developed. The goal of this R-21 treatment development research is to identify active ingredients of the therapy and to use this process research to improve the specificity of the manual. CT-PD is thought to have its effects by exposing patients to corrective information challenging existing personality patterns, identifying the historical roots of these patterns, and providing exercises to facilitate generalization. The proposed study will examine these interventions as predictors of three hypothesized precursors of change: turbulence in defensiveness and avoidance (protection), the therapeutic alliance, and in-session affect. Growth curve modeling will be used to examine sequencing and timing of therapist interventions and relations between these interventions and the hypothesized precursors of change, which will then be examined as predictors of symptom reduction. Quality of therapeutic alliance in early sessions will be examined as a predictor of treatment retention. With this information, sections of the treatment manual on OCPD and AVPD can be refined, strategies to facilitate therapeutic alliance and symptom change can be specified, and the refined manual can be used in future proposals examining treatment efficacy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COGNITIVE THERAPY VIA CD ROM FOR BINGE EATING DISORDER Principal Investigator & Institution: Bulik, Cynthia M.; Professor; Psychiatry; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: Although eating and weight-related disorders are treatable, most afflicted individuals never receive proper treatment. Despite the existence of excellent prototype cognitive-behavioral programs for the treatment of binge-eating disorder (BED) and other eating disorders, we face a crisis of dissemination. The goal of this project is to join
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cognitive-behavioral therapy (CBT) with novel information technology to develop an interactive CBT program that will allow individuals to experience the basics of CBT in the privacy of their own homes. This Exploratory/Development Grant for Mental Health Intervention (R21) proposes a four stage project to develop a CD-ROM-based program for the effective delivery of cognitive-behavioral therapy (CBT) to obese individuals with binge-eating disorder (OBED) and other unhealthy eating behaviors. In Phase 1 of the project, we will continue development of a CD-ROM program that we began in 1998. The program will be a rich, vivid, and interactive approach to CBT that provides helpful psychoeducation on unhealthy eating and weight-related practices; clearly introduces the basic concepts and techniques of CBT; provides rich and vivid examples of techniques; provides individualized and interactive exercises for practicing CBT principles; and enables users to contact the central web site and staff with questions. This program will be applicable to a broad range of adult women and men of all races and backgrounds. In Phase 2, we will implement a rigorous four-stage betatesting procedure that includes: group testing sessions followed by individual and focus group debriefing for feedback; peer review by experts in the field of CBT for eating disorders; and in-home beta testing prior to final production. Phase III of the project will be a small feasibility and pilot study comparing the efficacy of the CD-ROM-based delivery of CBT to traditional manual-based group therapy for individuals with OBED and a wait list control. Data from this pilot study will be used to support Phase IV, which will develop a proposal for a large-scale clinical trial comparing CD-ROM-based intervention with traditional group therapy. We anticipate that a CD-ROM-based program will be an efficacious and cost-effective intervention. For some, this program may suffice for treating their eating and weight-related problems. For others, it may be a useful adjunct to traditional psychotherapy or an introductory step to treatment which will familiarize them with the principles and techniques of CBT and increase their comfort and motivation to seek additional professional care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE TRAINING FOR SOCIAL ANXIETY Principal Investigator & Institution: Huppert, Jonathan D.; Assistant Professor of Psychology in Psy; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 11-JUN-2003; Project End 31-MAY-2007 Summary: (provided by applicant): This application proposes Jonathan D. Huppert, Ph.D. for a K23 Mentored Patient Oriented Research Career Development Award at the University of Pennsylvania. The overarching goal of this award is for the applicant to acquire expertise in information processing/cognitive science of anxiety disorders and to translate this knowledge to the treatment of anxiety disorders through an independent program of research funded by NIH. The four-year program discussed in this proposal is designed to accomplish this goal by through five aims: 1) to solidify his foundation in cognitive science and advanced research methods; 2) to establish a research program on cognitive training of social anxiety that will integrate cognitive science and clinical outcome research; 3) to write and publish empirical and theoretical papers about such an integration; 4) to create collaborative relationships with clinical and cognitive science faculty at the University of Pennsylvania as well as other experts in the field; and 5) to prepare for further funding for this programmatic line of research. These aims will be accomplished through a structured four-part plan: 1) to receive further formal instruction in cognitive science, advanced research design, and bioethics; 2) to obtain training and mentoring by a senior scientist experienced in this area (Edna
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B. Foa, Ph.D.) as well by a collaborator (Andrew M. Mathews, Ph.D.) and consultants (Colin M. MacLeod, Ph.D., Richard G. Heimberg, Ph.D., David M. Clark, Ph.D., and Xin Tu, Ph.D.); 3) to coordinate ongoing clinical research trials at the Center for the Treatment and Study of Anxiety; 4) to design and execute an original program of research. A series of studies examining the factors involved in the modification of interpretation and attentional biases in social anxiety will be conducted. The goal of these investigations is to create a cognitive training program that directly addresses the core biases involved in causing and maintaining social anxiety. First, a new measure of interpretation bias will be developed using contextual priming in order to have a measure that is less likely to be confounded by repeated administration. Simultaneously, the nature of attentional bias in social anxiety will be clarified in order to bring some resolution to conflicting findings in the literature. Then, potential for modifying interpretation bias will be examined. In parallel, parameters related to modifying attentional bias in social anxiety will be examined. In addition, the relationship between cognitive biases and cognitive-behavioral therapy outcome in patients diagnosed with social phobia will be evaluated. Based on these findings, a cognitive training program for social phobia will be developed and will be further evaluated in future research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMBINED PHARMACOTHERAPIES FOR ALCOHOLISM Principal Investigator & Institution: Johnson, Bankole A.; Wurzbach Distinguished Professor and Dep; Psychiatry; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2002; Project Start 10-SEP-2001; Project End 31-JUL-2006 Summary: Recent scientific and clinical interest in combining therapeutic agents for the treatment of alcoholism are based on the fact that derangement of multipleneurotransmitter systems are likely to underlie biological predisposition to the disease. Thus, combining effective medications working at different neurotransmitters should produce a synergistic or at least an added clinical response. In animals, the combination of the 5-HT3 antagonist, ondansetron, and the mu receptor antagonist, naltrexone show synergism of action at reducing ethanol consumption. Alcoholics with an early onset of disease are effectively treated by ondansetron, and those with a family history of alcoholism in first degree relatives may have the best clinical outcome to treatment with naltrexone. Given that family history of alcoholism is associated with an early onset of disease, it reasonable for us to predict that the combination of ondansetron and naltrexone should be more optimal than either alone for the treatment of Early Onset Alcoholics (EOA). Indeed, preliminary clinical data from our group provide strong support that the medication combination is an effective treatment for EOA. We will test this hypothesis by comparing the effectiveness of ondansetron (4 mg/kg) and naltrexone(50 mg/day), both alone and in combination, in treating EOA vs. Late Onset Alcoholics (LOA) (total N of 45 subjects/cell x 8 cells = 360) in a randomized, doubleblind, placebo-controlled, 12-week (1 week of single-blind placebo followed by 11 weeks of the double-blind condition) outpatient clinical trial. All subjects will receive standardized Cognitive Behavioral Therapy, and follow-up at 1, 3, 6, and 9 months posttreatment. Specifically, we predict that: 1) EOA, compared with LOA, will be more responsive to treatment with either ondansetron or naltrexone alone, and 2) that the combination of ondansetron and naltrexone will be superior to either medication alone in the treatment of EOA. We will have the unique opportunity to test with adequate power the secondary hypothesis that the combination of ondansetron and naltrexone
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will be better tolerated than naltrexone alone, thereby improving compliance. This is because nausea is an important side-effect of naltrexone which can limit compliance, and as shown in our preliminary study, ondansetron by having anti-nausea and antiemetic properties counteracts this naltrexone side-effect. We support NIAAA's mission to develop effective pharmacotherapies as adjuncts to psychotherapy for the treatment of alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COST EFFECTIVENESS OF ALCOHOL TREATMENT Principal Investigator & Institution: Zarkin, Gary A.; Director; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, Nc 27709 Timing: Fiscal Year 2002; Project Start 02-AUG-2000; Project End 31-JUL-2005 Summary: Alcohol and drug abuse impose significant costs on society. In 1992, the economic cost of alcohol and drug abuse was estimated to be 246 billion dollars. The majority of these costs arise from alcohol abuse (148 billion dollars). Partly in response to these costs, new pharmacotherapies have recently been developed to treat alcohol abuse and alcoholism. Likewise, important advances have been made in the development of behavioral interventions designed to treat alcohol abuse. While new alcohol abuse therapies have been developed over the last several years, pressures have been developing to identify therapies that are not only efficacious but also cost-effective. Much of this pressure has been driven by managed care, which has placed a premium on economic studies that assess whether the clinical and economic outcomes of new pharmaceutical and behavioral therapies justify their costs. To increase the understanding of the efficacy of two pharmacotherapies (naltrexone and acamprosate) and psychotherapy, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recently funded Project COMBINE, a multi-site, randomized control trial (RCT). This trial is one of the most ambitious clinical trials ever undertaken for the treatment of alcoholism. However, in spite of the importance of economic analysis of clinical trials, the Project COMBINE protocol does not include cost or cost-effectiveness studies. The purpose of this study is to examine the costs and cost-effectiveness of behavioral and pharmacotherapies for alcoholism (and their combination) included in Project COMBINE. Our proposed project builds on Project COMBINE's RCT design, which will provide great credibility of our results in the scientific community. Because of the number of therapies studied, the strength of the study design, and the limited existing literature on the cost and cost-effectiveness of alcohol treatments, the proposed study represents a major advance in the cost and cost-effectiveness analysis of alcohol treatment; our results should have a profound effect on the choice of alcohol treatment in the United States. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEPRESSION
CULTURALLY
RELEVANT
PSYCHOTHERAPY--PERINATAL
Principal Investigator & Institution: Grote, Nancy K.; None; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Depression during the perinatal period has adverse effects on the mother, on the development of her newborn infant, and on her family relationships. The purpose of this proposed mentored Patient-Oriented Research Career Development (K23) Award is to promote the Candidate's long-term goal of conducting
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clinical trials of culturally relevant, psychosocial interventions for perinatal depression in low-income, African American and White Ob/Gyn patients to ameliorate their depression during pregnancy and prevent postpartum depression. The training and research activities described in this application will take place in the cross-disciplinary environment of the School of Social Work and the Department of Psychiatry, University of Pittsburgh. Training will enable the Candidate to assess perinatal mood disorders, develop culturally relevant strategies to effectively engage and retain Ob/Gyn patients in multi-session psychosocial interventions, conduct randomized clinical trials of psychosocial treatments, and collaborate with health services researchers to enhance the public health value of the intervention. Interpersonal psychotherapy (IPT) addresses both depressive symptoms and problematic interpersonal relationships and is an efficacious treatment for depression in general (Weissman, Markowitz, & Klerman, 2000), as well as for depressed African American and White primary care patients (Brown et al, 1999). The first phase of this research plan consists of employing an 8session form of IPT 0PT-B; Swartz, Frank, & Shear, 2002) and modifying it to be more culturally relevant to poor, African American and White Ob/Gyn patients by incorporating a number of engagement strategies to minimize practical and psychological practical barriers to care. The second phase of the research plan consists of a small, randomized pilot trial comparing treatment as usual to culturally relevant IPT-B (followed by monthly maintenance IPT up to 6 months postpartum) in a sample of depressed, pregnant, low-income African American and White patients in a public care Ob/Gyn clinic. Participants will be assessed at baseline, posttreatment, and 2 months and 6 months postpartum. The skills, training, and pilot data obtained from this award will support the development of an RO1 application in Years 03-05 of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DAILY PROCESS DESIGN APPLIED TO COGNITIVE THERAPY Principal Investigator & Institution: Cohen, Lawrence H.; Psychology; University of Delaware Newark, De 19716 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): The proposed project represents the first application of daily process measures of stress and coping, and idiographic indices of affect regulation, to research on cognitive therapy (CT) for depression. The daily stress and coping measures will be administered by an interactive voice response (IVR) procedure, and the idiographic indices will be computed using hierarchical linear modeling (HLM). Specifically, idiographic indices of affect regulation will be computed at the beginning of CT (Time 1), and again six sessions later (Time 2). We will evaluate the utility of the Time 1 indices as predictors of CT outcome (depression-reduction), and the utility of the Time 2 indices as measures of the effects of CT. It is hypothesized that depressed individuals with better initial ability to regulate daily negative affect will show more symptom reduction in CT than individuals with worse initial ability to regulate daily negative affect. It is also predicted that patients' ability to regulate daily negative affect will-improve during the course of CT. If successful, our project will demonstrate the value of an IVR-based daily process methodology, and HLM-based idiographic indices of daily affect regulation, for research on psychotherapy outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEPRESSION AND HEALTH OUTCOMES IN REFRACTORY EPILEPSY Principal Investigator & Institution: Gilliam, Frank G.; Neurology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 24-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): Epilepsy is the most prevalent disabling neurologic illness, and depression is the most frequent comorbid condition associated with epilepsy. The prevalence of depression is 20-50 percent in patients with uncontrolled seizures. This combination affects between 250,000 and 450,000 people in the United States. Our recent clinical studies have shown that depression is a strong predictor of function and health outcomes in epilepsy. Despite the marked adverse effects and high prevalence of depression in epilepsy, most affected patients are not treated. This complacency toward treatment may result from insufficient use of diagnostic screening, the widespread belief that antidepressants lower the seizure threshold, or lack of demonstrated efficacy in the only controlled trial of antidepressant medications in epilepsy. The broad aims of this study are to define the benefits of antidepressant treatment on mood, compliance, and health outcomes in epilepsy patients with comorbid major depression. Based on our prior clinical and research experience, we hypothesize that 1) pharmacotherapy or psychotherapy will reduce depression and improve health-related quality of life in patients with refractory epilepsy, 2) antiepileptic medication compliance will improve after reduction of depression, 3) seizure frequency will not significantly increase during treatment with a selective seratonin reuptake inhibitor compared to psychotherapy, and 4) depression and antiepileptic medication toxicity are stronger predictors of health-related quality of life than seizure frequency or severity in patients with refractory epilepsy. The hypotheses will be tested through a randomized trial comparing the efficacy of sertraline (n=127) to cognitive behavior therapy (n=127) for mood and health outcomes in patients with refractory epilepsy and depression. Reliable and valid measures will be used to assess depression and healthrelated quality of life. Electronic, computer-assisted monitoring will determine compliance. Multivariate repeated-measures analyses will be used to determine the interrelationships of treatment, mood, antiepileptic medication toxicity, seizure frequency and severity, compliance and health-related quality of life. We anticipate that dissemination of the results of a positive study will support the modification of the current model of intervention for epilepsy from predominantly seizure reduction to a more comprehensive approach that includes assessment and treatment of depression Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEPRESSION AND INSULIN RESISTANCE IN TYPE 2 DIABETES Principal Investigator & Institution: Lustman, Patrick J.; Professor of Psychiatry; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): The overall purpose of this study is to determine the impact of depression on insulin resistance (IR) in diabetes. IR characterizes type 2 diabetes (T2DM) and is a predictor of diabetes complications, particularly coronary heart disease (CHD). CHD, in turn, accounts for more than 50% of deaths and 75% of hospitalizations among diabetic patients. Because of this, potentially modifiable factors contributing to IR are being sought. There is evidence linking IR to depression in nondiabetic subjects, and IR may improve with depression treatment in these subjects. Depression is present in approximately 20% of patients with type 2 diabetes (T2DM),
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precedes the onset of diabetes diagnosis by more than 5 years on average, and may be responsible for some of the IR typifying T2DM and its CHD risk. In a 10-year prospective study of diabetic women with and without depression, we found that depression accelerated the development of (p <0.01) and increased the risk for CHD (OR 3.1, 95%CI 1.1-8.9) and was retained as an independent predictor of CHD in multivariate analysis. In the proposed study, we plan to recruit 160 untreated subjects with a provisional diagnosis of T2DM, 80 with and 80 without major depression (per DSM-IV) matched for gender and BMI. IR (from oral glucose tolerance tests), as well as measures of mood, glycemic control, HPA-axis activity, central adiposity, diet, and physical activity, will be determined at baseline for all subjects. Depressed subjects also will undergo frequently sampled intravenous glucose tolerance tests (FSIGTT) and more detailed analyses of activity, adiposity, and intramyocellular fat. Depressed subjects will be randomly assigned to 12 weeks of cognitive behavior therapy or usual depression care; nondepressed subjects will be observed for comparison. All baseline measures (including FSIGTT and the additional tests in the initially-depressed) will be repeated alter intervention/observation. Univariate tests, analyses of covariance, and least squares regression techniques will be used to assess the independent effects of depression and change in the severity of depression symptoms on IR and change in IR over time. The effect of depression treatment and of depression remission on IR (controlling for baseline differences) and potential mediators of a depression-IR relationship also will be determined in the initially depressed subjects. We hypothesize that depression is associated with increased IR in untreated T2DM and that IR improves with successful depression treatment. The findings from this study could identify a potentially modifiable factor for improving the course and outcome of those living with T2DM. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPRESSION AND MEDICAL CARE:AGING AND CLINICAL SETTING Principal Investigator & Institution: Katz, Ira R.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This application for an Advanced Center for lntervention Services Research (ACISR) focuses on enabling research that develops, evaluates, and disseminates interventions for depression and related disorders for older adults in primary and specialty medical and long term care settings. It utilizes both scientific advances and stakeholder input to generate new research and to translate findings into changes in practice. This application consists of four sections describing the Operations, Research Methods, Principal Research, and Network Development Cores. The section on the Operations Core describes the Governance of the Center, its three advisory boards (Scientific, Providers, and Stakeholders), Research Support Units (Biostatistics and Data Management, Assessment, and Intervention Management), the Education and Career Development Unit that includes the Center's T32 postdoctoral training program, and the Data and Safety Monitoring Unit, as well as descriptions of the processes, through which the Center develops new research. The section for the Research Methods Unit describes the product Engineering model for its activities, describes the Core's Intervention Development, Research Design, Qualitative Research Development and Assessment Development Groups. The Principal Research Core outlines the scientific Background and significance for our focus, major recent findings, ongoing and planned grants, and a series of pilot studies proposed to evaluate the
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feasibility, and estimate effect sizes to enable the design of new research. These pilot studies reflect a number of themes of the Center as a whole: the focus on both enabling research and investigator development; the use of qualitative as well as quantitative methods, and newer as well as standard experimental designs; the investigation of both psychotherapy and pharmacotherapy; the locus of studies with primary-, medical specialty- and long term care; and the design of studies to facilitate the evaluation of findings between--as well as within--comorbidities and clinical contexts. Finally, the Network Development Core proposes to develop an inner network of primary-care practices in greater Philadelphia that will serve as major research sites for the Center, and an outer Network based in the Maryland Academy of Family Physicians that will be the primary focus for our dissemination research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPRESSION IN LATE LIFE AND CAUSES OF DEATH Principal Investigator & Institution: Gallo, Joseph J.; Associate Professor; Family Practice and Cmty Med; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): The overarching goal of this study is to assess mortality of depressive syndromes in older adults in relation to overall death rates as well as in relation to deaths from specific causes, especially cardiovascular disease, while accounting for baseline and time-varying cardiovascular risk factors and other potentially influential personal and clinical characteristics. We will compare death rates among a representative sample of older persons who participated in an intervention trial designed to increase the number of older adults who receive appropriate depression treatment, such as antidepressant medications and psychotherapy. The study sample is enriched with older primary care patients with major and minor depression (n = 719) participating in an intervention trial, making it possible to study the impact of treatment on mortality risk associated with depression. Specific aims of this study are: (1) to estimate the relative risk of all-cause mortality among older primary care patients with major depression and clinically significant minor depression compared to patients without significant depression after a 3-year follow-up interval, accounting for potentially influential personal and clinical characteristics; and, (2) to assess whether varying intensity of depression treatment is associated with different allcause mortality after a 3-year follow-up interval. To accomplish these aims, we will capitalize on screening, clinical assessment, treatment, and follow-up assessments which have occurred for up to 2 years in PROSPECT (the "Prevention of Suicide in Primary Care Elderly: Collaborative Trial"). PROSPECT is a collaborative multi-site intervention study funded by the NIMH in primary care practices have been randomized into one of two treatment conditions: (1) treatment as usual (n = 597 patients); and (2) a guideline management intervention (n = 620 patients). In all, 1,217 patients, including all patients who screened positive for depression and a random sample of patients who screened negative, have been enrolled in the 2-year longitudinal study and clinically evaluated for DSM-IV major depression, minor depression, and dysthymia. In PROSPECT, 719 patients met criteria for depression treatment. The adequacy of depression treatment is assessed for all 1,217 patients regardless of diagnosis. Our proposal seeks support for identifying the follow-up vital status of the participants (using the National Death Index) and, for the persons who have died, determining primary and underlying causes of death using data from NDI Plus and primary care medical records. What we learn from this follow-up will help design interventions that are specifically targeted to
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decrease mortality among older adults with depression that is frequently associated with concurrent medical conditions such as diabetes mellitus and hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPRESSION EMPLOYER USE
TREATMENT
QUALITY
INDICATORS
FOR
Principal Investigator & Institution: Rost, Kathryn M.; Professor; Family Medicine; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2002; Project Start 15-JUN-2001; Project End 31-MAY-2006 Summary: (Provided by applicant): This application is a application for a five-year NIMH Independent Scientist Career Development Award (K-02) to prepare the candidate to design an intervention to encourage employers to engage in efforts to assure their depressed employees receive high quality treatment for the condition. To accomplish this goal, the application presents a detailed research plan describing a scientifically rigorous process to select a performance indicator that predicts the work impairment costs employers absorb, and to evaluate how quality improvement initiatives impact the selected performance indicator and total employer costs. After validating the indicator in an independent database, the candidate will provide performance indicator feedback to large corporations created from their own claims databases. This pilot will assist the candidate in identifying additional components that need to be added to a performance indicator intervention to successfully engage employers in quality assurance activities. In order to succeed with this research agenda, the candidate proposes a specific learning plan to develop knowledge of advanced statistical skills needed to create performance indicators; cost effectiveness analysis skills needed to evaluate the effect of quality improvement interventions on total employer costs; and other important skill sets detailed in the application. During the final year of the award, the candidate proposes to pilot an intervention prototype and develop a proposal for a full intervention trial. In supplanting the salary the candidate draws for administrative and teaching duties, the Career Development Award will increase the applicants ability to better integrate mental health services research and employer decision-making. In addition, support from this award will allow the applicant to transfer existing and newly acquired skills to other investigators interested in testing new interventions for their effect on under-investigated work outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISULFIRAM FOR COCAINE ABUSE IN METHADONE- PATIENTS Principal Investigator & Institution: Oliveto Beaudoin, Alison; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-MAY-2001; Project End 31-MAR-2006 Summary: (Applicant's Abstract) Because cocaine use remains epidemic among most opioid maintenance programs and pharmacological therapeutic strategies specifically aimed at cocaine's dopaminergic actions have shown little efficacy in unselected populations, this proposal will examine a novel pharmacological strategy for treating cocaine abuse in opioid-maintained cocaine abusers; i.e., treatment with disulfiram. Specifically, the aim of this proposal is to examine the effects of disulfiram (0, 62.5, 125, or 250mg /day) on treatment outcome in methadone-maintained cocaine abusers. This 14-wk, double blind, randomized clinical trial will provide treatment for 160 opioid- and cocaine-dependent individuals (18-65 years). Participants will be placed on methadone
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maintenance during weeks 1-2, at which time level of cocaine use is assessed. Then participants will continue on methadone maintenance and be randomly assigned to receive one of the following doses of disulfiram: 0, 62.5, 125, or 250 mg/day. During stabilization on methadone (wks 1-2), participants typically are administered increasing doses of methadone on a daily basis until maintenance doses are attained. Then during the treatment phase (weeks 5-14), participants continue to receive their daily maintenance doses of methadone. In addition, they receive disulfiram/placebo on a daily basis. At the end the study, participants will undergo detoxification from methadone over a 4-week period. In order to enhance outcome, all participants receive weekly 1-hour psychotherapy (Cognitive Behavioral Treatment) with experienced clinicians specifically trained to deliver the therapy and who will receive ongoing supervision. The primary outcomes will be retention and reduction in opioid and cocaine use, as assessed by self-report and confirmed by thrice-weekly urinalyses. Secondary outcomes will include reductions in other illicit drug and alcohol use, as well as improvements in psychosocial functioning. The prognostic relevance of genotype at the dopamine beta-hydroxylase locus, dopamine beta-hydroxylase enzyme activity, and severity of cocaine dependence will also be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DYNAMIC TECHNIQUES FOR TREATMENT EFFECTIVENESS ANALYSES Principal Investigator & Institution: Leon, Andrew C.; Professor of Biostatistics; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 15-FEB-2001; Project End 31-JAN-2004 Summary: (Applicant's abstract): This methodological project proposes a novel statistical strategy. The strategy integrates two components that are fundamental to longitudinal analysis of treatment effectiveness in an observational study. First, treatment status and level of psychopathology are dynamic processes, in that they change over the course of an illness. Second, there are clinical and demographic characteristics, which define, in part, the propensity of an individual to be treated. Standard data analytic strategies fail to capture the complex nature of treatment effectiveness over extended follow-up. Rosenbaum and Rubin (1983) have shown that the propensity scoring method can be used for causal inference from observational data. This proposal extends their approach to a dynamic model for analysis of longitudinal treatment effectiveness data. The procedure that is proposed here will adapt a mixedmodel approach to propensity score methodology (Aim 1). It will be used to examine antidepressant treatment effectiveness in subjects who were initially identified with affective disorders and have been followed-up over 15 years as part of the NIMH Collaborative Study of the Psychobiology of Depression. This dynamic data analytic approach provides a framework for incorporating multiple observations per subject, over the repeated episodes and recoveries that typically comprise a chronic illness, into an evaluation of treatment effectiveness (Aim 2). Furthermore, incorporating the propensity for treatment in the analyses reduces the bias that is inherent in an observational study of effectiveness. The methodology that is proposed here will also be applied to archival randomized clinical trial (RCT) data sets. The propensity for study completion and the propensity for missingness will be accounted for in the evaluation of treatment effectiveness in RCTs (Aim 3). Its use could preclude the need for both endpoint and completer analyses. The performance of the proposed methodology will be evaluated and compared to standard procedures in a Simulation Study (Aim 4). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTIVENESS OF PSYCHOLOGICAL TREATMENT FOR BED Principal Investigator & Institution: Wilfley, Denise E.; Professor; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007 Description (provided by applicant): Binge Eating Disorder (BED) is characterized by frequent and persistent episodes of binge eating and associated eating disorder psychopathology as well as general psychiatric comorbidity, psychosocial impairment, and obesity. Although a distinct clinical syndrome, BED is indistinguishable from bulimia nervosa on core eating disorder features such as eating, weight, and shape concerns. To date there is no definitive answer as to what constitutes the most efficacious treatment of BED. Specialty treatments (e.g., interpersonal psychotherapy [IPT]) have demonstrated significant short- and long-term reductions in binge eating and associated psychopathology, but not body weight. Behavioral weight loss (BWL) interventions produce clinically significant short-tem weight loss and reductions in binge eating among obese BED individuals, but the long-term impact on binge eating and other outcomes remains unclear. Guided self-help (GSH) has also demonstrated efficacy for BED in the short-term. The overall aim of this study is to compare the longterm effectiveness of three conceptually and procedurally distinct BED treatments: IPT, BWL, and GSH. A primary question posed is whether BED participants require a specialty treatment (i.e., IM, or whether BWL by itself is sufficient. BWL has the potential advantages of producing weight loss, at least in the short term and being more disseminable as a non-specialty treatment widely administered to obese individuals. Previous tests of BWL for BED have lacked adequate sample sizes, valid measurement of binge eating, and sufficient long-term follow-up. The proposed study remedies these methodological shortcomings, while also evaluating whether IPT or BWL have specific effects beyond that of a credible, minimal treatment (GSH) that is briefer, less costly, and more broadly disseminable than the professionally administered therapies of IPT and BWL. Further, the proposed study tests the differential effectiveness of these BED treatments across levels of negative affect, a dimension along which BED participants reliably subtype. Because IPT targets negative affect, we predict that IPT will prove more effective than either BWL or GSH for the subset of participants with high negative affect. 210 overweight BED participants will be recruited and divided into low negative affect and high negative affect subtypes. Participants will be stratified by negative affect sub-type and randomized to receive one of the three 24-week interventions: IPT, BWL, or GSH. Two treatment sites are required to recruit the large sample needed and to establish generalizability of findings. A third site will serve the function of data coordination and assessment/treatment oversight. Binge eating and associated outcomes will be assessed pre-treatment, post-treatment, and at 6-, 12-, and 24-month follow-up. In addition, likely mediators of change will be assessed during treatment. This study promises to not only clarify the most efficacious overall treatment for individuals with BED, but also to identify sub-groups for whom specific treatments are indicated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTIVENESS OF PSYCHOLOGICAL TREATMENTS FOR BED Principal Investigator & Institution: Agras, William Stewart.; Professor; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007
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Description (provided by applicant): Binge Eating Disorder (BED) is characterized by frequent and persistent episodes of binge eating and associated eating disorder psychopathology as well as general psychiatric comorbidity, psychosocial impairment, and obesity. Although a distinct clinical syndrome, BED is indistinguishable from bulimia nervosa on core eating disorder features such as eating, weight, and shape concerns. To date there is no definitive answer as to what constitutes the most efficacious treatment of BED. Specialty treatments (e.g., interpersonal psychotherapy [IPT]) have demonstrated significant short- and long-term reductions in binge eating and associated psychopathology, but not body weight. Behavioral weight loss (BWL) interventions produce clinically significant short-tem weight loss and reductions in binge eating among obese BED individuals, but the long-term impact on binge eating and other outcomes remains unclear. Guided self-help (GSH) has also demonstrated efficacy for BED in the short-term. The overall aim of this study is to compare the longterm effectiveness of three conceptually and procedurally distinct BED treatments: IPT, BWL, and GSH. A primary question posed is whether BED participants require a specialty treatment (i.e., IM, or whether BWL by itself is sufficient. BWL has the potential advantages of producing weight loss, at least in the short term and being more disseminable as a non-specialty treatment widely administered to obese individuals. Previous tests of BWL for BED have lacked adequate sample sizes, valid measurement of binge eating, and sufficient long-term follow-up. The proposed study remedies these methodological shortcomings, while also evaluating whether IPT or BWL have specific effects beyond that of a credible, minimal treatment (GSH) that is briefer, less costly, and more broadly disseminable than the professionally administered therapies of IPT and BWL. Further, the proposed study tests the differential effectiveness of these BED treatments across levels of negative affect, a dimension along which BED participants reliably subtype. Because IPT targets negative affect, we predict that IPT will prove more effective than either BWL or GSH for the subset of participants with high negative affect. 210 overweight BED participants will be recruited and divided into low negative affect and high negative affect subtypes. Participants will be stratified by negative affect sub-type and randomized to receive one of the three 24-week interventions: IPT, BWL, or GSH. Two treatment sites are required to recruit the large sample needed and to establish generalizability of findings. A third site will serve the function of data coordination and assessment/treatment oversight. Binge eating and associated outcomes will be assessed pre-treatment, post-treatment, and at 6-, 12-, and 24-month follow-up. In addition, likely mediators of change will be assessed during treatment. This study promises to not only clarify the most efficacious overall treatment for individuals with BED, but also to identify sub-groups for whom specific treatments are indicated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ELECTROACUPUNCTURE FOR MAJOR DEPRESSION: A PILOT STUDY Principal Investigator & Institution: Mulsant, Benoit H.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 08-SEP-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Major depression is a common and serious mental illness. It is associated with a markedly lower quality of life, significant functional impairment, and premature death due to suicide or comorbid physical illness. Over the past 50 years, effective and safe treatments for major depression have been developed, including antidepressant pharmacotherapy, psychotherapy, and electroconvulsive
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Psychotherapy
therapy. However, many Americans who suffer from a depressive disorder either do not accept to receive one of these conventional treatments or do not complete an adequate course of treatment. A growing number of Americans with depression are choosing to be treated with complementary and alternative therapies. Acupuncture, in particular, is increasingly being used to treat depression even though only limited data support its safety and efficacy. The proposed pilot study builds upon the complementary expertise of a group of investigators of conventional antidepressant treatments and a group of practitioners of alternative medicine. It will use a randomized parallel-group design to compare the safety, efficacy, and tolerability of electroacupuncture (EA) and sham electroacupuncture (SA) for the treatment of major depression. Over a 15-month period, 60 adult outpatients with a major depressive disorder of mild or moderate severity (as defined by the DSM-IV) will be randomized to either 12 sessions of EA or SA to be provided over 6 weeks. Safety and symptomatic improvement (as measured with the Hamilton Rating Scale for Depression) will constitute the primary outcome measures. Tolerability and functional improvement will constitute secondary outcome measures. The data generated by this pilot project will be used to support the feasibility of conducting, and inform the design of, a large multicenter study comparing the efficacy of two forms of acupuncture with a conventional treatment for depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENHANCED ALCOHOLISM TREATMENT STRATEGIES Principal Investigator & Institution: O'malley, Stephanie S.; Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: This application seeks renewal of an Independent Scientist Award to permit the candidate to devote full time effort to human research and research mentoring with the goal of improving alcoholism treatment by developing better methods of psychosocial and pharmacological treatments. To this end, the applicant has followed two paths: clinical studies of naltrexone in combination with psychotherapy and laboratory studies designed to examine the effects of these same medications on responses to alcohol and alcohol self-administration. Using these methods, future research efforts will focus on pharmacotherapies, such as acamprosate, that target other aspects of alcohol dependence and may be effective alone or in combination with naltrexone. The renewal of the K02 award will include an expanded emphasis on abstinence initiation and withdrawal symptomatology, and medications the purport to attenuate protracted withdrawal, and advanced statistical techniques to evaluate change. The Research Plan provides a detailed description of a laboratory study designed to provide critical information about the effects of acamprosate on central aspects of alcohol dependence: withdrawal and loss of control drinking. Acamprosate is approved for treatment in Europe based on studies showing that acamprosate improved rates of abstinence. However, there is little information regarding whether acamprosate reduces relapse following a lapse and on whether acamprosate attenuates withdrawal as hypothesized. One hundred-twenty nontreatment seeking alcohol dependent volunteers will be randomized to receive placebo or one of two doses of acamprosate and studied in the laboratory to assess the effects of the medication on alcohol withdrawal symptomatology, alcohol intoxication and alcohol self-administration. Better characterization of these effects will be important for determining the optimal sequencing and timing of pharmacotherapies such as acamprosate and for increasing the overall success rate for achieving and maintaining abstinence. The Career
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Development Plan include collaborations with investigators at the Scripps Institute, Brown University and the University of Missouri and selected course work in statistical methods. The objective of the career development plan will be to acquire an understanding of preclinical models to study homeostatic mechanisms involved in addiction and the effect of pharmacological interventions during acute withdrawal, protracted withdrawal, and relapse. In addition, a major objective will be to acquire training in statistical methods appropriate for the analysis of change and mediational processes in longitudinal data sets, including hierchical linear modeling, repeat event time analysis, regression analyses, and structural equation modeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FAMILY THERAPY FOR ADOLESCENT BULIMIA NERVOSA Principal Investigator & Institution: Le Grange, Daniel; None; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (provided by applicant): Bulimia nervosa (BN) is a disabling eating disorder and affects as many as 2% of young women. It is a major source of psychiatric and medical morbidity that often impairs several areas of functioning. BN is occurring with increasing frequency among adolescents and preadolescents. Applying stringent diagnostic criteria for BN, studies have found 2-5% of adolescent girls surveyed qualify for diagnosis of BN. Research specific to treatment of child and adolescent eating disorders remains limited. No psychological treatment has been systematically evaluated in the treatment of adolescents with BN. The rationale for the proposed study derives from the candidate's participation in the conduct of treatment studies for adolescents with anorexia nervosa at the Maudsley Hospital in London. These data indicate that a specific form of family therapy is effective in the treatment of adolescents with anorexia nervosa. Involving the parents and siblings in treatment has beneficial effects on reversing the course of the eating disorder as well as improving family interaction. A preliminary report from the Maudsley group has also shown that this family therapy may be helpful in the treatment of adolescents with BN. Because most young adolescents still live with their families of origin, and are embedded in their families. This raises the important clinical possibility that adolescent BN patients can also be successfully treated with family therapy. We hypothesize that family therapy is an effective and essential way to reduce binging and purging in adolescents with BN, and will lead to long-term amelioration of bulimic symptoms. In the proposed study we aim to adapt and pilot a recently developed family therapy manual for adolescent anorexia nervosa for use in the treatment of adolescent BN patents, and to compare the efficacy of this conceptually and procedurally distinct family therapy treatment with a manualized individual control psychotherapy. To achieve these aims, we propose a five-year controlled treatment study to be carried out at The University of Chicago. Ninety newly referred adolescents meeting DSM-IV diagnostic criteria for BN will be randomly allocated to one of two groups: 1) family therapy or 2) individual supportive control treatment. All patients will receive the same medical evaluation and monitoring throughout the study period. Assessment of psychiatric and medical outcome measures will be carried out at the onset of treatment, during treatment, at the end of treatment, and again at six-month follow-up. The primary clinical outcome variables assessed will be binge and purge frequency (Eating Disorder Examination), while secondary outcome variables will include the Schedule for Affective Disorders and Schizophrenia, Rosenberg Self-esteem Scale, and Expressed Emotion. The candidate is a clinical psychologist who seeks to acquire skills in sophisticated statistical techniques for
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Psychotherapy
longitudinal data analysis, more in-depth knowledge of child and adolescent development and mentoring to conduct an independent controlled treatment trial in adolescent BN. This award will allow the candidate to train in appropriate research methodology and statistical procedures, and provide instruction, mentorship and experience in conducting a randomized trial of psychosocial treatments. Dr. Le Grange will engage in course work, workshops, controlled treatment trial research, and have ongoing mentorship from experts in the field. Through this award, the candidate will be able to build upon his prior experience as a participant in the conduct of controlled studies, put himself in a competitive position to apply for funding in the future, and establish himself as an independent treatment outcomes researcher. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FOLLOWUP OF DEPRESSED ADOLESCENTS RECEIVING CBT + SSRIS Principal Investigator & Institution: Clarke, Gregory N.; Senior Investigator; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, Ca 946123433 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-MAR-2005 Summary: (provided by applicant): This proposal aims to extend the follow-up of 152 depressed youth ages 12 to 18 who have already been enrolled in a randomized controlled trial of a collaborative cognitive-behavioral treatment (CBT) program for youth who have initiated SSRI pharmacotherapy for their depression. This study, called STEADY (Study for Testing Effective Approaches for Depressed Youth), has completed subject recruitment (N= 152). Enrolled subjects are currently in various stages of their follow-up assessments. This application is to obtain timely funding to extend the followup from the current 12-months to 24-months post-randomization. The rationale for requesting this extended follow-up is to examine more fully the persistence of positive findings detected in preliminary outcome analyses at the 12-month assessment point (the final assessment point funded by the original award). The pattern of results observed in the preliminary analyses that the main advantage of the CBT program in this study seemed to be later (at month 12 post-enrollment) rather than earlier (within the first 6 months post-enrollment). This is contrary to what is typically observed in randomized mental health trials-where the experimental arm often has the largest advantage immediately after acute treatment. Our interpretation is that the CBT program adds little to acute recovery from the index depression episode (at least beyond the improvement attributable to usual care SSRIs that are employed in both conditions), but that the emerging significant advantage seen at the 12-month point may be an early sign of delaying or preventing depression relapse/recurrence during a longer-term continuation period. This advantage of the CBT treatment is consistent with the recent conclusions about the advantages of combined pharmacotherapy and psychotherapy treatment for depression in adults, particularly when CBT is added to pharmacotherapy. We argue that this result justifies funding for continued follow-up through the period of greatest risk of relapse back into depression (the first two years post-recovery), in order to confirm that this relapse/recurrence prevention is genuine and enduring. This is a particularly important question, given the high risk of depression relapse/recurrence in these youth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FOLLOW-UP STUDY OF OBSESSIVE COMPULSIVE DISORDER Principal Investigator & Institution: Rasmussen, Steven A.; Associate Professor; Butler Hospital (Providence, Ri) 345 Blackstone Blvd Providence, Ri 02906
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Timing: Fiscal Year 2002; Project Start 09-APR-2001; Project End 31-MAR-2006 Summary: There have been significant advances over the last decade in our understanding of the epidemiology, etiology, and treatment of obsessive-compulsive disorder (OCD). Data from older studies suggests that the course of OCD is usually chronic. However, there are significant gaps in the literature regarding the long-term patterns of course and predictors of this disorder. We do not know whether certain subtypes of OCD have a more pernicious course than other subtypes. The impact of OCD on psychosocial functioning over time is another currently clinically relevant area that has not been examined in previous studies. The broad objective of this proposal is to develop a comprehensive picture of the longitudinal course and outcome of OCD using a prospective, longitudinal, observational design to follow 400 subjects with OCD over a period of three to five years. Specific aims are to: comprehensively describe the long-term patterns of course of OCD; identify clinically meaningful predictors of remission and relapse; prospectively describe the amount of psychiatric treatments received; assess the relationship between psychosocial function, quality of life and OC symptom severity over the follow-up period. Using a well-defined method developed by Keller and colleagues for observational studies of anxiety and depression, the study will evaluate 400 consecutive patients with OCD using DSM-IV criteria for the disorder over a three to five year follow-up period. Detailed information on symptom status and severity, functional impairment, quality of life, diagnostic Status and treatments received will be recorded systematically using instruments with proven reliability and validity at yearly intervals. This study will be the first comprehensive prospective observational study of the course of illness in OCD and will be the first study to prospectively determine remission and relapse rates according to DSM-IV criteria. It will provide important new information about longitudinal aspects of treatment and predictors of remission and relapse that will, in turn, help refine data supporting the existence of homogeneous subtypes in OCD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GROUP TREATMENT FOR DEPRESSION IN HEART FAILURE Principal Investigator & Institution: Friedman, Michael A.; Psychology; Rutgers the St Univ of Nj New Brunswick Asb Iii New Brunswick, Nj 08901 Timing: Fiscal Year 2003; Project Start 14-FEB-2003; Project End 31-JAN-2006 Summary: (provided by applicant): The overall aim of this research is to develop an efficacious group psychotherapy for the treatment of major depression among individuals with congestive heart failure. Both major depression and heart failure are associated with severe loss of functioning and increased mortality, and this co-morbid condition is particularly debilitating. While treating depression among heart failure patients has the potential to improve functioning and prolong life in this population, there are currently no empirically-supported treatments for depression among heart failure patients. Among the several well-validated psychosocial treatments, group cognitive-behavioral therapy (CBT) has been proposed as efficacious, and has established feasibility among heart failure patients. Group CBT may be particularly efficacious among CHF patients with depression due to the potential for increasing patient social support. Initial research suggests that there are several ways in which current group CBT could be improved to treat major depression among CHF patients, including: (1) the use of an "open" group format that allows for immediate patient care, (2) integration of individual interventions to individually tailor treatment goals and improve adherence to treatment, and (3) family-based interventions within the group CBT format to mobilize patient social support. The proposed integrated cognitive-
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Psychotherapy
behavioral therapy program includes group, individual, and family treatment (GIFT) for depression among individuals with CHF (GIFT-CHF). The current proposal is designed to develop the GIFT-CHF program. The proposal consists of three phases: a Development, Pilot, and Revision Phase. During the Development phase of the GIFTCHF, the goal of the research will be to: (a) develop an integrative group therapy program for depressed patients with heart failure (GIFT-CHF); (b) develop a therapist training program; and (c) develop and test the reliability and validity of competence and adherence rating scales. During the Pilot phase of the GIFT-CHF program, the goal will be to conduct a small pilot trial investigating the short-term efficacy of the GIFT-CHF program in comparison to a Standard Medical Care/Wait-List control group, and determine effect size. Finally, during the Revision phase of the GIFT-CHF program, the goal of the research will be based on the results of the Development and Pilot phases, to revise the GIFT-CHF program and treatment manual. This treatment development grant will lay the groundwork for a large-scale treatment outcome study of the GIFT-CHF program for depressed individuals with congestive heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HEALTH SERVICES FOR PARASUICIDAL BEHAVIOR Principal Investigator & Institution: Comtois, Katherine A.; Psychiatry and Behavioral Scis; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 13-JUN-2001; Project End 31-MAY-2006 Summary: The Mentored Research Scientist Development Award (K01) will provide the education and skills that I need to make the transition from clinically based randomized controlled trials and survey designs to population-based health services research. I am particularly concerned about assuring that high quality treatments with empirical support are in use in the public mental health system. This will require not only available evidence based treatments but the skills to adapt these treatments when necessary for effectiveness, dissemination, and implementation trials. Some disorders, such as depression in primary care, have benefitted from adaptation of evidence based efficacy treatments to meet the clinical needs of primary care patients and to fit into the primary care system. I am interested in expanding such research interventions to the treatment of parasuicidal behavior in the public sector. My long term goal is to develop a population-based allocation of mental health services for parasuicidal behavior within the public sector that is (a) guided by evidence based treatments, (b) implementable, given variable local system needs and structures, and (c) is cost-effective relative to usual care. To pursue this goal, I will need to expand my training in three areas: (1) clinical epidemiology and quality of care evaluation of usual care, (2) issues that facilitate or impede implementation of evidence based treatments in public mental health settings, and (3) health services research and design of population-based effectiveness studies. These goals reflect NIMH's recommendations of bridging science and service. The proposed study is a naturalistic epidemiologic follow-up of a sample of patients admitted to the psychiatric emergency department (ER) of a county hospital on a random-selection of assessment periods. Subjects will be assessed in the ER for parasuicidal behavior, psychiatric diagnosis, and service utilization for the previous 6 months. Subjects will then be re-interviewed 3 and 6 months following their ER admission regarding parasuicidal behavior and service utilization since admission. The goal is to identify the patterns and predictors of the course of parasuicide as it relates to utilization of treatment. The specific aims for the research study are as follows: 1) Determine subgroups of parasuicidal patients as defined by service utilization patterns and describe them based on clinical and diagnostic characteristics. 2) Evaluate quality of
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care for parasuicidal patients based on process indicators of mental health treatment quality. 3) Identify service utilization patterns related to system factors above and beyond patient factors (e.g., crisis services replacing outpatient as primary treatment for parasuicidal individuals). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HELPING AFRICAN AMERICAN LIGHT SMOKERS QUIT Principal Investigator & Institution: Ahluwalia, Jasjit S.; Chair and Director of Research; Preventive Medicine and Public Health; University of Kansas Medical Center Msn 1039 Kansas City, Ks 66160 Timing: Fiscal Year 2002; Project Start 21-AUG-2001; Project End 31-JUL-2005 Summary: Cigarette smoking is the leading preventable cause of disease and death for all Americans. African Americans (AAs) continue to have a high prevalence of smoking, up to 50 percent among the urban poor. Enabling them to quit smoking is a national health priority. In the United States, smoking cessation efforts have focused primarily on heavy smokers and excluded light smokers (smoke s10 cigarettes per day). However, up to 50 percent of African American (AA) smokers are light smokers. Despite smoking fewer cigarettes a day, AAs extract more nicotine per cigarette smoked, and have higher tobacco- related morbidity and mortality. Using a nicotine inhaler may help smokers quit; however, it has not been studied among light smokers. Because light smokers constitute a large proportion of AA smokers, it is critical that cessation interventions, including pharmacological aids and counseling strategies, be developed to include AA light smokers. The primary aim of this study is to assess the efficacy of nicotine inhaler and motivational interviewing for smoking cessation among inner-city AA light smokers. This randomized, placebo-controlled study will be conducted at a communitybased clinic, Swope Parkway Health Center, in Kansas City, Missouri. The primary outcome of the study is biochemically-verified 7-day point prevalence abstinence from cigarette at 6 months. Secondary outcomes include: 1) 7-day point prevalence abstinence at 12 weeks and 1 year; 2) continuous abstinence at 12 weeks, 6 months, and 1 year; 3) change in the number of cigarettes smoked; 4) differences among groups in the effect of MI counseling based on participants' level of motivation; and, 5) differences among groups in the effect of the inhaler based on number of cigarettes smoked. This study will use a factorial design (2X2) in which 756 (189 in each arm) light smokers will be randomly assigned to one of four study arms: Tx1, Tx2, Tx3, and Tx4. Participants in Tx1 will receive placebo inhaler plus four health education sessions; Tx2 will receive placebo inhaler plus four MI counseling sessions; Tx3 will receive active nicotine inhaler plus four health education sessions; and, Tx4 will receive active nicotine inhaler plus four MI counseling sessions. Inhaler treatment (active or placebo) will be for 12 weeks. Recruitment and retention will be enhanced by use of monetary reimbursement for transportation and for completing study assessments, provision of attractive intervention materials, and a community advisory board. Post-intervention focus groups of quitters and non-quitters will assess the project's intervention components. Ultimately, we envision that the intervention, if efficacious, would enhance our understanding of smoking cessation and nicotine dependence, and could be used as a pre-packaged intervention for AA light smokers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OUTCOMES
IMPROVING
DEPRESSION
TREATMENT
ADHERENCE
&
Principal Investigator & Institution: Flynn, Heather A.; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 31-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): This application seeks support for a Mentored Patient-Oriented Research Career Development Award (K23). The award would provide me the opportunity to transition to a successful independent research career focused on improving treatment adherence and outcomes for women with depression. I have had a thematic clinical and investigational interest in identifying factors that maintain depression, determining effective prevention and treatment strategies to overcome them. I have followed a career trajectory to develop a research focus in this area. The K23 mechanism will continue this trajectory, allowing me to: 1) obtain additional knowledge and skills in targeted areas pertaining to treatment adherence and transition to an independent research career in this area, 2) expand research methodology and grant-writing skills sufficiently so as to become competitive for extramural funding in this adherence/outcome arena, and 3) obtain support to pursue these academic and research goals under the mentorship of successful researcheracademicians in a multidisciplinary academic environment. Specifically, the educational and research endeavors for the proposed career development period will focus on developing incremental skills in 3 areas: I) theoretical/conceptual models (and associated methodological skills) of etiology, maintenance and treatment of depression in women, 2) exploration of how to incorporate selected psychological theoretical/conceptual models to improve treatment adherence, and 3) clinical and health services projects to objectively assess changes in treatment adherence and effectiveness of treatments for depression in women in naturalistic settings. To achieve these goals, I propose specific mentoring, coursework, didactic training, visits to national consultants, and participation in national meetings. The research plan aims to examine the underlying mechanisms and processes of psychotherapeutic approaches (Interpersonal Psychotherapy; IPT) and other psychological and interpersonal factors that might enhance treatment adherence and improve outcomes in women with depression. The first study proposed will examine the effectiveness of IPT in improving adherence and depression outcomes in pregnant women with depression. A second proposed project will examine the role of a number of factors hypothesized to affect treatment adherence in a more heterogeneous group of women (i.e. pregnant and nonpregnant) with depression in primary care. At the later stages of the proposed career development period, I will have achieved the training, mentoring and research experiences to permit independent formulation and execution of competitive ROl applications. This research has potential to meaningfully improve medication adherence, enhance outcomes and quality of life, and minimize the terrible morbidity burden experienced among women with depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTEGRATING PSYCHOTHERAPY
EVIDENCE
AND
PRACTICE
OF
YOUTH
Principal Investigator & Institution: Garland, Ann F.; Associate Professor; Psychiatry; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 920930934 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-JUL-2007
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Summary: (provided by applicant): The proposed study addresses the lack of knowledge about psychotherapeutic treatment processes for youth in community settings and, more specifically aims to improve the integration between the evidencebase and common practice of youth psychotherapy for children ages 4-13 with disruptive behavior problems. The study has been designed, and will be conducted in partnership with a team of practitioners from community clinics, thus enhancing the clinical utility. The aims of the project are to: (a) examine the extent to which evidencebased and practitioner-based principles of effective psychotherapy for these youth are consistent and inconsistent; (2) characterize actual practice of psychotherapy for these youth in community, publicly funded clinics, and determine the extent to which practice reflects evidence-based and practitioner-based principles; (3) examine how practice consistent and inconsistent with these principles is associated with changes in child and family outcomes; and (3a) examine how these linkage between practice and outcomes may be moderated by child and family characteristics such as race/ethnicity and parental psychopathology. The design includes a prospective, longitudinal study of 288 children entering a new episode of out-patient care for treatment of disruptive behavior problems. Thirty-six clinicians from six out-patient clinics will be selected to represent the distribution of clinicians across the clinics by discipline. Eight patients for each of these 36 clinicians will be followed for 16 months. Psychotherapy process data will be collected through videotapes of therapy sessions; randomly selected sessions will be coded for type, breadth, and depth of intervention strategy using a comprehensive coding system. Data on therapeutic alliance and service use (dose and intensity) will also be collected. Outcome data assessing child symptomatology, functional impairment. family functioning, and perceived treatment benefit will be collected at entry and every 4 months up to 11 months, regardless of length of treatment. Data will be analyzed using mixed effects regression models to examine how variations in treatment elements are related to outcome trajectories. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPRESSION
INTERPERSONAL
PSYCHOTHERAPY
FOR
ANTENATAL
Principal Investigator & Institution: Stuart, Scott P.; Associate Professor; Psychiatry; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2003; Project Start 01-JUL-2000; Project End 31-MAR-2005 Summary: (Adapted from the Applicant's Abstract): The primary aim of the proposed research is to evaluate the efficacy of Interpersonal Psychotherapy (IPT) as a treatment for antenatal depression. The treatment outcomes to be investigated in this study include the effects of IPT on the reduction of women's depressive symptoms and on their rates of remission from depression. Changes in social and marital adjustment which result from treatment will also be evaluated. The second aim of the proposed research is to identify factors that are associated with response to IPT, so that women who may benefit from IPT can be more accurately identified in the future. The third aim of the proposed research is to evaluate the effect of treatment with IPT during pregnancy on women's depressive symptoms during the puerperium. The fourth aim of the proposed research is to identify factors that are associated with high levels of postpartum depressive symptomatology among women receiving either IPT or the control treatment during pregnancy. A total of 110 women in their first and second trimesters of pregnancy will be recruited from Maternal Health Centers (MHC's) across the state of Iowa. This recruitment strategy will include women from a wide range of socioeconomic classes and both rural and urban settings. Women will be randomly
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assigned to treatment with IPT or to a treatment as usual condition. Women in the treatment as usual condition will receive treatment from physicians at their local MHC. The treatment as usual condition is designed to reflect the treatment that women currently receive for antenatal depression in the community, and to provide a valid test of the effectiveness of IPT. IPT will be delivered over 12 weeks during the antenatal period to women in the group receiving IPT. Assessments of women before, during, and after the completion of treatment will be conducted to evaluate its effectiveness. Women will also be followed for a year following delivery to assess their postpartum emotional and social adjustment. We expect that women treated with IPT will have significantly lower levels of depression and higher levels of social functioning than women in the control condition. We also expect that women receiving IPT will have significantly lower levels of depressive symptomatology during the puerperium than women in the control condition. We hypothesize that IPT will be an effective low-risk alternative to the use of medication during pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERPERSONAL PSYCHOTHERAPY FOR SOCIAL PHOBIA Principal Investigator & Institution: Lipsitz, Joshua D.; Anatomy and Cell Biology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2004 Summary: (Applicant's abstract): Social phobia is a common and debilitating disorder. Because established treatments are effective for many but not all social phobia patients, research into alternative treatments in needed. In response to this need, this Mentored Clinical Scientist Development Award proposal pursues two distinct, yet interdependent goals. The first is to develop the principal investigator's ability to conduct independent research in the psychosocial treatments of anxiety disorders. Second, the proposed research tests the efficacy of interpersonal psychotherapy (IPT) for social phobia and expands on this question through additional projects. The training program will integrate: 1) course work in research design, statistics, and the ethical conduct of research, 2) intensive tutorials and ongoing training in specific psychotherapy approaches, 3) supervision by the primary mentor in carrying out the research plan, and 4) supervision from specialized preceptors in various aspects of research with IPT and psychotherapy research for the anxiety disorders. The planned research expands on promising preliminary results with interpersonal psychotherapy for social phobia through three projects. The primary project is a controlled clinical trial with randomized assignment to interpersonal psychotherapy for social phobia (IPT-SP) or a credible psychotherapy control. Comprehensive assessment will be conducted periodically during treatment and at 6 and 12 months following treatment. In a second project, IPT-SP will be modified for treatment of groups, and this treatment will be piloted in a group of social phobia patients. In a third project, available narrative summaries from 120 panic disorder patients will be analyzed to explore the relevance of IPT for panic disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEDICATION DEVELOPMENT FOR COCAINE ABUSE--CDP CHOLINE Principal Investigator & Institution: Lukas, Scott E.; Professor of Psychiatry; Mc Lean Hospital (Belmont, Ma) Belmont, Ma 02478 Timing: Fiscal Year 2003; Project Start 10-APR-1999; Project End 31-MAR-2004
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Summary: (Applicant's Abstract) This is a revised application that focuses on the development of a novel medication for cocaine dependence--CDP-choline. This naturally occurring nucleotide is a major component in phospholipid metabolism and is an integral ingredient in membrane synthesis. It is approved for use in Europe to treat head trauma and a variety of neurological degenerative disorders. Interestingly, it also enhances dopamine activity. Thus, CDP-choline's efficacy as a treatment for cocaine dependence may be high because it repairs two putative consequences of chronic cocaine abuse: 1) membrane damage, and 2) depleted dopamine levels. Two experiments are proposed in this three year study. The first is a challenge study designed to assess the acute effects of cocaine administration in CDP-choline treated non-dependent, casual cocaine users. A multidisciplinary assessment battery including EEG, physiologic, subjective responses and plasma cocaine and metabolite levels will be conducted after cocaine or placebo challenge. This experiment will be conducted in the first six months of the project and will provide basic information on how cocaine's effects are altered by this medication. Study 2 is a 6-week placebo-controlled clinical trial of CDP-choline in cocaine dependent men and women. Follow-up assessments will be made at 8, 12 and 26 weeks. In an attempt to gain insight into the possible mechanism of CDP- choline's effects, two different assessments of CNS function will be conducted at baseline, after 6 weeks of treatment and at the 12 week follow-up visit. The first is a cue reactivity challenge using subjective reports of craving, physiologic and EEG activity after neutral, emotionally laden and cocaine-related stimuli. The second assessment is Magnetic Resonance Spectroscopy (MRS), which will be used to measure changes in brain chemistry that reflect neuronal damage. One of the major appeals of CDP-choline is its low inherent toxicity. Large doses have been given for relatively long periods of time with no adverse effects. The implication of this is that CDP-choline may be safe enough to treat cocaine dependence in pregnant women and adolescents and may even be useful for treating infants who are born to cocaine-dependent mothers. Although we have collected very encouraging preliminary data on CDP-choline's effects in cocainedependent male and female subjects, we recognize that it is not a "magic bullet" and that CDP-choline may serve as an important adjunct to other psychotherapy or pharmacotherapy programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MENTAL HEALTH SERVICE DELIVERY TO TRAUMA VICTIMS Principal Investigator & Institution: Frueh, B Christopher.; Associate Professor; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2002; Project Start 01-FEB-1999; Project End 31-JAN-2004 Summary: The purpose of this project is to develop the candidate as an independent researcher, investigating issues related to mental health service delivery to racially diverse trauma victims. The project will focus initially on male combat veterans with PTSD receiving services within and outside the VA system, with a plan to broaden the scope of research focus in the last phase to include civilian trauma victims. At this point we know almost nothing about service delivery to combat veterans across different types of service settings. Most of the current treatment research has been conducted at VA research centers, and therefore, we do not have empirical data on a host of relevant variables (e.g., appropriateness of care, treatment effectiveness) in applied, real-world settings such as Vet Centers, community, or primary care clinics. The Career Development Plan includes training to design and conduct research in three important areas: (1) veterans' concerns about services; (2) racial differences; and (3) service costs
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and effectiveness. This training plan will consist of three components; (a) individually administered mentoring from a multidisciplinary team of specialists; (b) formal course work and seminars to further develop a body of knowledge in relevant areas; and (c) completion of relevant research projects. The mentorship team will be led by Albert O. Santos, M.D., and includes Samuel M. Turner, Ph.D., Terence M. Keane, Ph.D., Dean Kilpatrick, Ph.D., and Judith Cooke, Ph.D. The Research Development Plan consists of three phases: (I) exploration and identification, via focus groups, of salient dimensions of concern, need, and cultural acceptance of mental health services currently delivered, as perceived by service recipients among male veterans with combat-related PTSD; (II) investigation of the hypothesis that African-American combat veterans with PTSD manifest poorer functioning, lower quality of life, and a higher rate of psychiatric symptoms associated with their clinical presentation than Caucasians; (III) development of a series of grant proposals to examine costs and effectiveness associated with treatment for combat-related PTSD, incorporating what was learned in phases I and II; and development of projects to examine service needs among racially diverse groups of civilian trauma victims. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MINORITY PREDOCTORAL FELLOWSHIP PROGRAM Principal Investigator & Institution: Acra, Caroline F.; Psychology; University of Miami Coral Gables Box 248293 Coral Gables, Fl 33134 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): 45,000 to 375,000 children are affected each year by prenatal cocaine exposure. Children prenatally exposed to cocaine are at-risk for later cognitive and language delays, as well as behavior problems, and therefore are likely to benefit from early intervention services. The Linda Ray Intervention Project (LRIP) was designed to compare the effects of early intervention of different intensities on prenatally exposed infants. Intervention was child-focused, and the project provided intervention from 6 months to 36 months of age. Two intensities of intervention were contrasted with a group not receiving intervention. The preliminary 36-month outcome data showed that intervention was effective at improving both cognitive and language outcome. The aims of this proposed study will be to continue longitudinal analyses of outcome for these LRIP children. Specifically, it will examine cognitive, language and behavior outcomes as these children enter first grade and examine how much of the benefits gained from early intervention are maintained three years after the completion of the program, when the child is ready to enter grade school. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MODELING TREATMENT USE & EFFECTIVENESS IN MENTAL ILLNESS Principal Investigator & Institution: Normand, Sharon-Lise T.; Associate Professor of Biostatistics; Health Care Policy; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JAN-2004 Summary: (Applicant's abstract): This application seeks support for a team of statisticians, economists, clinicians, and mental health services researchers to collaborate on the development and application of discrete choice models for understanding treatment use and for causal inferences in experimental and naturalistic studies of mental illness. By studying how patients are matched with treatments in extant systems,
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researchers will gain greater insight into the determinants of quality of care. The Specific Aims will involve the 1) extension of likelihood-based methods to estimate treatment effectiveness at the levels actually received using experimental data from two influential clinical trials (Schulberg, Block, Madonia et al., Acrh Gen Psychiatry 1996;53:913-9 & Rosenheck, Neale, Arch Gen Psychiatry 1998;55:459-66) and to compare these estimates with those based on conventional approaches, such as intention-to-treat, adequate, and completer principles, 2) development of new models of discrete choice to explain variation in treatment use based on patient, provider, and insurance characteristics for privately insured and Medicaid beneficiaries, and 3) application of these discrete choice models to explain variation in adherence with treatment recommendations and in treatment effectiveness for depression and for schizophrenia across a diverse array of practice settings. An Advisory Board comprised of leaders in statistics, economics, and psychiatry will convene annually to validate methods and ensure integration of techniques into mental health services research. The methodological advances from this research will enable mental health researchers and policy makers to better characterize usual care and to expand the inferences drawn from clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MULTIFACETED HOME CARE DEPRESSION PROGRAM Principal Investigator & Institution: Ell, Kathleen R.; None; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-JUL-2004 Summary: (Applicant's abstract): High rates of depression among the elderly with physical illness and impaired functioning are well documented. Efficacious treatments for depression among the elderly are available, but all too often depressed elderly are either not diagnosed or not treated properly. Elderly patients have been consistently found to underutilize formal mental health services. On the other hand, the elderly are heavy utilizers of general health or primary care services. The Multi-faceted Home Care Depression Program (MHCDP) is a fully integrated, stepped care, collaborative, multimodal home care model designed to influence the process of home care, the home care provided by physicians and nurses, and patient self-management. It aims to improve the detection and treatment of major depressive disorder (MD} and dysthymia. A controlled, block-randomized clinical trial is proposed to test the effectiveness, acceptability, feasibility, and cost of the MHCDP among 600 enrolled subjects aged 65 years and older who are receiving services in a large urban/rural home care program (SunPlus). The direct cost of detection and treatment under MHCDP is covered through existing reimbursement mechanisms and MHCDP is fully integrated within standard home care practices. Key components of the MHCDP are: 1) a phased baseline detection strategy which includes a depression symptom inventory (SCL-90 Depression) and a structured diagnostic assessment procedure (PRIME-MD PHQ-9) that is brief and will be implemented during the existing standard admitting RN evaluation conducted (during a 2-hour home visit) on all patients referred for home care services; 2) a stepped care treatment algorithm that includes patient choice of medication or psychosocial treatment; and 3) specific quality of care enhancements that are fully integrated within existing standard home care practice. These include training existing psychiatric team nurses and social workers in structured Problem-Solving Treatment, informational materials for referring primary care physicians, nurse and social worker training, home care management services to monitor and facilitate depression treatment and to address barriers to care, patient and family/caregiver education, and follow up provided by psychiatric nurses and social workers. Major Hypotheses and Research Questions: (1)
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MHCDP intervention will result in greater reduction of depressive symptoms vs. usual care; (2) MHCDP will result in greater frequency of primary care physician prescription for drug or psychosocial treatment vs. usual care; and (3) MHCDP will increase patient acceptance of and adherence to treatment and satisfaction with care vs. usual care. In addition, we will conduct: (1) comparisons of functional status, quality of life, suicidal ideation, and service utilization between intervention vs. usual care patients; and (2) cost-benefit comparisons of estimates of direct costs of the intervention and usual care arms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL APPROACHES TO ALCOHOLISM PHARMACOTHERAPY AND RISK Principal Investigator & Institution: Kranzler, Henry R.; Professor of Psychiatry; Psychiatry; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): This Mid-Career Investigator Award (K24) will provide the candidate with an opportunity to continue his career development, to continue to mentor beginning clinical investigators and to continue research in the pharmacotherapy of alcoholism and the genetics of alcohol and drug dependence. The research plan includes five projects, three of which have been funded and are ongoing; the others are being considered for funding or under scientific review. The ultimate research goal of proposal is the synthesis of findings from neuropsychopharmacology and genetics to yield a coherent pharmacogenetic approach to the etiology and treatment of alcoholism. The specific research aims of the proposal are 1) to complete data analysis and report preparation for a study of targeted naltrexone for early problem drinkers (data collection for which was recently completed), 2) to complete ongoing studies of the genetics of cocaine dependence (CD) and opioid dependence (OD), 3) to conduct a study of the genetics of alcohol dependence (AD) using the method of linkage disequilibrium and 4) to conduct a study examining the safety, efficacy, mechanism of action and duration of effects of sertraline in alcoholics who are subtyped by age of alcoholism onset. The mentoring plan will focus on training psychiatric residents, postdoctoral fellows in addiction psychiatry, postdoctoral fellows in alcohol research, and junior faculty in psychiatry and medicine to conduct patient-oriented research. That training will focus on clinical research methods, data interpretation, manuscript and grant preparation, research ethics and human subjects protections. Mentoring will occur through trainees' participation in the research projects and through lectures and seminars that are offered through the Alcohol Research Center, Department of Psychiatry, and the General Clinical Research Center at the University of Connecticut School of Medicine. This range of research and educational activities offers a rich matrix of opportunities for trainees and junior investigators in patient-oriented research. In addition, the K24 will enable the candidate to take coursework in areas that are important to his continued development as an investigator and mentor. Over the next five years, the candidate seeks to: 1) maintain full-time effort in research and research mentoring, 2) increase the depth and breadth of his own skills through specific training in molecular genetics, biostatistics and bioinformaties and through continued collaboration with established experts in these areas, 3) continue the dissemination of research findings through presentation at scientific meetings and publication in the scientific literature and 4) help to train the next generation of investigators who will advance the field of patient-oriented research in alcoholism and drug dependence.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NURSING MANAGEMENT OF IBS: IMPROVING OUTCOMES Principal Investigator & Institution: Heitkemper, Margaret M.; Professor and Director; Biobehavioral Nursing and Health Systems; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2003; Project Start 01-AUG-1996; Project End 31-JAN-2007 Summary: (provided by applicant): The proposed application is a competitive supplement to the NINR funded project titled "Nursing Management of IBS: Improving Outcomes". In the United States, it is estimated that 10-20% of the population experience symptoms compatible with a diagnosis of irritable bowel syndrome (IBS). IBS is a functional condition characterized by change in bowel patterns, (e.g., constipation, diarrhea), interfering with functional activities and increasing health care utilization. Current recommended therapies include diet manipulation, self-management, psychotherapy, and motility and pain modulation via pharmacological therapy. The purpose of the parent project funded in 2002 is 1) to determine whether the CSM intervention is equally effective in men and peri- and postmenopausal women and 2) to determine whether the CSM intervention is as effective when delivered over the telephone as compared to a face-to-face approach. A three-group randomized clinical trial with longitudinal follow-up will be used to test the effectiveness of a face-to-face versus telephone comprehensive self-management (CSM) program relative to a usual care control group. Outcome variables will be measured during the assessment phase (T1) then 6 months (T2) and 12 months (T3) after the randomization phase. The primary aim of this supplement is to compare the distribution of SET polymorphisms across predominate bowel pattern subgroups and gender in people with IBS. We hypothesize that the distribution of SERT polymorphisms (5'-flanking promoter region [5-HTTLPR] and in exon 2 [VNTR]) will differ across predominate bowel pattern subgroups and the distribution of SERT polymorphisms will differ by gender. Exploratory aims of this study include: 1) Evaluate the relationship of SERT polymorphisms to symptom experiences and psychological profile; 2) Test whether the degree of improvement in response to the CSM therapy differs by SERT polymorphism; and 3) Evaluate the relationship of platelet rich plasma 5-HT levels to SERT polymorphisms, predominate bowel pattern. This study will provide information on the potential role of serotonin processing in IBS as well as potential gender and bowel symptom predominance. Such results may ultimately be used to tailor therapies for this common health problem. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ONLINE SCHIZOPHRENIA
FAMILY
SUPPORT
AND
EDUCATION
FOR
Principal Investigator & Institution: Glynn, Shirley M.; Clinical Research Psychologist; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-JUL-2004 Summary: (Provided by applicant): Participation in family psychoeducational programs for schizophrenia has been found to reduce patient relapse rates and reduce relative distress. Nevertheless, participation rates are often low, reflecting both family impediments to attending sessions (e.g. transportation difficulties, time constraints, sensitivity to stigma) and limited professional dissemination of the interventions. To address these difficulties, we are proposing a test of a novel intervention -- a private,
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secure educational internet website with family-to-family chat capabilities, streaming video mini-lectures on the management of schizophrenia, written materials on topics pertinent to key issues in schizophrenia management, professionally facilitated online discussions of the material, and additional resource links. Recent technological advancements in video conferencing, online communication, and streaming audio/visual presentations, which are increasingly easy to use and gaining widespread acceptance among mental health professionals, make the test of this intervention feasible. Equally important, the widespread growth of Internet access makes a test of such an intervention particularly timely. In this developmental project, we propose a randomized trial of 72 relatives of outpatients with schizophrenia to 18 months of customary care alone, or 18 months of customary care with access to the website for the first year. We hypothesize that participation in the website will reduce patient symptom exacerbations by increasing family knowledge of illness management, and reduce family burden by increasing perceived social support. This project involves an extension of our 15 years of work in psychosocial family interventions for schizophrenia into a new dissemination/communication medium. We intend our end product to be a set of empirically-validated low-cost materials which has the potential to be exported to multiple sites, used by families unable to attend face-to-face meetings, and adaptable to other psychiatric disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OPTIMIZATION OF ELECTROCONVULSIVE THERAPY Principal Investigator & Institution: Isenberg, Keith E.; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 05-FEB-2001; Project End 31-JAN-2006 Summary: (Adapted from Applicant's Abstract): Patients treated with electroconvulsive therapy typically present with the most severe forms of major depression. Likely due to the increasing representation of medication-resistant patients, ECT response rates have diminished relative to earlier decades. This diminished response rate and early relapse following response are critical clinical problems in the use of ECT. Using the CSMD mechanism, this project addresses two key issues in the optimization of ECT in patients with major depression: whether patients treated with ECT should receive concurrent treatment with antidepressant medications (to enhance ECT outcome and/or prevent early relapse) and the role of electrode placement (high dosage right unilateral (RUL) ECT versus low dosage bilateral (BL) ECT) in maximizing short-term response and minimizing side effects. Patient enrollment, treatment, and evaluation will be conducted at Wake Forest University, Washington University, and the Western Psychiatric Institute and Clinic, with staff at the New York State Psychiatric Institute responsible for study coordination and monitoring. The study uses a random assignment, double-masked, parallel group design with two phases. In Phase 1, stratified by the classification of medication resistance, patients are randomized to concurrent treatment with nortriptyline (NT, n=210], venlafaxine (VEN, n=210) or placebo (PL, n=210), and simultaneously to high dosage (6 times threshold) RUL ECT (n=315) or low dosage (1.5 times threshold) BL ECT (n=315). Based on substantial preliminary data, the hypotheses will be tested that (1) compared to PL, concurrent NT or VEN results in superior symptomatic response, without a meaningful difference in side effects, and (2) RUL and BL ECT are equal in efficacy, but with significant advantages to high dosage RUL ECT in the magnitude of short- and long-term cognitive side effects. Support for these hypotheses in a large and diverse sample should have widespread ramifications for clinical practice. In the Phase 2 double-masked, 6-month continuation trial, remitters
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who received PL during ECT are randomized to NT and lithium (LI) or to VEN-LI. Patients who had been randomized to concurrent NT or VEN during ECT receive continuation treatment with NT-LI or VEN-LI, respectively. Standard practice involves the discontinuation of antidepressant medications prior to ECT, the abrupt discontinuation of ECT upon response, and then a switch to continuation pharmacotherapy. This practice likely diminishes response to ECT and heightens relapse in the first several weeks following ECT. Phase 2 of this study, centering on the comparison of patients treated with an antidepressant medication (NT or VEN) or placebo during ECT, will provide the very first data on whether starting an antidepressant medication from the beginning of the ECT course reduces the rate of early relapse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OUTCOME OF ATTENTION DEFICIT HYPERACTIVITY DISORDER Principal Investigator & Institution: Biederman, Joseph; Chief; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 01-APR-1998; Project End 31-MAR-2003 Summary: This proposal intends to follow a group of 117 adolescents with ADHD and a comparable control group for as well as over 100 of their siblings, subjects already followed for five years, for an additional five years. Given the mean age of the sample, this study will provide information about ADHD as subjects mature from adolescence into young adult life. These subjects will be assessed on six domains: psychopathology, cognitive-neuropsychological functioning, school dysfunction, adaptive functioning, treatment interventions and psychosocial adversity. A variety of measures are included in the assessment of each domain. Analytic methods address six issues: variable age of onset of psychiatric illness; nonindependence of observations within families and between time periods; effects of treatment; integration of information across multiple informants; effects of confounding variables; wide age range of the sample at baseline. The investigators will test three general hypotheses: prediction of outcome based on baseline ADHD (or sibling of ADHD); prediction of outcome based on comorbidity; prediction of outcome and comorbidity based on DSM-IV subtypes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PANIC CONTROL THERAPY IN A MANAGED CARE SETTING Principal Investigator & Institution: Addis, Michael E.; Assistant Professor; Psychology; Clark University (Worcester, Ma) 950 Main Street Worcester, Ma 01610 Timing: Fiscal Year 2002; Project Start 15-APR-1998; Project End 31-JAN-2004 Summary: (Applicant's Abstract): Panic Disorder (PD) is a serious psychiatric illness which, if left untreated, can be associated with significant life dysfunction and distress. Although a number of controlled experimental studies have supported the efficacy of Panic Control Therapy (PCT) as a cognitive-behavioral treatment for PD, no studies have evaluated the transportability of PCT to real-world clinical practice. Investigating the outcomes of an empirically validated manual-based psychotherapy in clinical practice is a crucial step in disseminating effective treatments and working towards empirically-based standards of care. The purpose of this study is to investigate the impact of training in PCT for master's level therapists working in a managed care context. Ten clinicians will be randomly assigned to PCT training or treatment as usual (TAU). Patients meeting criteria for PD = 120) with varying degrees of severity and with or without agoraphobia will be randomly assigned to PCT-trained or TAU therapists.
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Outcomes will be evaluated at post-treatment, 3 months 1 year, and 2 years following treatment. Blind ratings of therapist adherence to PCT will provide an assessment of how well clinicians can learn and implement the protocol in clinical practice following state of the art training. By maintaining random assignment of therapists and patients, this study will possess the necessary internal validity to draw conclusions regarding the effectiveness of PCT in clinical practice. The use of non- expert master's level clinicians, and a more heterogeneous sample of patients than previous studies, will greatly enhance the generalizability of the findings, and speak to the effectiveness of PCT in real-world clinical practice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATIENT PREFERENCE IN PRIMARY CARE DEPRESSION TREATMENT Principal Investigator & Institution: Raue, Patrick J.; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2008 Summary: (provided by applicant): This is a submission for a K23 Mentored PatientOriented Research Scientist Award. The applicant is a clinical psychologist and a developing investigator in the Cornell Advanced Center for Interventions and Services Research (ACISR). The goal of this application is to provide further interdisciplinary training and research opportunities to transition the applicant to become an independent investigator in interventions research. The career goal of the applicant is to develop interventions to improve the use and effectiveness of mental health services for older patients treated in a variety of medical settings. The career development objectives of this application are to learn about: 1. The assessment of treatment preferences and expectations in elderly primary care patients; 2. Treatment guidelines, and the assessment of ongoing patient engagement in and adherence to different forms of treatment; 3. Theories of health decision making and choice by patients, and how to optimize the treatment selection process within the primary care service delivery system; and 4. Research methodology, including the utilization of partial randomization research designs in clinical trials, and statistics. This training will provide the knowledge and skills necessary to conduct research that examines the impact of treatment preferences on treatment initiation, engagement in and adherence to treatment, and clinical outcomes of elderly depressed primary care patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: POPULATION-BASED GENETIC RISK INTERVENTION VIA THE WEB Principal Investigator & Institution: Robbins, Robert J.; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109 Timing: Fiscal Year 2002; Project Start 30-SEP-1999; Project End 31-JUL-2004 Summary: (adapted from investigator's abstract): The field of genetic risk is advancing at a pace that the general public, and even health professionals, have trouble keeping up with. The media reports new discoveries frequently, often related to 'cancer-prone genes', or hereditary cancer syndromes, and the availability of cancer mutation testing. Health professionals often lack time to consult with patients over new discoveries showcased in the evening news. Thus, many people are left uncertain of their personal risk for cancer, worried about the possibilities, and unsure of what to do. There is a need for delivery of personalized, accurate, up-to-date risk information to the general public.
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The investigators believe the best way to deliver this rapidly changing and sensitive information is via the new media available through the Internet, on the World Wide Web (WWW), now accessible through a telephone connection. The WWW can deliver up-to-date personalized information interactively, through test, audio, or video, at a pace chosen by the user. Studies are needed to demonstrate the value of this technology in public health. The investigators propose to do this by conducting a population-based randomized test of an interactive Web-based breast cancer risk information intervention to help women from the general public cope with their breast cancer risk and to make appropriate screening choices. They will identify women from the public, screen them for simple eligibility criteria, and randomize them to receive either the intervention package or to participate in a delayed intervention control arm. The intervention will be based on a project-specific website integrated with existing cancer information services, delivered directly to users' homes through their televisions via Web TV, and augmented with interactive components to maximize the user's ability to access information in a timely and satisfactory manner. A small proportion of eligible participants will be offered genetic counseling to consider genetic mutation testing. The main outcomes of this project are cancer worry, perceived risk, quality of life, and breast screening intentions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: POST TREATMENT EFFECTS OF NALTREXONE Principal Investigator & Institution: Davidson, Dena; Assistant Professor; Psychiatry; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2002; Project Start 26-SEP-2000; Project End 31-JUL-2005 Summary: APPLICANT'S ABSTRACT: The long-term research goal of the applicant investigators is to maximize the clinical effectiveness of treatment for alcoholism. The specific aims of this protocol are to compare 3 and 6 months of naltrexone (NTX) as an adjunct to two psychotherapies that differ in scope and intensity. The effect of these treatments will be assessed with patients who differ in their psychosocial need and psychosocial resources at their disposal, and in their level of cravings for alcohol. In this randomized clinical trial, 50 mg of NTX daily and either Motivational Enhancement Treatment (MET), or the more comprehensive Broad Spectrum Treatment (BST), will be provided over 12 weeks (Phase I). Following Phase I, half of the group receiving NTX in both psychotherapy conditions will crossover to placebo, in double-blind fashion. Daily medication will continue for an additional 3 months (Phase II). MET will terminate in Phase I, while those patients with greater psychosocial need and fewer psychosocial resources may continue in BST during Phase II. Medication and BST terminate at the end of Phase II, and patients are then followed for 12 months (Phase III). Outcome measures during all treatment phases include: 1) drinking outcomes (time to first drink; % days abstinent; % heavy drinking days); 2) negative drinking consequences; and 3) psychosocial adjustment. Overall, it is anticipated that the optimum treatment package will be one that targets the majority of the unique psychosocial needs of the patient while addressing the biological aspects of alcohol dependence via effective medication management. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PRESURGERY HYPNOSIS--BENEFITS ANALYSIS IN BREAST CANCER Principal Investigator & Institution: Montgomery, Guy; Ruttenberg Cancer Center; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 17-AUG-2001; Project End 31-JUL-2004 Summary: Over 90% of the 184,000 women diagnosed with breast cancer in 2000 will undergo surgery as part of their curative treatment. Despite improvements in pharmacological management, surgical procedures under general anesthesia continue to be associated with clinically significant side effects, chief among which are pain and nausea. These clinical problems are particularly severe following surgical treatment for breast cancer and can require additional pharmacologic intervention, prolong recovery room stay, delay discharge, and lead to unanticipated readmission. Clinical research with other surgical populations has indicated that hypnosis can reduce intraoperative complications, reduce postoperative symptoms and enhance recovery (e.g., reduce pain, nausea, hospital stays), however, the treatment efficacy of hypnotic techniques with breast cancer surgical patients has yet to be established. A separate line of previous clinical research with surgery populations has indicated that preoperative psychological factors (emotional distress and cognitive expectations) are predictive of patients' postoperative experiences of side effects, but again research on breast cancer surgical patients is scant. The proposed research will bridge the two previous lines of research by combining a randomized clinical trial, (in which the effects of a preoperative hypnosis intervention to control side effects are compared to attention control), with a prospective quasi-naturalistic study, (in which the relations between preoperative psychological factors and patients' reactions to surgery are examined). In addition to establishing the applicability to breast cancer patients of findings in the general psychological, hypnosis and surgical literatures, the goal of proposed study is to make novel theoretical contribution by examining the potential role of psychological factors as the "active ingredients" in the beneficial effects of hypnosis. The proposed study will also make a novel practical contribution by examining cost-effectiveness of the hypnosis intervention, an approach which may have compelling implications for clinical practice as well as future behavioral research. The Specific Aims of the study are: 1) To investigate the impact of a presurgical hypnosis intervention on women scheduled for surgical treatment for breast cancer; 2) To investigate the contribution of preoperative emotional distress, and cognitive expectations to post- surgery side effects and recovery; 3) To determine whether the beneficial effects of the hypnosis intervention are accounted for (mediated) by differences in presurgery cognitive expectations and emotional distress; and 4) To investigate the cost-effectiveness of the presurgical hypnosis invention. o achieve these aims, 140 breast cancer patients scheduled for mastectomy will be randomly assigned to a hypnosis intervention group or an attention control group. The impact of the hypnosis intervention on postoperative nausea, pain, recovery from surgery, and cost- effectiveness will be analyzed within an experimental study design. The influence of presurgery distress and expectations of side effects will be analyzed within quasi-naturalistic study designs. The possible mediational role of these factors in hypnosis effects will be examined will classic statistical approaches. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREVENTING ADJUSTMENT PROBLEMS IN YOUNG SIBLINGS Principal Investigator & Institution: Bank, Lewis L.; Oregon Social Learning Center, Inc. 160 E 4Th Ave Eugene, or 97401 Timing: Fiscal Year 2002; Project Start 01-SEP-1994; Project End 31-MAR-2004
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Summary: Prior work has demonstrated that antisocial behavior in one sibling is significantly correlated with the emergence of similar behavior across time in other siblings (e.g., Farrington, Barnes, & Lambert, 1996; Wasserman, et al., 1996). Although sibling interventions have been studied only rarely (Johnston & Freeman, in press), a number of intervention studies have reported findings in which treatment of an older sibling with antisocial behavior problems has resulted in reductions in antisocial behaviors in younger siblings as compared to control group younger siblings. Bank et al. (1997) have demonstrated that high levels of sibling Conflict during middle childhood are predictive of poor adjustment outcomes--including antisocial behavior -- during adolescence. The Bank et al. findings were statistically reliable in the context of parenting variables, suggesting that sibling intervention components as a companion to parent training interventions should be evaluated. In the present study, I proposed that 150 families with a 6- to 8-year-old child with conduct problems be recruited from Oregon Health Plan participants. Each of these children will have a younger sibling at least 4 years of age. Families will be randomly assigned to one of three groups--Parent Training (N=50), Sibling and Parent Training (N=50), and a Control (N=50--who will receive intervention as usual from Lane County service providers. There are three central hypotheses. First, at intervention completion and 1-year follow-up, sibling conflicts reported by parents and coded during home observations will be significantly reduced in those families receiving the siblings' intervention component (SPT) as compared to the Parent Training (PT) and Control (CT) families; second, for the SPT older siblings at termination and follow-up and for their younger siblings at follow-up in the school setting, peer skills are expected to be significantly better than in the PT or CT groups. Third, at intervention completion and 1-year follow-up, older siblings in both intervention groups will show diminished levels of conduct problems and improved levels of academic skills as compared to control older siblings; among younger siblings, however, at follow-up in the school setting, SPT, but not PT, will exhibit significantly fewer conduct problems and better academic skills than CT younger siblings. Multiple-agent, multiple-method data--including observation of home, school, and laboratory interactions--will be collected at baseline, intervention completion, and follow-up for key constructs for Parent Discipline, Parent Supervision, Problem Solving, Sibling Negative Interaction, Antisocial Behavior, Academic Skills, and Peer Relations. MANOVA and structural equation modeling will be used to test the key hypotheses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTING DEPRESSION IN MACULAR DEGENERATION Principal Investigator & Institution: Rovner, Barry W.; Psychiatry and Human Behavior; Thomas Jefferson University Office of Research Administration Philadelphia, Pa 191075587 Timing: Fiscal Year 2002; Project Start 06-FEB-2001; Project End 31-JAN-2006 Summary: Applicant's This application describes a randomized controlled clinical trail to evaluate the efficacy of a brief, standardized cognitive psychotherapy, Problem Solving Therapy (PST), to prevent incident depressive disorder (DSM-IV diagnoses) in elderly patients with age-related macular degeneration (AMD). AMD is the most common cause of blindness in older adults and limits the ability to read, see familiar faces, and walk independently. Almost 2 million persons (about 5 percent of the U.S. population over age 65) are now affected and their number will triple by the year 2020. We will target patients with neovascular AMD (NV-AMD), a form of AMD that can lead to sudden vision loss, substantial disability, and depression. Because depression is itself
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Psychotherapy
disabling and not likely to be recognized nor treated by ophthalmologists, preventing depression is clearly important. We will recruit 230 non-depressed AMD patients from the retinovascular clinic of Wills Eye Hospital with newly diagnosed NV-AMD one eye, who already have AMD in the fellow eye. Because they have recently developed bilateral vision loss they will be at high risk for depression. We will randomize subjects to PST or a usual care control condition in this 6-month clinical trial. The primary outcome measure will be a DSM-IV diagnosis of depression diagnosed by a geriatric psychiatrist masked to treatment assignment. We will evaluate subjects at baseline, month 2 (immediately post-intervention), month 6 (for the primary efficacy analysis) and month 12 (to evaluate sustained effects). Although depressive disorder is the primary outcome, we will also assess the impact of PST on levels of disability and vision-related quality of life. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTION FOR INFANTS OF LOW-INCOME DEPRESSED MOTHERS Principal Investigator & Institution: Cicchetti, Dante; Clinical/Social Psychology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 31-JAN-2009 Summary: (provided by applicant): This longitudinal investigation will evaluate the relative efficacy of two theoretically-informed approaches to preventing maladaptation, a depressotypic developmental organization, and emergent psychopathology in young offspring of low-income depressed mothers. Research participants will include 260 mothers and their infants; 195 mothers will have a current major depressive disorder and 65 demographically comparable mothers will have no lifetime history of mental disorder. All families will be at or below the federal poverty level. Depressed mothers and their infants will be randomly assigned to 1 of 3 treatment conditions: 1) Interpersonal Psychotherapy (IPT) for 4 months followed by an attention control for 8 months; 2)IPT for 4 months followed by Infant-Parent Psychotherapy (IPP) for 8 months; and 3) Enhanced Community Standard (ECS) treatment for depression, involving facilitated referrals for standard interventions in the community. Baseline assessments will be conducted when infants are 12 months old, with subsequent reassessments when infants are 14, 16, 24, 36, and 48 months of age. Assessments will measure three major areas: 1) Maternal depressive symptomatology and Major Depressive Disorder (MDD) diagnosis, social role functioning, support, and home contextual features; 2) the quality of the mother-child relationship and affective features of parenting; and 3) child functioning, stage-salient issues, and stress-reactivity. Longitudinal comparisons of the two active preventive intervention groups (IPT and IPT/IPP) with the ECS and nondisordered groups will be used to determine: 1) whether IPT and IPT/IPP are efficacious in reducing maternal depressive symptomatology and MDD relapse through the child's age of four; 2) whether treatment targeted on maternal depression is sufficient to alter the developmental course in offspring; and 3) whether intervention directly focused on the mother-child relationship also is necessary to promote positive outcomes and reduce risk for maladaptation and psychopathology in young offspring of depressed mothers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREVENTION OF POST-STROKE DEPRESSION-TREATMENT STRATEGY Principal Investigator & Institution: Robinson, Robert G.; Professor and Head; Psychiatry; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Previous studies have shown that about 35% of all depression occurring in the 2 years following stroke begin after the acute in-hospital period. We have shown that both acute and delayed onset depression influence cognitive and ADL recovery throughout the 1st year following stroke. A recent treatment study aimed at preventing the development of post-stroke depression found that nortriptyline (NT) and fluoxetine were effective in preventive depression (i.e., 1 of 13 patients given NT and 1 of 13 given fluoxetine became depressed compared with 5 of 15 patients given placebo; p=.03). During the next 6 mos. after treatment, a significantly greater number of active treatment patients developed depression compared with patients given fluoxetine or placebo. This increased rate of depression among the treated patients raises the question of whether a longer period of treatment would continue to prevent depression. Furthermore, a 7-year follow-up of the 37 non-depressed patients who were given fluoxetine, nortriptyline or placebo found that those given antidepressants were more likely to survive than those given placebo (Kaplan Meier Log Rank, x(2)=4.3, df=1, p=0.4)(i.e., 65% treated survived vs 29% of placebo). This grant will examine these questions by treating consenting non-depressed stroke patients who are within the first 3 mos. post-stroke. Patients will be given problem-solving therapy (PST) over 12 mos. or 12 mos. of double blind treatment with NT, citalopram or placebo. Patients who develop depressing meeting criterion for major or minor depression of at least 2 weeks duration will be given all of the tests intended to be given at 12 mos. and then will be terminated so that their depression can be treated. After 1 year of treatment, all patients will be followed without treatment of another 6 mos. We will determine whether psychosocial or pharmacological treatment provides extended protection from depression and thereby enhances post-stroke recovery. We will also determine whether abnormalities in startle response either before or after treatment or atrophy of specific rain regions are correlated with the development of depression. The significance of this study is that it will answer the most important question with remains in the therapeutics of post-stroke depression and that is whether prophylactic antidepressant treatment of this population should be given to all stroke patients because it will enhance their recovery from stroke by decreasing their likelihood of suffering the emotional, physical, cognitive and mortality consequences of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREVENTION OF RECURRENCE IN DEPRESSION WITH DRUGS AND CT Principal Investigator & Institution: Derubeis, Robert J.; Professor of Psychology; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 16-JUL-2002; Project End 31-MAR-2007 Summary: (provided by applicant): It is commonly believed that the combination of antidepressant medications (ADM) and psychotherapy is more effective in the treatment of depression than is either treatment alone. There is evidence that adding cognitive therapy (CT) enhances the initial effects of ADM, but most of the relevant studies have suffered from low power. Moreover, findings from numerous studies suggest that CT has an enduring effect, but most of the evidence has been relevant to the
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prevention of relapse - the return of symptoms associated with the treated episode. There is little evidence on what is arguably the more critical prevention question: whether prior exposure to CT prevents recurrence - the onset of new episodes. What is needed is a study that is sensitive enough to detect the benefits that might accompany the addition of CT to ADM, and that can begin to address the attendant costeffectiveness questions. The proposed design combines the goals and methods of efficacy and effectiveness research to these ends. We plan to randomly assign 450 depressed outpatients (150 at each of three sites) to ADM alone or to ADM plus CT. All patients will be treated to remission with a clinically representative ADM regimen, and half will, in addition, receive CT. Remitted patients will then be continued on medications for up to 12 months until they meet criteria for recovery, during which time CT will be continued as clinically indicated for patients in combined treatment. Once recovered, patients will be randomly assigned to either maintenance medications or medication withdrawal. Shortly thereafter, patients who have been receiving CT will be withdrawn from it as well. Patients will then be followed for a three-year period for the purpose of detecting recurrences. The main hypotheses are: (1) initial response will be better in ADM plus CT, relative to ADM alone; and (2) prior exposure to CT will protect against subsequent recurrence following medication withdrawal, to the same extent as maintenance ADM. Analyses will be employed to estimate the relative cost-effectiveness of adding CT to ADM for acute response and recurrence prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PRIMARY CARE DIAGNOSIS & TREATMENT OF DEPRESSED CHILDREN Principal Investigator & Institution: Rushton, Jerry L.; Pediatrics & Communicable Dis; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 31-MAY-2003 Summary: (provided by applicant): Dr. Rushton proposes a career award to study and improve the diagnosis and treatment of children and adolescents with depressive disorders by primary care physicians. Recent changes in health care have important implications for management of depression including primary care gatekeeping, limited access to mental health providers and counseling, and new antidepressants. Yet, little information exists on the current role of primary care physicians, or how these physicians can improve coordination of care and services to improve patient outcomes. Dr. Rushton plans two phases of research to address his aims using complementary methods: (1) analysis of health system administrative data, (2) survey of primary care physicians. The proposed studies will describe depressed children and adolescents and their health care utilization; define the scope of primary care and relationships to mental health providers; analyze variations in prescriptions, referrals, and management of depressed youth; and examine influences on physician triage and treatment decisions. This research will be accomplished over five years and incorporate coursework and training in survey techniques (quantitative and qualitative), statistical analysis, pharmacology, child and adolescent psychiatry, and health services research. In the final years of the grant period, Dr. Rushton will develop a grant proposal based on his findings to design interventions to improve the quality of mental health services and integrate primary care with specialty and community providers. The University of Michigan provides the clinical and research environment to accomplish the proposed aims and career goals with support from many disciplines led by co-mentors, Dr. Gary Freed (Pediatric Health Services Research) and Dr. John Greden (Psychiatry). The
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candidate will acquire skills and connections that will allow him to become an independent researcher working at the important interface of delivery systems. The proposed research will set the stage for additional mental health services for children, quality improvement interventions on prescriber practices, and health system efforts to coordinate mental health services with primary care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROCESS AS A PREDICTOR OF OUTCOMES IN CBT FOR YOUTH Principal Investigator & Institution: Kendall, Philip C.; Professor & Director; Psychology; Temple University 406 Usb, 083-45 Philadelphia, Pa 19122 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Anxiety disorders are common and, if untreated, influence children's lives. In randomized clinical trials (RCT), research has shown that cognitive behavioral therapy (CBT) benefits anxiety-disordered youth. We are currently comparing individual CBT, family CBT, and an education/support/attention condition. Though there has been an increase in outcome research, there has been very little study of the treatment process. With audio and video taped sessions from 154 cases that have received individual CBT in previous RCTs and 50 cases from the current trial, we will examine the relations between process variables and treatment outcome within CBT. The process variables are (1) therapeutic alliance, (2) child involvement and (3) therapist flexibility with the manual-based treatment. These three variables will be measured from sessions 1-4 (earlier process) and sessions 5-8 (later process) for the entire data set. In addition, the three process variables will be measured from sessions 9-16 for the 50 cases in the current RCT. Raters will rate the entire sessions a third at a time from a total of 1600 sessions of individual CBT using the Child Psychotherapy Process Scale, Child Involvement rating scales and the Modified Protocol Adherence Checklist. It is hypothesized that a strong therapeutic alliance and high levels of child involvement will predict positive treatment outcome. The identification of mediating influences (e.g., later involvement, therapist flexibility) will further enable the outcome researcher and the practicing clinician to develop a better understanding of the causal mechanisms between therapy and the accrual of beneficial outcomes. To evaluate potential process variables that contribute to patient attrition, we will compare the early process variables for children completing treatment and those who discontinue. It is hypothesized that noncompleters will have the experienced lower levels of alliance, flexibility, and involvement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PST DYSFUNCTION
IN
GERIATRIC
DEPRESSION
WITH
EXECUTIVE
Principal Investigator & Institution: Alexopoulos, George S.; Professor and Vice Chair; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This study proposes to compare the efficacy of Problem Solving Therapy (PST) to that of Supportive Therapy (ST) in non-demented elderly patients with major depression and cognitive impairment. Among them, we will focus on patients with major depression and executive dysfunction because this combination of symptoms (as defined in our preliminary studies) is prevalent, debilitating, and responds poorly to treatment with antidepressant agents. Therefore, we find it compelling to identify an effective treatment for these patients, who would
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otherwise remain depressed, debilitated, and demoralized during the last years of their lives. We selected PST because it can address depression as well as deficits in problem solving skills that impact on the patients' ability to negotiate their environment and contribute to their depression and disability. Moreover we now have empirical evidence suggesting that PST can reduce depressive symptoms and disability in cognitively unimpaired depressed elderly patients as well as elderly patients with major depression and executive dysfunction. The subjects will be 240 (120 from each Center) elderly (>64 years) patients with non-psychotic, unipolar major depression and executive dysfunction and will be randomly assigned to receive 12 sessions of PST or ST. The study is designed to test the hypotheses that the PST is more effective than ST in reducing depressive symptoms and disability. Furthermore, we hypothesize that these effects are mediated by improvement in generation of alternative solutions, decision making, and solution implementation. While we are aware of the methodological problems and confounds posed by studying a "sick and old population", we bring to this project two groups with complementary expertise in treatment studies and psychotherapy research, and experience in directing multicenter studies. Moreover, the project will be supported by the structures of the Cornell Intervention Research Center (IRC), whose principal objective is to develop treatment interventions targeting specific clinical and biological characteristics of geriatric depression. Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTION
PSYCHOSIS:
EARLY
DETECTION,
INTERVENTION
AND
Principal Investigator & Institution: Mcfarlane, William R.; Chief; Maine Medical Center 22 Bramhall St Portland, Me 04102 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 31-JAN-2008 Summary: (provided by applicant): The primary aim of this application is to conduct a randomized, controlled clinical trial of a specialized mental health service delivery system specifically developed for prodromal psychotic disorders. The intervention is Family-aided Assertive Community Treatment (FACT). The proposed study will be part of a larger program, Portland Identification and Early Referral (PIER), under foundation and Center for Mental Health Center sponsorship, that has established a populationbased system of early detection for Greater Portland, Maine. Previous and present effort has educated and trained the community-at-large and all health, education and other professionals, with the result that referrals are occurring at the expected frequency. The principle strategy is to intervene early, prior to onset, in the course of the onset of psychotic disorders to arrest the development of psychotic symptoms and functional disability. The test treatment is a specialized combination of psychoeducational multifamily group and assertive community treatment. In pilot studies FACT has led to very low rates of conversion to psychosis and very high rates of engagement and retention in treatment, thereby decreasing the burden on the family and the community. The goal of the treatment is prevention of psychosis and disability. This study will assess experimentally the clinical effectiveness of this new type of mental health service. Other domains of outcome include cognitive dysfunction and functional disability. The project will support an EDIPFACT team of clinical staff with the ability to: a. foster detection of prodromal disorders in the Greater Portland community by general practitioners, guidance counselors, mental health professionals and the general public; b. accurately assess individuals at high risk for psychosis; c. reliably deliver an evidence-
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based psychosocial and, if indicated, pharmacological treatment package using standardized methodology. The research study will test, in a randomized controlled trial, the symptomatic and functional outcome of treatment in 96 subjects ages 12 to 35 identified by that system. It will allow the analysis of key social factors contributing to psychosis and their interaction with the treatment conditions and each other. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOSOCIAL INTERVENTIONS FOR SCLERODERMA Principal Investigator & Institution: Haythornthwaite, Jennifer A.; Associate Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2004 Summary: (adapted from investigator's abstract): Systemic sclerosis (scleroderma: SSc) is a rare, disfiguring connective tissue disease characterized by inflammation vascular injury, and fibrosis. Despite the significant physical disability, pain, disfigurement, negative prognosis, and lack of a cure associated with SSc, no psychosocial interventions have been developed and tested to guide these individuals in managing the daily challenges of living with a chronic illness and improving the quality of their lives. The proposed research will examine the efficacy of two psychological interventions designed to target important areas of daily living: pain, depression, and distress about disfigurement (Specific Aim #1). Individual differences in treatment outcome will be examined by determining whether clinical depression predicts the effects of professionally guide self-help materials (Specific Aim #2). Since psychological interventions requiring a trained professional can be costly and are often not available to the majority of patients, professional involvement in the proposed interventions will be minimal. Two hundred and one patients with systemic sclerosis who report symptoms of pain, depression, or distress about disfigurement will be recruited and randomized to one of three interventions: individual cognitive-behavioral therapy, self-help cognitivebehavioral intervention facilitated by a Psychologist, or a disease/health education intervention. Measures of pain, functioning, distress about disfigurement, and mood will be collected at baseline and following the 8-week intervention period by an individual blind to intervention assignment. Both the cognitive-behavioral self-help materials and the educational materials (8 written chapters and audiotapes) will be designed for home use but will be supplemented by individual sessions (2) and telephone contacts (2) with the professional. Patients will be followed for one year after completing the active intervention phase (Specific Aim #3). It is hypothesized that the therapist administered CB intervention and the self-help CB intervention will result in greater declines in pain, depression, and distress about disfigurement both at the end of the active intervention and at one year follow-up as compared to the disease/health educational intervention. Depression is expected to reduce the efficacy of the CB selfhelp intervention. These findings will increase our understanding of the quality of life of individuals with scleroderma and determine whether self-help interventions can be used effectively to manage pain, depression, and distress about disfigurement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PSYCHOSOCIAL TREATMENT EFFECTS ON CANCER SURVIVAL Principal Investigator & Institution: Spiegel, David; Professor; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 01-AUG-1990; Project End 31-JUL-2005
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Summary: NIMH is supporting a 10-year investigation by our laboratory of the influence of psychosocial treatment on survival of women with metastatic breast cancer. We have recruited 125 metastatic breast cancer patients, and randomly assigned them either to one year of weekly supportive/expressive group therapy or to an educational control condition. This research is designed to replicate and extend our earlier finding that metastatic breast cancer patients randomly assigned to a year of weekly supportive/expressive therapy (SET) groups lived an average of 18 months longer than control patients (Spiegel et al., 1989). In this competing continuation we seek to accomplish two overall Aims: In Aim 1 we seek to complete follow-up of long-term survivors in our existing study. We currently have 73% overall mortality and must follow the sample until treatment/control differences in survival are analyzable at greater than 90% mortality. We have discovered an abnormality in diurnal variation of cortisol that predicts significantly shorter survival time, and plan to pursue our investigation of HPA dysfunction and breast cancer progression. In addition, we will examine the characteristics that distinguish long-term survivors, and mediators of treatment effects, specifically, analyses of in-group emotional expression and diurnal cortisol. In Aim 2 we seek to recruit a new, socioeconomically and ethnically diverse sample of 180 metastatic breast cancer patients with a range of PTSD. The sample will include 60 patients who meet diagnostic criteria for cancer-related posttraumatic stress disorder (PTSD), 60 patients with partial cancer-related PTSD, and 60 patients without a cancer-related PTSD diagnosis, as a comparison group. The subaims of this new study are to: A) evaluate the efficacy of SET on PTSD and other psychiatric Symptoms, quality of life, and survival in metastatic breast cancer patients with PTSD; B) examine hypothesized mediators of treatments effects (including emotional expression and cognitive processing of cancer-related stressors); and C) identify correlates of baseline adjustment (including SES, trauma/PTSD history, social constraints) and moderators of treatment response (including level of PTSD symptoms). The results of this study will provide evidence of the efficacy of group psychotherapy for metastatic breast cancer patients, including those with comorbid psychiatric (PTSD) symptoms, on the basis of proven psychiatric, psychosocial, and health benefits. The recruitment of this diverse sample of patients will also increase generalizability of findings regarding group psychotherapy outcome and its predictors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOTHERAPY PROCESS IN ALCOHOLISM TREATMENT MATCHING Principal Investigator & Institution: Longabaugh, Richard H.; Professor of Psychiatry and Human Behavi; Ctr for Alcohol & Addict Studs; Brown University Box 1929 Providence, Ri 02912 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-OCT-2003 Summary: APPLICANT'S ABSTRACT: Recent research on patient-treatment matching effects in alcohol treatment has produced mixed and inconclusive results. Further, psychotherapy treatments (e.g., cognitive behavioral and motivational enhancement therapies) continue to demonstrate roughly equivalent efficacy, despite different theoretical stances and purported mechanisms of patient change. The specific objective of this project is to identify how treatment effectiveness is impacted by the interaction between patient characteristics and the process of psychotherapy. This study will utilize an archival data set of patient information and videotaped psychotherapy treatment from Project MATCH, a randomized clinical trial originally designed to evaluate patient-treatment matching effects across 3 psychosocial treatments for alcoholism. The
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proposed research will compliment Project MATCH's analyses of manualized treatments by examining underlying processes present in all of the treatments. The 168 patients from Project MATCH's Brown University research unit will be selected for this study. Patient and therapy process dimensions that have shown promise for predicting the effectiveness of alcoholism treatment will be selected from a model of patienttreatment matching called Systematic Treatment Selection (STS). Project MATCH data can be used to test 3 such matching hypotheses from the STS model. Each hypothesis specifies ideal relationships between a patient characteristic and a therapy process variable. The 3 patient attributes of focus will be: (1) emotional distress, (2) an externalizing coping style, and (3) psychological reactance. For each of these patient attributes, the STS model specifies treatment processes that will result in optimal outcomes. The 3 corresponding therapy process variables will be the extent to which therapist interventions with each patient (1) attempt to increase or decrease a patient's emotional arousal level, (2) are insight or behavior focused, and (3) are directive or nondirective. These aspects of therapy will be measured by the STS Therapy Rating Scale, which will be completed by two trained observers on 4 selected therapy sessions for each patient. The relationship between each patient-therapy interaction (e.g., patient reactance and the directiveness of therapy interventions) and alcohol use outcomes will be assessed at the three-month and one year post-treatment follow-ups. This study will reveal new information about the importance of tailoring therapist interventions to patients seeking treatment for alcoholism. Such information will significantly enhance alcoholism treatment effectiveness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: QUALITY IMPROVEMENT FOR DEPRESSION Principal Investigator & Institution: Ford, Daniel E.; Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 30-SEP-1994; Project End 31-MAR-2004 Summary: Policy makers do not know how to alter the structure and process of primary care to provide treatment which will improve and sustain improvement in the functional impairment associated with major depression, the fourth leading cause of disability worldwide. To address this problem, we propose an R-10 to fund Quality Improvement for Depression (QID). The specific aims of QID are: (1) to provide integrated analyses of the long term impact of four distinct but related primary care interventions to improve depression treatment during the acute, continuation, and maintenance phase of care; and (2) to estimate the effects of high quality primary care depression treatment on long term disability. In the early stages of QID collaboration, funded investigators of four separately conceived quality improvement interventions planned and implemented a coordinated strategy for recruitment, intervention, and data collection in 108 primary care clinics in network and staff model HMOs, IPAs, PPOs, and mixed model settings. In addition to common baseline organizational and provider data, QID investigators are collecting over 80 common variables from 1,980 patients with major depression at each of three waves across the first year. This application seeks support to conduct effectiveness analyses in the combined database after standardizing patient follow-up during the second year across the four projects. This effort is needed to understand the "big picture" of how four dissemination interventions which are feasible to integrate across a variety of practice settings and populations, impact the quality and outcome of care, with sufficient power to determine whether they improve outcomes over a duration meaningful to policy makers. The analyses will inform policy debates about effective mental health treatment by providing generalizable estimates of
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the effect of antidepressant medication and psychotherapy on disability over the long term. To address these policy questions through the QID is more efficient than funding another large new project and more scientifically rigorous than drawing conclusions from heterogeneous studies whose differing methodologies complicate meta- analytic methods and conclusions. In addition to serving as a competing continuation for the Depression Guidelines Cooperative Agreement, QID serves as an important model of how mental health effectiveness research can be efficiently conducted by intensive collaboration of independently funded projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RACE, PSYCHIATRIC DISORDERS, AND HEADACHE Principal Investigator & Institution: Heckman, Bernadette D.; Psychology; Ohio University Athens Athens, Oh 45701 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): This application requests five years of support for a Mentored Research Scientist Development Award (K01) for a new minority investigator. The objectives of the planned training program are two-fold. The first objective is to provide the minority candidate with contemporary training in the areas of statistics, research methodology, research ethics, the pathophysiology of headache disorders, cross-cultural psychology, and health disparities. Formal coursework in these areas will facilitate the successful conduct of the planned study and prepare the candidate for future research endeavors throughout her career. The second objective is to examine how race and psychiatric co-morbid conditions are related to headache severity, quality of life, treatment adherence, and ability to respond favorably to treatments in people with episodic migraines, chronic migraines, episodic tension-type headaches, chronic tension-type headaches, substance abuse headaches, or cluster headaches. Using a quasi-experimental prospective research design, 400 patients presenting at outpatient medical centers in four urban areas of Ohio (Cincinnati, Cleveland, Columbus, and Toledo) will complete self-administered assessments, telephone-based interviews, and daily headache diaries that elicit data on headache severity, quality of life, social support, treatment self-efficacy, locus of control, treatment adherence, and treatment outcome. Guided by Social Cognitive Theory (SCT; Bandura, 1986), the planned study will employ structural equation modeling path analysis to determine whether SCT constructs, such as social support, health-related locus of control, and treatment selfefficacy, mediate associations between race and the presence of a co-morbid psychiatric disorder and key outcome measures, such as quality of life and treatment outcome. If successful, the candidate will obtain extramural funding prior to the completion of the training program that will enable her to conceptualize, implement, and evaluate a culturally-contextualized intervention to reduce headache pain and improve the life quality of people who experience severe headache characteristics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REHABILITATION, SCHIZOPHRENIA
BRAIN
FUNCTION
AND
EARLY
Principal Investigator & Institution: Keshavan, Matcheri S.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 15-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): Therapeutic intervention early in the course of schizophrenia may positively influence the outcome of this illness. The Environmental
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and Personal Indicators of Course in Schizophrenia (EPICS) treatment program at WPIC has developed a disorder-relevant rehabilitation of cognitive deficits (CET) found to be highly effective in chronic schizophrenic outpatients. Improvements in these cognitive deficits may reflect improved structural and functional integrity of the PFC and related structures. The Center for the Neuroscience of Mental Disorders (CNMD) at WPIC prospectively investigates PFC function in first-episode schizophrenia using structural and functional MRI and MRS. In this study, CNMD and EPICS investigators collaboratively seek to determine the efficacy of CET in ameliorating specific cognitive, structural and functional brain abnormalities in early course schizophrenia. We predict that CET will be more effective than enriched supportive psychotherapy (EST) in differentially improving behavioral and neurobiological dysfunctions in schizophrenia that compromise "executive" cognitive functions, specifically the structural and functional integrity of the PFC. We also predict that a relatively preserved PFC integrity will be associated with a better response to CET. A series of early course schizophrenic patients, stabilized on an atypical antipsychotic will be randomized to CET or EST. Cognitive and functional outcomes will be assessed before, and following 1 and 2 years of psychosocial treatment and maintenance antipsychotic treatment. In a subset of these patients, an integrated neuroimaging study will be conducted before and one year after the CET or EST. If successful, the study will provide the first evidence of neurobiological remediation, and possible mechanisms and site(s) of action, for cognitive rehabilitation in early schizophrenia. An understanding of the cerebral correlates of improvement (or lack thereof) in cognition and behavior might guide development of future cognitive rehabilitation strategies for schizophrenia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RISK AND PREDICTORS OF POSTPARTUM DEPRESSION Principal Investigator & Institution: Cohen, Lee S.; Associate Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 11-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): The postpartum period is a time of heightened risk for the emergence of psychiatric illness, particularly in women who already have a history of mood disorder. Given the prevalence of depressive disorders during the childbearing years, it is crucial to identify women who are at highest risk for new onset or recurrence of depression during the postpartum period. Identification of those women at greatest risk for postpartum depression may allow for interventions that would limit maternal morbidity associated with untreated postpartum depression. This proposal outlines a multi-institutional collaborative research project (R01) in response to PA-00-074, in which risk for postpartum depression will be evaluated in women with histories of major depressive disorder. Subjects who have had at least one episode of DSM-IV major depression will be followed prospectively from late pregnancy (32-36 weeks gestation) up to six months after delivery using a series of standardized instruments. The primary aims of this investigation are (1) to identify clinical and psychosocial predictors of postpartum depression and functional impairment and (2) to determine the extent to which treatment (pharmacologic, nonpharmacologic or a combination) proximate to delivery modulates risk for postpartum relapse. How clinical and psychosocial variables including history of postpartum depression, severity of past depression, number of previous episodes, age at illness onset, depression during pregnancy, and social support affect risk for postpartum depression, as well as psychosocial functioning, will be investigated. The current submission is a natural extension of an ongoing academically productive collaboration in which risk for
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Psychotherapy
depressive relapse is evaluated in pregnant women with histories of major depression who either discontinue or maintain antidepressant treatment. This proposal provides an opportunity to study a rigorously followed population into a period of risk -- the postpartum period -- and to investigate the factors that confer or modulate risk for depression at this time. The three participating sites for this investigation include the Perinatal and Reproductive Psychiatry Clinical Research Program at the Massachusetts General Hospital, Harvard Medical School (Drs. Cohen, Nonacs and Otto), the Women's Life Center and Mood Disorders Research Program at UCLA (Dr. AItshuler, Dr. Hendrick), and the Emory Women's Mental Health Program at Emory University School of Medicine (Dr. Stowe). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SCHOOL-BASED MENTAL HEALTH INTERVENTIONS FOR REFUGEES Principal Investigator & Institution: Birman, Dina; Psychologist; Psychology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2004; Project Start 23-JAN-2004; Project End 31-DEC-2008 Summary: (provided by applicant): The applicant is requesting five years of funding through the Mentored Research Scientist Development Award (K01) program to enhance her skills in services research in order to extend mental health services to refugee and immigrant children and adolescents. The long term scientific goal is to possess the expertise to conduct large-scale services and intervention research on refugee children in collaboration with schools, mental health agencies, and parents in multiethnic communities. This application builds upon the applicants' strong background in clinical, community, and cross-cultural psychology, extensive experience working in diverse refugee communities and agencies and post doctoral training in intervention research. Recognizing the importance of schools for newly arrived immigrant and refugee students as the primary setting where they confront the new culture and experience acculturative stress, the application proposes to support the needs of refugee children, parents, and teachers through adapting school-based mental health services models such as "Positive Attitudes Toward Learning in Schools" (PALS) proposed by Atkins, the applicant's primary mentor. The training skills to be acquired consist of fundamentals of health services research with particular attention to intervention development, adaptation, and transportability. In addition, training will include learning about existing evidence-based models for treatment of PTSD in children. The training will also focus on acquisition of qualitative and quantitative methods necessary for services intervention research. Two studies are proposed to complement the training activities. Study 1 is designed to understand mental health problems that occur in classrooms for refugee and immigrant children. The goal of this work is to determine what issues require mental health interventions in these classrooms in order to enhance successful academic and social adaptation of refugee and immigrant students. Study 2 will evolve from results of study 1 to test of the feasibility and acceptability of an adapted PALS intervention approach (PALS-R) for refugee and immigrant students. Completion of this program of training and research will enable the applicant to pursue timely, ethnoculturally appropriate, empirically supported services research on mental health issues of refugee and immigrant children attending urban schools and develop interventions that can meet the mental health needs of this underserved population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SHAPING SCHIZOPHRENIA
ATTENTION
IN
53
TREATMENT--REFRACTORY
Principal Investigator & Institution: Silverstein, Steven M.; Associate Professor; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2003; Project Start 14-FEB-2003; Project End 31-JAN-2006 Summary: (provided by applicant): Despite pharmacologic treatment advances, there are many treatment-refractory schizophrenia patients remaining in state hospitals. Many of these patients are sufficiently cognitively impaired that they benefit little from psychosocial interventions and have little chance of returning to the community without the introduction of novel cognition-enhancing interventions. Moreover, many patients who have been discharged from state hospitals in the wake of recent census reductions also have attentional problems that preclude their ability to fully engage in, and benefit from, psychosocial interventions. Such patients can be considered at heightened risk for relapse and rehospitalization as long as their limited ability to benefit from treatment remains undressed. Compounding this problem is the inability of current cognitive rehabilitation interventions to improve attentional functioning in schizophrenia patients with the most severe attentional problems. For such patients, behaviorally oriented attention shaping procedures have demonstrated effectiveness in several small-scale studies. However, the lack of a user-friendly, standardized format for the delivery of this intervention has led to its almost complete nonuse outside of academic research centers. Therefore, the proposed study seeks to draw on the expertise of those investigators who have pioneered the use of shaping techniques to improve attention in treatment-refractory schizophrenia patients, in order to integrate these techniques into a standardized, manualized treatment intervention, along with an accompanying training videotape and therapist fidelity evaluation measure. The proposed project would develop this standardized treatment delivery format, and then refine it through a series of pilot treatment groups at three sites: Weill Medical College of Cornell University, Lincoln Regional Center, and Hawaii State Hospital. In addition, data would be collected and pooled regarding treatment-related changes in attentional functioning, skill acquisition in groups, and symptomatology. The expected results of this project include: 1) the development of a user-friendly set of materials to facilitate dissemination of the attention shaping intervention to real-world settings; 2) the collection of preliminary data on its effectiveness; and 3) the generation of estimates of power and subject variability which can serve as the foundation from which to design a large-scale controlled treatment study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STEPPED CARE VS. BEST AVAILABLE CARE FOR BULIMIA NERVOSA Principal Investigator & Institution: Halmi, Katherine A.; Professor; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 01-MAY-2000; Project End 31-MAR-2005 Summary: Although the available treatment research literature suggests that cognitive behavioral therapy (CBT) is an effective treatment for bulimia nervosa, there is evidence that CBT is often not available to patients outside of research protocols and that most therapists are not trained to deliver this technique. This observation may well hold true for many forms of psychotherapy, and speaks to a growing discrepancy between the manual based therapies that are being developed in academic centers and what is available in clinical practice. This study is designed to examine two treatment sequences
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Psychotherapy
for bulimia nervosa. This first includes cognitive behavior therapy, coupled to fluoxetine treatment for those who fail to respond to CBT alone, a treatment package that is currently the state-of- the-art treatment for this condition. The second sequence will be a potentially cost-effective stepped treatment approach comprising the use of supervised self-help followed by the use of antidepressant medication (fluoxetine) if remission isn't attained with self-help, and finally followed by CBT, if remission isn't attained with drug therapy. The first two steps could be made widely available in areas where patients currently have no ready access to CBT specific for bulimia nervosa, with referral for CBT for the more treatment resistant cases. We are proposing a sample size of 324 subjects. Considering the sample size requirements for this study, we are proposing a multisite study wherein patients will be recruited and treated at 4 treatment sites, one of which includes the data center. The treatment sites chosen range from large urban areas (e.g. New York City), to small cities (e.g. Fargo) which draws extensively from rural areas. This strategy will also allow us to target enhanced minority recruitment. Outcomes of interest include the relative effectiveness of the 2 intervention strategies, their cost-effectiveness, their ability to successfully hold patients in therapy and prevent attrition, and their ability to prevent the need for further treatment for those successfully treated (relapse prevention). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STEPPED PHARMACOTHERAPY FOR AGGRESSIVE YOUTH WITH ADHD Principal Investigator & Institution: Blader, Joseph C.; Long Island Jewish Medical Center 270-05 76Th Ave New Hyde Park, Ny 11040 Timing: Fiscal Year 2002; Project Start 19-SEP-2002; Project End 31-JUL-2003 Summary: (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Development Award is to promote the candidate's progress toward an independent scientific career focused on treatment strategies for youth with severe disruptive disorders. Didactics and apprenticeship in interventions research skills in Year 1 will prepare the candidate to initiate a study of stepped pharmacotherapy for aggressive youth with attention-deficit/hyperactivity disorder (ADHD). This study, conducted in Years 2, 3 and part of 4, will a) provide the candidate with supervised experience in controlled treatment research, and b) address the critical need for rigorous trials to examine if combined medication approaches improve outcomes over monotherapy in this patient group. Childhood aggressive behavior most often develops alongside other disruptive disorder symptoms, which are highly comorbid with ADHD. Stimulant medication is first-line treatment for ADHD. Yet, for many children receiving stimulant treatment, aggressive behavior and affective instability remain significant impairments, leading clinicians to layer additional medications in efforts to diminish aggressive dyscontrol. However, the lack of evidence to support any medication combination strategy for these children is a great concern. The proposed study will first optimize open stimulant treatment for aggressive children 6- 12 years old with ADHD and a comorbid disruptive disorder. Children whose ADHD symptoms benefit from stimulant treatment but whose aggression persists will be randomly assigned to the mood stabilizer divalproex sodium or placebo during an 8-week double-blind trial while their stimulant treatment continues. All families will receive structured psychosocial treatment. The study will furnish preliminary data to enable a full-scale efficacy study, supported through an R01 to be submitted in Year 4. Further training activities throughout the award period will equip the candidate with research skills and provide experience in the areas of: a) intervention trial design and statistics, b)
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development and adoption in clinical settings of treatment strategies, including combined medication and psychosocial treatment, and c) assessment, including observational and laboratory approaches to outcome and mediator measurement. Mentors (N. Schooler, P. Jensen, V. Kafantaris) and consultants (including H. Abikoff, P. Frick, C. Grillon, J. Halperin, J. Kane, D. Kolko, S. Pliszka) will provide expert training and supervision. The proposed program will therefore culminate in the awardee's competence as a well-rounded clinical scientist focused on the complex treatment needs of youth with severe behavior disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SUSTAINABLE CHANGE IN LONG-TERM POSITIVE AFFECT Principal Investigator & Institution: Lyubomirsky, Sonja; Psychology; University of California Riverside 900 University Ave Riverside, Ca 92521 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2008 Summary: (provided by applicant): Long-term positive affect (the core component of happiness or well-being) is a central criterion of mental health and has been found to be associated with numerous tangible benefits, such as enhanced physical health, heightened vocational and social functioning, superior coping skills, and even longer life. Although enhancing people's levels of positive affect thus appears to be a worthy scientific goal, a surprisingly modest amount of scientific research has focused on how well-being can be increased, let alone sustained. Moreover, the broad conclusion of the existing work is that the pursuit of happiness may be futile. Two major findings support this pessimism - the idea of a genetically -determined set point for well-being, and the notion of a hedonic treadmill. Both of these ideas suggest that, even after intensely positive life events or circumstantial changes, people are fated to return to their previous "baseline" of well-being. Nevertheless, emerging research findings give reason for optimism regarding the possibility of sustainable well-being increases. How can this paradox be resolved? The research question motivating this application is "By what mechanisms can a level of well-being higher than a person's genetically-determined set point be achieved and sustained?" We believe that durable increases are indeed possible and focus our investigation on identifying the mechanisms of sustainable change in long-term positive affect. Accordingly, we present a new conceptual model of wellbeing, which proposes that an individual's chronic happiness level is governed by three classes of factors - (1) his or her genetically-determined set point (or set range) for happiness, which is relatively immune to influence, (2) happiness-relevant circumstantial factors (such as location, income, and marital status), which are difficult but not impossible to change, and (3) intentional cognitive, motivational, and behavioral activities that can influence well-being, and are feasible but effortful to deploy. Seven longitudinal studies (8 mos. to 2 yrs.) are proposed, which comparatively examine the immediate and longer-term effects of applying three promising happiness-boosting activities: 'counting one's blessings," "visualizing best possible selves,' and 'committing acts of kindness." The studies will include undergraduate samples, as well as community adult, and immigrant South Korean and Russian samples. In addition, we will test whether the model can be applied to clinically depressed individuals, as most depression interventions have focused on remedying distress, rather than increasing well-being directly. Several moderators (dedicated activity enactment, optimal timing and variety of activity enactment, personality-activity fit, interpersonal support, and basic circumstances) and one mediator (accumulated positive daily experiences) of activity-based happiness increases will be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TELEPHONE PSYCHOTHERAPY--TREATMENT OF DEPRESSION IN MS Principal Investigator & Institution: Mohr, David C.; Northern California Institute Res & Educ 4150 Clement Street (151-Nc) San Francisco, Ca 941211545 Timing: Fiscal Year 2002; Project Start 08-SEP-2000; Project End 31-JUL-2005 Summary: (Adapted from the Applicant's Abstract): Rates of depression in multiple sclerosis (MS) have been estimated at between 14% and 54%, and have been shown to be higher than rates in the general population or in other chronic illnesses. While untreated depression in MS is likely to worsen over time, it has been shown to respond well to treatment with cognitive behavioral therapy (CBT). Nevertheless, many patients with MS remain untreated. This may be due in part to common symptoms of MS, which can interfere with regular office visits. We are proposing to test a model of CBT, administered over the telephone, designed to treat depression in MS. While the use of telephone counseling and support services is increasing, empirical evidence on the efficacy of such services for the treatment of depression is scant at best. A patient workbook and therapist CBT treatment manual were developed by the PI and tested in an uncontrolled pilot study. In the 8-week pilot, 32 MS patients were randomly assigned to either telephone CBT or standard care (SC) in an HMO. Patients receiving telephone CBT showed improvement, as compared to patients receiving SC as measured by the Profile of Mood States Depression-Dejection scale (p=.01). This study proposed to enroll 128 patients in a randomized treatment study. Patients will be selected from the diverse population of patients in the Northern California Kaiser Permanente Medical Care Group (KPMC). Patients who meet inclusion criteria, including definite MS, activity limitation (disability) criteria, and DSM-IV diagnosis of Major Depressive Disorder (MDD), will be randomized into one of two treatment groups: 1) Coping with MS (CMS) telephone psychotherapy, which is a 16 week, 18 session, manualized form of telephone CBT that focuses on depression and adjustment to illness; or 2) a non-directive (ND) therapy contrast condition that controls for the nonspecific effects of psychotherapy. Outcomes include dichotomous and continuous measures of MDD, Quality of Life, and activity limitations. Patients will be followed for one year after the end of treatment. If the treatment proves efficacious, it will result in a validated form of telephone CBT for the treatment of depression that can be provided to MS patients independent of their mobility status or geographic location. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE BD FACSARIA, A NEW FLOW CYTOMETER CELL SORTER Principal Investigator & Institution: Chang, Yung; Associate Professor; Microbiology; Arizona State University P.O. Box 873503 Tempe, Az 852873503 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2005 Summary: (provided by applicant): Funds are requested to obtain a Becton Dickinson FACSAria TM Cell Sorter to conduct a variety of biomedical related studies. The BD FACSAria is a newly developed FACS sorter, surpassing the earlier model, FACSVantage, in its superior application performance and low maintenance requirement. The availability of this instrument comes at a perfect time when great demand is presented as a result of establishment of Arizona BioDesign Institute (AZ Bio-Design) and recent expansion of ASU biomedical research activities. A major user group consisting of eight NIH grantees has been formed, of whom seven are the investigators on this grant application (see below). The research activities of this group involve identification of potential chromosomal translocation during attempted V(D)J
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recombination events; development of vaccines against HBV and smallpox; determination of functional activity of Heat-Shock Protein 20 in smooth muscle relaxation; identification of molecular targets of anti-cancer drugs; construction and screening recombinant phage-display antibodies for treating neurodegenerative diseases; assessment of psychotherapy in treating Rheumatoid Arthritis and characterization of outer membrane proteins in bacterial antibiotic resistance. In addition, other investigators at ASU will use this equipment to assist their studies in protein delivery, photosynthesis and immune modulation. The requested instrument will greatly enhance the ability of NIH grantees and other investigators at ASU to perform their research activities and to explore new research directions that would not be possible otherwise. This instrument will be part of a core facility of AZ Bio-Design, and will be administered by an internal advisory committee at AZ Bio-Design. Cost will be shared among NIH users, AZBioDesign and the university. To maximize the usage of this core facility, we will continue our effort to expand the user group, including researchers outside the campus. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE TREATMENT OF BINGE EATING DISORDER Principal Investigator & Institution: Crow, Scott J.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 15-FEB-2002; Project End 31-JAN-2005 Summary: (provided by applicant): Research over the last few decades has shown that a sub-group of overweight individuals have an abnormal eating pattern best characterized by discrete binge eating episodes. The presence of binge eating episodes in obese individuals is associated with increased rates of psychopathology, social dysfunction, early onset obesity, and greater severity of obesity. However, recent research suggests that binge eating can be effectively treated in obese individuals using certain forms of psychotherapy such as cognitive behavioral techniques, and certain antidepressant drugs, strategies that have also been shown to be useful in suppressing binge eating in individuals of normal weight with bulimia nervosa. Certain self-help techniques have also been shown to be quite useful in improving binge eating symptoms and in encouraging healthy eating behavior in individuals with disordered eating. Our research groups have demonstrated the utility of a self-help manual in working with individuals with bulimia nervosa and most recently the utility of a group self-help approach in targeting binge eating behavior in overweight individuals with binge eating. Therefore, as an extension of our prior research, and given the preliminary data that will be reported in the application, we propose to study the utility of treatments targeting binge eating in obese individuals who binge eat through a random assignment, parallel study wherein subjects who satisfy inclusion criteria will be assigned to one of 6 conditions: 1) manual-based self-help targeting binge eating without therapist involvement; 2) supervised manual-based self-help; 3) group self-help therapy, without contact with a psychotherapist; 4) group therapy delivered partially through videotapes and partially with therapist leadership; 5) a traditional therapist-led group psychotherapy, and 6) a wait list control to control for the effects of time and the non-specific effects of being involved in the protocol. Of note, the materials presented in the five treatment arms will be essentially identical, but are written for self-help vs. audio-visual vs. therapy presentation based on the treatment assignment. This protocol is not designed to test a weight loss strategy, but instead to focus on strategies for bingeeating. Such strategies could then be administered in combination with, or sequentially with, various weight loss strategies (e.g., behavioral, pharmacologic) in those who are
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Psychotherapy
overweight. Treatments for weight loss are currently undergoing significant evolution with the introduction of two new pharmacologic agents in the last 18 months. We believe that to attempt to address both strategies for binge eating and strategies for weight loss in this study would make it overly complex. The result of this study could inform the design of trials to treat both binge-eating and promote weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSPORTABILITY OF NEW TREATMENTS: MST AS A TEST CASE Principal Investigator & Institution: Schoenwald, Sonja K.; Associate Professor; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2002; Project Start 15-SEP-1999; Project End 31-MAY-2004 Summary: This study examines the factors associated with the effective transport of a complex family-based mental health treatment, Multisystemic Therapy (MST), to community settings. As such, the study directly addresses major gaps in both clinical (psychotherapy) and mental health services research pertaining to the translation of efficacious treatments to effective mental health services. MST has proven effective in improving child behavior and family functioning in randomized trials with youth experiencing serious clinical problems. In three randomized trials with violent and chronic juvenile offenders, MST reduced long-term rates of rearrest and out-of-home placement and improved child behavior and family functioning. Earlier randomized trials demonstrated the promise of MST in treating child abuse/neglect and juvenile sex offenders, and an ongoing study is evaluating its effectiveness as an alternative to psychiatric hospitalization. In response to demand from policy makers and providers to develop MST programs, 27 programs serving 1500 youth and families annually have been established in 8 states and Canada. Recent research on MST has demonstrated a significant association between clinicians' adherence to the MST treatment protocol and favorable outcomes for youth. Thus, the foremost challenge in transporting the model and its favorable outcomes to usual care settings is determining the organizational and extra- organizational conditions that support the fidelity of MST interventions. Specifically, this study will examine the child and outcomes associated with MST as delivered by clinicians in 26 programs. Participants will be 2550 youth and families referred to MST programs and the clinicians and administrators employed by those programs. A multi-method multi-source measurement battery will be used to examine the organizational and extra-organizational factors thought to support fidelity to MST and concomitant child outcomes. The aims of this study are to: 1). Document the relationship between clinician adherence to a specific treatment model and child outcomes in usual care settings; 2). Examine the impact of intra-organizational variables on clinician adherence; 3). Examine the extent to which organizational variables relevant to transportability are influenced by selected extra-organizational factors; 4). Examine the influence of clinician variables on adherence; 5). Test a mediation model of treatment effectiveness in which the impact of intra- and extra-organizational factors and individual clinician variables on outcomes is mediated by clinician adherence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TRAUMATIC CONTROLLED STUDY
GRIEF
TREATMENT--A
RANDOMIZED
Principal Investigator & Institution: Shear, M. Katherine.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260
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Timing: Fiscal Year 2002; Project Start 15-AUG-2000; Project End 31-JUL-2005 Summary: (Adapted from the Applicant's Abstract): This application requests funding for a 5 year study of a treatment for "traumatic grief." Over 16 million people are bereaved each year in the United States. For a substantial minority, grief is chronic, debilitating, and complicated by psychiatric or medical problems. In these cases, intervention is clearly indicated, yet there is little information about how best to treat such individuals. The field has been slow to develop criteria for abnormal grief reactions, and lack of such criteria has impeded development and testing of treatments. With the aid of a new instrument, the Inventory of Complicated Grief (ICG), we can now reliably identify a syndrome currently designated "traumatic grief." Found in 20% of bereaved persons, traumatic grief is associated with significant long-term morbidity. Symptoms of traumatic grief are distinct from symptoms of depression, and do not respond to standard treatments for depression. Therefore, we undertook development of a targeted Traumatic Grief Treatment (TGT). Pilot data in 10 patients show a robust treatment effect, much larger than that achieved by published reports of grief counseling. We now propose a randomized controlled trial to test the efficacy of TGT. Our primary aim is to compare effects of traumatic grief treatment (TGT) to a control, interpersonal psychotherapy (IPT) on measures of traumatic grief, depression, anxiety, functional impairment, self esteem and social support. We plan to conduct assessments of all randomized subjects at 16 weeks and 40 weeks. We will conduct exploratory analyses and instrument development to test and refine hypotheses related to putative mechanisms of action of TGT. We hypothesize that TGT will result in significantly greater improvement in traumatic grief than IPT, and that these differences will be sustained at 6-month follow-up. Almost a decade of work on the description and treatment of bereavement-related distress has prepared our research group for the treatment trial we now propose. We have come to understand who among those with bereavement-related symptomatology is at greatest risk for psychiatric and physical morbidity (i.e., those with traumatic grief) and we have developed what appears to be an effective intervention for this treatment-resistant population. The time is propitious for a controlled study of the efficacy of Traumatic Grief Treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATING DEPRESSED MOTHERS IN A COMMUNITY CLINIC Principal Investigator & Institution: Swartz, Holly A.; Assistant Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): When mothers suffer from depression, the effects of their illness are borne not only by mothers but also by their dependent offspring. The converse may also be true: that is, effective treatments for mothers with depression may also improve outcomes for their children. The purpose of this proposed Mentored Patient-Oriented Research Career Development (K23) Award is to promote the Candidate's long-term goal of conducting clinical trials of psychosocial interventions for mothers with depression in community settings and to study the impact of these treatments on mothers and their dependent children. The activities described in this application will enable the Candidate to assess the reciprocal relationship between maternal depression and child illness, successfully engage and retain mothers in multisession psychosocial treatments, and collaborate with health services researchers in order to enhance the public health value of the intervention. Interpersonal psychotherapy (IPT), an efficacious treatment for depression, addresses both depressive symptoms and problematic interpersonal relationships. For mothers whose struggles
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caring for ill children contribute to her psychiatric illness, IPT provides the opportunity to resolve both the depression itself and depression-engendering conflicts with a child or partner. The first phase of the research plan consists of modifying an 8-session form of IPT (IPT-B) for depressed mothers with ill children by incorporating an engagement strategy and minimizing practical barriers to care. The second phase of the research plan consists of a small, preliminary, randomized trial comparing enhanced IPT-B to a referral for usual care in a sample of depressed mothers who bring their school-age children for treatment in a community mental health clinic. Mothers and children will be assessed at baseline, post-treatment, and 6-month follow-up. The skills, training, and pilot data obtained from this award will subsequently support the Candidate's development of an R01 application in Years 03-05 of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT OF DEPRESSION IN PARENTS--IMPACT ON CHILDREN Principal Investigator & Institution: Garber, Judy; Professor; Psychology & Human Development; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2003; Project Start 20-AUG-1998; Project End 31-JUL-2004 Summary: (Adapted from applicant's abstract): The proposed project will study the impact of treating parental depression on children's socio-emotional adjustment. This project will interface with two newly funded NIMH treatment studies of adults diagnosed with major depressive disorder. The first is a two-site study being conducted at Vanderbilt University (PI, Steve Hollon, Ph.D.) and at the University of Pennsylvania (PI, Rob DeRubeis, Ph.D.). The second study will be at the University of Washington (PI, Neil Jacobson, Ph.D.). Across the three sites, 640 adults will receive cognitive therapy, pharmacotherapy, or placebo (plus a behavioral cell at UW). Based on preliminary data collected in the last four months, we estimate that about 25% of the patients will have children between 8 and 16 years old and will agree to participate. These preliminary data provide evidence of the feasibility and acceptability of the project, and showed that the targeted children of currently depressed parents were experiencing significant levels of symptoms and dysfunction. The proposed project will involve a comprehensive assessment of an index child with regard to psychopathology and functioning at the time the parent enters the treatment study and again at 2,4,8,12,18, and 24 months. A comparison group of children whose parents are lifetime-free of psychiatric and medical disorders also will be included. The primary aims of the study are: (a) to examine the relation between decreases in parent's depression and changes in children's functioning;(b) to explore possible mediators of these changes including the parent-child relationship, marital functioning, stressors, and cognitions; and (c) to test whether changes in child adaptation, the hypothesized mediators, and the relation between parent and child symptoms differ as a function of the type of treatment the parent received. Data analysis will involve traditional methods of repeated measures multivariate analyses of variance and a more general and innovative approach of individual growth curve modeling using covariance structure analysis. This study represents a truly unique opportunity to further our theoretical understanding of the link between parent and child psychopathology that can serve as a guide for the development of preventive interventions for high risk populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: USING BEHAVIORAL SCIENCE TO EXPLAIN PCP DEPRESSION CARE Principal Investigator & Institution: Meredith, Lisa S.; Staff Scientist; Rand Corporation 1700 Main St Santa Monica, Ca 90401 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: (provided by applicant): Improving care for depression is a fundamental goal of mental health services research. The need to improve care within primary care is particularly relevant because most patients receive care solely within that setting. Primary care provider (PCP) behavior is a key vehicle for achieving improvement. This application (responding to PAR99-073) aims to enhance the understanding of underlying relationships among provider attitudes, intentions, and PCP treatment behavior to improve care for depression. The multidisciplinary research team will examine and compare selected theories from the social and behavioral sciences to gain new insights into PCP depression treatment behavior. This work will ask old questions about improving mental health care in new ways by applying and integrating models traditionally used to study personal health behavior to study PCP depression treatment behavior. Lessons from application of these frameworks could inform future interventions for changing provider behavior to improve depression care. These objectives will be addressed through secondary analyses of data from a sample of 414 PCPs and 2,030 patients (5-15 per provider) with major depression participating in the four Quality Improvement for Depression consortium studies. These PCPs are from 80 different clinics in 11 different managed care organizations across the U.S. Few databases contain the breadth of constructs necessary for broad theoretical testing with a relatively large sample of providers. Regression and structural equation analyses will elucidate the degree to which the selected expectancy-value frameworks from social and health psychology, and agency theory from behavioral economics explain provider depression treatment behavior. The relative efficacy of these adapted theories will be compared (using indicators of variance explained and relative goodness of fit) to identify the most useful combination of PCP attitudes, behavioral intentions, and treatment choices in modeling PCP depression treatment behavior. We will also outline the strengths and weaknesses of the models from the different disciplines. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: WOMEN'S PRISON TC: OUTCOMES, PROCESS & ECONOMIC ANALYSIS Principal Investigator & Institution: Sacks, Joann Y.; National Development & Res Institutes Research Institutes, Inc. New York, Ny 10010 Timing: Fiscal Year 2002; Project Start 20-SEP-2001; Project End 31-JUL-2006 Summary: The number and proportion of substance abusing women in prison are increasing, creating a need for programs tailored to this population, and for evaluation of such programs. The specific aims of this project are: 1) to conduct a rigorous evaluation of the effectiveness of prison TC treatment for substance abusing women offenders; 2) to investigate the treatment process for the target population and to explore the relationship between the process and outcome of treatment; 3) to evaluate the cost and cost effectiveness of treatment; and 4) to assess issues in obtaining and making use of aftercare services and provide information regarding the additional contribution of aftercare treatment. The core investigation randomly assigns female substance abusing offenders, over four years (n=1000), at the Denver Women's Correctional Facility to either a TC program, Recovery By Choice, the experimental (E)
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condition (n=500), or to a non-TC standard program, the comparison (C) condition (n=500). The study predicts better outcomes for the TC group in an intent- to-treat analysis of all study entrants. The Aim 4 supplementary study of aftercare, with no random assignment, follows program completers from E and C as they enter mandatory aftercare, choosing either TC aftercare or a non-TC treatment alternative. The research employs a prospective, longitudinal, repeated measures assessment with five points (baseline, 6-, 12-, 18-, and 24-months post-baseline) and employs standard outcome measures (e.g., drug use, crime, and employment), and specific measures of particular concern to female offenders (e.g., self-esteem, trauma and abuse, and parenting practices). In addition to self-report data, urine toxicology and criminal record data are obtained. The study collects process data, guided by the Texas Christian University Treatment Process Model, and cost data using a specially designed cost analysis instrument. The project contributes to a theoretical advance in our understanding of the process of treatment for women offenders in prison TCs. It advances research through a rigorous study of TC prison program effectiveness for women compared to another, routine treatment. It guides practice by delineating treatment elements for women and by examining the effectiveness of a TC program that organizes these elements. Finally, it integrates outcome and economic analysis to inform policy and planning about the effectiveness and cost-effectiveness of the TC treatment under study. Perhaps most significantly, it tests TC principles and methods found effective with substance-abusing male offenders that are adapted for women, thereby increasing the potential utility of these strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: YOUTH PARTNERS IN CARE: DEPRESSION & QUALITY IMPROVEMENT Principal Investigator & Institution: Asarnow, Joan R.; Professor; Psychiatry & Biobehav Sciences; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2004 Summary: The proposed study is an effectiveness trial of a quality improvement intervention for the treatment of adolescent and young adult depression within managed primary care settings under usual care conditions. Depression in youth interferes with functioning during a critical developmental period and is associated with adverse outcomes, such as suicide, risk for drug and alcohol problems, and adult depression. Does improving rates of use of efficacious treatment improve outcomes, and at what costs? To address this question, we propose a randomized trial at the clinic level to evaluate an intervention featuring patient and primary care-provider education about treatment for depression, coupled with clinic resources that facilitate initiation and provision of appropriate care, whether medication management or full-course Cognitive Behavioral Therapy. We assess intervention effects, compared to care as usual, on quality of care, satisfaction with care, clinical symptoms and daily functioning, service use and costs, and indirect costs and parental psychological distress. This proposal is a unique opportunity to extend Partners in Care (PIC), an AHCPR PORT-II on the costeffectiveness of quality improvement interventions for adult depressed patients in primary care. This proposal uses PIC intervention materials and study measures. Patients identified as depressed in intervention and control clinics will be evaluated at baseline, 6-months, 12 months, and 18 months. We hypothesize that the intervention will improve quality of care, and through quality of care, improve clinical and functioning outcomes for depressed youths and reduce family burden. The study has an
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interdisciplinary team including psychiatrists, psychologists, nurses, primary care clinicians, statisticians, sociologists, and economists. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “psychotherapy” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for psychotherapy in the PubMed Central database: •
A Marriage Between Pharmacotherapy and Psychotherapy. by Dalton ME, Schuyler D.; 2001 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181175
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Efficacy of combined, sequentialand crossover psychotherapy and pharmacotherapy in improving outcomes in depression. by Segal Z, Vincent P, Levitt A.; 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161662
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Prescribing Brief Psychotherapy. by Schuyler D.; 2000 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181103
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Psychotherapy and Psychoanalysis, Man, and Society. by Cooksley FA.; 1953 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=199652
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Psychotherapy Clarified the Diagnosis and Treated the Problem. by St. Germaine K, Schuyler D.; 2001 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181157
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Psychotherapy of a Patient With Terminal Cancer. by Schuyler D, Brescia F.; 2002 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181240
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Specialized Techniques in Psychotherapy. by Overholser W.; 1953 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=195486
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Teaching the Tools: Prolonging the Benefit of Psychotherapy. by McLean LS, Schuyler D.; 2001 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181219
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The BATHE Method: Incorporating Counseling and Psychotherapy Into the Everyday Management of Patients. by Lieberman JA III, Stuart MR.; 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181054
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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The Fifteen Minute Hour: Applied Psychotherapy for the Primary Care Physician, 2nd ed. by Tavernier LA.; 1999 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181097
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The Roots of Psychotherapy. by Callaway E III.; 1955 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=199839
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The use of fiction in psychotherapy: a contribution to bibliotherapy. by Kinney MM.; 1951 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=195107
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Treatment for chronic depression: cognitive behavioral analysis system of psychotherapy (CBASP). by Bland RC.; 2001 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=167192
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Twelve-Step Programs as an Adjunct to Psychotherapy and Psychopharmacology. by Chanin A.; 2000 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181125
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with psychotherapy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “psychotherapy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for psychotherapy (hyperlinks lead to article summaries): •
“Wild Child”: how three principles of healing organized 12 years of psychotherapy. Author(s): Terr LC. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 December; 42(12): 1401-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14627874
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A brief discourse on psychotherapy and psychoanalysis: historical perspective. Author(s): Schwartz C. Source: Psychoanalytic Review. 2003 April; 90(2): 153-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14569836
6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease. Author(s): de Godoy DV, de Godoy RF. Source: Archives of Physical Medicine and Rehabilitation. 2003 August; 84(8): 1154-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12917854
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A setting including psychotherapy and psychopharmacological treatment in a case of anorexia nervosa with obsessive compulsive disorder comorbidity. Author(s): Ramacciotti A, Pallanti S, Pazzagli A. Source: Eat Weight Disord. 1997 December; 2(4): 222-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655832
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Adolescent psychotherapy: an introduction. Author(s): Rubenstein AK. Source: Journal of Clinical Psychology. 2003 November; 59(11): 1169-75. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566952
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Anaesthesia or psychotherapy: eradicating thoughts or working them through. Author(s): Hinz H. Source: The International Journal of Psycho-Analysis. 2003 April; 84(Pt 2): 203-11; Discussion 211-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12856348
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Appraisal of published reviews of research on psychotherapy and counseling with adults 1990-1998. Author(s): Mackay HC, Barkham M, Rees A, Stiles WB. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 652-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12924669
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Are samples in randomized controlled trials of psychotherapy representative of community outpatients? A new methodology and initial findings. Author(s): Stirman SW, DeRubeis RJ, Crits-Christoph P, Brody PE. Source: Journal of Consulting and Clinical Psychology. 2003 December; 71(6): 963-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14622071
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Assessing psychotherapy competence in psychiatric residents: getting real. Author(s): Yager J, Kay J. Source: Harvard Review of Psychiatry. 2003 March-April; 11(2): 109-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12868511
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Assessing residents' competence in psychotherapy. Author(s): Giordano FL, Briones DF. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Fall; 27(3): 145-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969836
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Burning Mouth Syndrome: open trial of psychotherapy alone, medication with alphalipoic acid (thioctic acid), and combination therapy. Author(s): Femiano F, Gombos F, Scully C. Source: Medicina Oral : Organo Oficial De La Sociedad Espanola De Medicina Oral Y De La Academia Iberoamericana De Patologia Y Medicina Bucal. 2004 January-February; 9(1): 8-13. English, Spanish. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14704612
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Clinical conversations: brief psychotherapy training and HIV. Author(s): Ali D. Source: Focus. 2003 August; 18(8): 1-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14672066
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Cognitive-existential group psychotherapy for women with primary breast cancer: a randomised controlled trial. Author(s): Kissane DW, Bloch S, Smith GC, Miach P, Clarke DM, Ikin J, Love A, Ranieri N, McKenzie D. Source: Psycho-Oncology. 2003 September; 12(6): 532-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12923794
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Commentary on “Reflections on Sullivan and the language of psychiatry”. Interpersonal psychotherapy and neuroscience. Author(s): Holloway HC. Source: Psychiatry. 2003 Summer; 66(2): 99-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12868286
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Comparing the effectiveness of process-experiential with cognitive-behavioral psychotherapy in the treatment of depression. Author(s): Watson JC, Gordon LB, Stermac L, Kalogerakos F, Steckley P. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 773-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12924682
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Competency assessment in the McMaster Psychotherapy Program. Author(s): Weerasekera P, Antony MM, Bellissimo A, Bieling P, Shurina-Egan J, Spencer A, Whyte R, Wolpert-Zur A. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Fall; 27(3): 166-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969840
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Confidentiality and dual relationships in group psychotherapy. Author(s): Pepper RS. Source: Int J Group Psychother. 2004 January; 54(1): 103-14. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14986575
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Counselling and psychotherapy: media distortion. Author(s): Rose S, Bisson J, Wessely S. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 September; 183: 263-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12949005
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Cultural psychotherapy--are there common factors? Author(s): Machleidt W. Source: Seishin Shinkeigaku Zasshi. 2003; 105(5): 561-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12875222
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Diet and exercise in addition to psychotherapy, in the treatment of patients suffering from eating disorders with obesity. Author(s): Hoie LH, Myking E, Reine EC, Bruusgaard D. Source: Eat Weight Disord. 1997 December; 2(4): 207-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655829
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Differential responses to psychotherapy versus pharmacotherapy in patients with chronic forms of major depression and childhood trauma. Author(s): Nemeroff CB, Heim CM, Thase ME, Klein DN, Rush AJ, Schatzberg AF, Ninan PT, McCullough JP Jr, Weiss PM, Dunner DL, Rothbaum BO, Kornstein S, Keitner G, Keller MB. Source: Proceedings of the National Academy of Sciences of the United States of America. 2003 November 25; 100(24): 14293-6. Epub 2003 Nov 13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14615578
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Dream screen phenomenon in psychotherapy and artistic work. Author(s): Saarinen PI. Source: Nordic Journal of Psychiatry. 2003; 57(5): 383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14522612
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Economic grand rounds: financial disincentives for the provision of psychotherapy. Author(s): West JC, Wilk JE, Rae DS, Narrow WE, Regier DA. Source: Psychiatric Services (Washington, D.C.). 2003 December; 54(12): 1582-3, 1588. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14645792
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Effectiveness of psychotherapy and combination treatment for chronic depression. Author(s): Arnow BA, Constantino MJ. Source: Journal of Clinical Psychology. 2003 August; 59(8): 893-905. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12858430
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Efficacy vs. effectiveness research in psychotherapy: implications for clinical hypnosis. Author(s): Amundson JK, Alladin A, Eamon G. Source: Am J Clin Hypn. 2003 July; 46(1): 11-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12894928
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Empowerment psychotherapy with adolescent females of color. Author(s): Querimit DS, Conner LC. Source: Journal of Clinical Psychology. 2003 November; 59(11): 1215-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566956
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Equine-facilitated psychotherapy benefits students and children. Author(s): Roberts F, Bradberry J, Williams C. Source: Holistic Nursing Practice. 2004 January-February; 18(1): 32-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765690
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Eroticism in group psychotherapy: psychoanalytic reflections on desire, agony, and ecstasy. Author(s): Tylim I. Source: Int J Group Psychother. 2003 October; 53(4): 443-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14562521
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Establishing specificity in psychotherapy: a meta-analysis of structural equivalence of placebo controls. Author(s): Baskin TW, Tierney SC, Minami T, Wampold BE. Source: Journal of Consulting and Clinical Psychology. 2003 December; 71(6): 973-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14622072
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Ethical issues in psychotherapy with adolescents. Author(s): Koocher GP. Source: Journal of Clinical Psychology. 2003 November; 59(11): 1247-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566959
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Evaluating competence in psychotherapy. Author(s): Manring J, Beitman BD, Dewan MJ. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Fall; 27(3): 136-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969835
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Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) interview with a psychiatric inpatient population. Author(s): Strong JE, Farrell AD. Source: Journal of Clinical Psychology. 2003 September; 59(9): 967-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12945062
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Fighting for life: a qualitative analysis of the process of psychotherapy-assisted selfhelp in patients with metastatic cancer. Author(s): Cunningham AJ, Phillips C, Stephen J, Edmonds C. Source: Integrative Cancer Therapies. 2002 June; 1(2): 146-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14664740
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From psychotherapy to e-therapy: the integration of traditional techniques and new communication tools in clinical settings. Author(s): Castelnuovo G, Gaggioli A, Mantovani F, Riva G. Source: Cyberpsychology & Behavior : the Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society. 2003 August; 6(4): 375-82. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14511449
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Group psychotherapy and people with dementia. Author(s): Cheston R, Jones K, Gilliard J. Source: Aging & Mental Health. 2003 November; 7(6): 452-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14578007
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In defense of cultural competency in psychotherapy and treatment. Author(s): Sue S. Source: The American Psychologist. 2003 November; 58(11): 964-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609392
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Individual differences in misremembering pre-psychotherapy distress: personality and memory distortion. Author(s): Safer MA, Keuler DJ. Source: Emotion (Washington, D.C.). 2002 June; 2(2): 162-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12899189
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Informed consent for psychotherapy: a look at therapists' understanding, opinions, and practices. Author(s): Croarkin P, Berg J, Spira J. Source: American Journal of Psychotherapy. 2003; 57(3): 384-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12961822
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Interpersonal psychotherapy for chronic depression. Author(s): Markowitz JC. Source: Journal of Clinical Psychology. 2003 August; 59(8): 847-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12858426
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Legislative warriors: American psychiatrists, psychologists, and competing claims over psychotherapy in the 1950s. Author(s): Buchanan RD. Source: Journal of the History of the Behavioral Sciences. 2003 Summer; 39(3): 225-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12891691
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Mentalizing in the psychotherapy of a disturbed adolescent girl. Author(s): O'Malley F. Source: Bulletin of the Menninger Clinic. 2003 Spring; 67(2): 150-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14604100
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Movement towards coherence in the psychotherapy of schizophrenia: a method for assessing narrative transformation. Author(s): Lysaker PH, Wickett AM, Campbell K, Buck KD. Source: The Journal of Nervous and Mental Disease. 2003 August; 191(8): 538-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12972857
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Narrative transformation as an outcome in the psychotherapy of schizophrenia. Author(s): Lysaker PH, Lancaster RS, Lysaker JT. Source: Psychology and Psychotherapy. 2003 September; 76(Pt 3): 285-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14577894
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NEO-five factor personality traits as predictors of response to two forms of group psychotherapy. Author(s): Ogrodniczuk JS, Piper WE, Joyce AS, McCallum M, Rosie JS. Source: Int J Group Psychother. 2003 October; 53(4): 417-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14562520
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On treating adolescent girls: focus on strengths and resiliency in psychotherapy. Author(s): Johnson NG. Source: Journal of Clinical Psychology. 2003 November; 59(11): 1193-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566954
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Overview of the methodological considerations for conducting psychotherapy trials in primary care. Author(s): Huibers M, Knipschild P. Source: Psychological Medicine. 2003 August; 33(6): 1135-6; Author Reply 1136-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12946098
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Personal reflections of mental health nurses training to use Hobson's Conversational Model (psychodynamic-interpersonal) of psychotherapy. Author(s): Paley G, Shapiro DA, Myers J, Patrick S, Reid E. Source: Journal of Psychiatric and Mental Health Nursing. 2003 December; 10(6): 735-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005488
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Pharmacotherapy plus psychotherapy for treatment of depression in active injection drug users. Author(s): Stein MD, Solomon DA, Herman DS, Anthony JL, Ramsey SE, Anderson BJ, Miller IW. Source: Archives of General Psychiatry. 2004 February; 61(2): 152-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14757591
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Practical geriatrics: psychodynamic psychotherapy with older adults. Author(s): Morgan AC. Source: Psychiatric Services (Washington, D.C.). 2003 December; 54(12): 1592-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14645796
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Practice development in psychological interventions: mental health nurse involvement in the Conversational Model of psychotherapy. Author(s): Paley G, Myers J, Patrick S, Reid E, Shapiro DA. Source: Journal of Psychiatric and Mental Health Nursing. 2003 August; 10(4): 494-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887642
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Predictors of change during long-term analytic group psychotherapy. Author(s): Lorentzen S, Hoglend P. Source: Psychotherapy and Psychosomatics. 2004 January-February; 73(1): 25-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665793
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Prevention of relapse and recurrence in depression: the role of long-term pharmacotherapy and psychotherapy. Author(s): Nierenberg AA, Petersen TJ, Alpert JE. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 15: 13-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14658986
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Psychopharmacology plus psychotherapy for depression treatment. Author(s): Mark J. Source: Psychiatric Services (Washington, D.C.). 2003 July; 54(7): 1042; Author Reply 1042-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12851450
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Psychotherapy and paroxetine: cost effective for severe IBS, or a waste of resources. Author(s): Chitkara DK, Cremonini F, Talley NJ. Source: Gastroenterology. 2003 November; 125(5): 1554-5; Author Reply 1555-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14628812
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Psychotherapy and pharmacotherapy in depression. Author(s): Powers RH, Kniesner TJ, Croghan TW. Source: The Journal of Mental Health Policy and Economics. 2002 December; 5(4): 15361. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14578549
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Psychotherapy competencies: development and implementation. Author(s): Mellman LA, Beresin E. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Fall; 27(3): 149-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969837
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Psychotherapy for postpartum depression: a preliminary report. Author(s): Clark R, Tluczek A, Wenzel A. Source: The American Journal of Orthopsychiatry. 2003 October; 73(4): 441-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609406
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Psychotherapy: a new era. Author(s): Bateman A, Margison F. Source: The Australian and New Zealand Journal of Psychiatry. 2003 October; 37(5): 5124. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14511077
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Reflections on relevance: Psychotherapy and Psychosomatics in 2003. Author(s): Balon R. Source: Psychotherapy and Psychosomatics. 2004 January-February; 73(1): 5-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665790
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Relationships among psychological mindedness, alexithymia and outcome in four forms of short-term psychotherapy. Author(s): McCallum M, Piper WE, Ogrodniczuk JS, Joyce AS. Source: Psychology and Psychotherapy. 2003 June; 76(Pt 2): 133-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12855060
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Research findings on psychotherapy of addictive disorders. Author(s): Woody GE. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003; 12 Suppl 2: S19-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12857660
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Short-term intercultural psychotherapy: ethnographic inquiry. Author(s): Seeley KM. Source: Social Work. 2004 January; 49(1): 121-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14964524
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The challenge of group psychotherapy. Author(s): von Ornsteiner JB. Source: Body Posit. 2002 December; 15(7): 23-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989208
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The Danish national multicenter schizophrenia project: assessment of psychotic patients for dynamic psychotherapy (APPP). Author(s): Valbak K, Koster A, Larsen KA, Nielsen JR, Norrie B; Danish National Multicenter Schizophrenia Project. Source: Nordic Journal of Psychiatry. 2003; 57(5): 333-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14522605
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The early impact of therapeutic alliance in brief psychodynamic psychotherapy. Author(s): Marcolino JA, Iacoponi E. Source: Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999). 2003 June; 25(2): 7886. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12975703
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The external validity of controlled clinical trials of psychotherapy for depression and anxiety: a naturalistic study. Author(s): Morrison KH, Bradley R, Westen D. Source: Psychology and Psychotherapy. 2003 June; 76(Pt 2): 109-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12855059
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The little puppet: working with autistic defences in mother-infant psychotherapy. Author(s): Sidoli M. Source: The Journal of Analytical Psychology. 2000 April; 45(2): 159-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533392
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The management of affect storms in the psychoanalytic psychotherapy of borderline patients. Author(s): Kernberg OF. Source: J Am Psychoanal Assoc. 2003 Spring; 51(2): 517-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12866756
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The modern confessional: Anglo-American religious groups and the emergence of lay psychotherapy. Author(s): Falby A. Source: Journal of the History of the Behavioral Sciences. 2003 Summer; 39(3): 251-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12891692
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The outcomes of psychotherapy with adolescents: a practitioner-friendly research review. Author(s): Roberts MC, Lazicki-Puddy TA, Puddy RW, Johnson RJ. Source: Journal of Clinical Psychology. 2003 November; 59(11): 1177-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566953
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The psychotherapy of schizophrenia: its place in the modern world. Author(s): Silver AL. Source: J Am Acad Psychoanal Dyn Psychiatry. 2003 Summer; 31(2): 325-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12866694
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The symbolic and concrete: Psychotic adolescents in psychoanalytic psychotherapy. Author(s): Pestalozzi J. Source: The International Journal of Psycho-Analysis. 2003 June; 84(Pt 3): 733-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12873371
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The transformation of the internal dead mother into the internal living mother in the psychoanalytic psychotherapy of anorexia nervosa. Author(s): Keinanen M. Source: The Israel Journal of Psychiatry and Related Sciences. 2003; 40(3): 220-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14619681
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Theoretical model of psychotherapy: Eastern Asian-Islamic women with mental illness. Author(s): Carter DJ, Rashidi A. Source: Health Care for Women International. 2003 May-June; 24(5): 399-413. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12916145
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Therapeutic alliance as a measurable psychotherapy skill. Author(s): Summers RF, Barber JP. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Fall; 27(3): 160-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969839
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Transforming psychotherapy in order to succeed with adolescent boys: male-friendly practices. Author(s): Kiselica MS. Source: Journal of Clinical Psychology. 2003 November; 59(11): 1225-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566957
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Trauma-focused psychotherapy after a trial of medication for chronic PTSD: pilot observations. Author(s): Marshall RD, Carcamo JH, Blanco C, Liebowitz M. Source: American Journal of Psychotherapy. 2003; 57(3): 374-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12961821
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Treatment for chronic depression using Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Author(s): McCullough JP Jr. Source: Journal of Clinical Psychology. 2003 August; 59(8): 833-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12858425
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What works for people with mental retardation? Critical commentary on cognitivebehavioral and psychodynamic psychotherapy research. Author(s): Beail N. Source: Mental Retardation. 2003 December; 41(6): 468-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14588054
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Words and transitional phenomena in psychotherapy. Author(s): Favero M, Ross DR. Source: American Journal of Psychotherapy. 2003; 57(3): 287-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12961815
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Working through a psychotherapy group's political cultures. Author(s): Ettin MF, Cohen BD. Source: Int J Group Psychother. 2003 October; 53(4): 479-504. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14562523
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CHAPTER 2. NUTRITION AND PSYCHOTHERAPY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and psychotherapy.
Finding Nutrition Studies on Psychotherapy The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “psychotherapy” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “psychotherapy” (or a synonym): •
Approaches to psychotherapy in Africans: do they have to be non-medical? Author(s): Dept. of Psychiatry, College of Medicine, University of Lagos, Nigeria. Source: Ilechukwu, S T Cult-Med-Psychiatry. 1989 December; 13(4): 419-35 0165-005X
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Complementary psychotherapy in dermatology: hypnosis and biofeedback. Author(s): Division of Dermatology and Cutaneous Surgery, Department of Internal Medicine, College of Medicine, University of South Florida, Tampa, Florida, USA.
[email protected] Source: Shenefelt, P D Clin-Dermatol. 2002 Sep-October; 20(5): 595-601 0738-081X
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Psychotherapy with severely traumatized refugees. Source: Kinzie, J D Fleck, J Am-J-Psychother. 1987 January; 41(1): 82-94 0002-9564
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Skoptic syndrome: the treatment of an obsessional gender dysphoria with lithium carbonate and psychotherapy. Author(s): Department of Family Practice and Community Health, University of Minnesota Medical School. Source: Coleman, E Cesnik, J Am-J-Psychother. 1990 April; 44(2): 204-17 0002-9564
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. PSYCHOTHERAPY
ALTERNATIVE
MEDICINE
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to psychotherapy. At the conclusion of this chapter, we will provide additional sources.
The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “psychotherapy” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •
Discussing Complementary Therapies With Cancer Patients: What Should We Be Talking About? (editorial) Source: Journal of Clinical Oncology. 18(3): 2501-2504. July 2000. Summary: This editorial discusses the use of complementary and alternative medicine (CAM) by cancer patients and the implications for oncologists. The author highlights findings from two recent studies of CAM use among cancer patients. In the study by M.A. Richardson and colleagues (see AMJA02604), 83 percent of patients across a spectrum of malignancies and disease stages reported using CAM, including 69 percent who used some modality other than spirituality or psychotherapy. In the study by H. Boon and colleagues (see AMJA02603), the prevalence rate for CAM use among breast cancer patients was 67 percent. In both studies, cancer patients used a large number of CAM therapies and did so to improve quality of life, feel hopeful, gain control, and
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obtain relief from symptoms or side effects of conventional treatment. However, the available data suggest that patients are using CAM in conjunction with, not instead of, standard oncologic care. The author concludes that oncologists should directly ask patients if they are using CAM and what they expect from the CAM therapy. Oncologists also need to better address patients' needs for management of pain, anxiety or mood disorders, sleep disturbance, and other symptoms, and to offer patients greater empowerment and choice by encouraging them to participate more directly in the clinical decision-making process. The article has 19 references.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to psychotherapy and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “psychotherapy” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to psychotherapy: •
"Picture that". Introducing elementary school children to nursing. Author(s): Hough J. Source: Imprint. 2003 September-October; 50(4): 71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14669743
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Cognitive-existential group psychotherapy for women with primary breast cancer: a randomised controlled trial. Author(s): Kissane DW, Bloch S, Smith GC, Miach P, Clarke DM, Ikin J, Love A, Ranieri N, McKenzie D. Source: Psycho-Oncology. 2003 September; 12(6): 532-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12923794
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Developments in treatment of anxiety disorders: psychotherapy, pharmacotherapy, and psychosurgery. Author(s): Balon R. Source: Depression and Anxiety. 2004; 19(2): 63-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15022141
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Efficacy vs. effectiveness research in psychotherapy: implications for clinical hypnosis. Author(s): Amundson JK, Alladin A, Eamon G. Source: Am J Clin Hypn. 2003 July; 46(1): 11-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12894928
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Fighting for life: a qualitative analysis of the process of psychotherapy-assisted selfhelp in patients with metastatic cancer. Author(s): Cunningham AJ, Phillips C, Stephen J, Edmonds C. Source: Integrative Cancer Therapies. 2002 June; 1(2): 146-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14664740
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Reflections on relevance: Psychotherapy and Psychosomatics in 2003. Author(s): Balon R. Source: Psychotherapy and Psychosomatics. 2004 January-February; 73(1): 5-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665790
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Technology in psychotherapy: an introduction. Author(s): Newman MG. Source: Journal of Clinical Psychology. 2004 February; 60(2): 141-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14724921
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The modern confessional: Anglo-American religious groups and the emergence of lay psychotherapy. Author(s): Falby A. Source: Journal of the History of the Behavioral Sciences. 2003 Summer; 39(3): 251-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12891692
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Theoretical model of psychotherapy: Eastern Asian-Islamic women with mental illness. Author(s): Carter DJ, Rashidi A. Source: Health Care for Women International. 2003 May-June; 24(5): 399-413. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12916145
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to psychotherapy; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Anxiety and Panic Attacks Source: Prima Communications, Inc.www.personalhealthzone.com Breast Cancer Source: Healthnotes, Inc.; www.healthnotes.com Breast Cancer Source: Integrative Medicine Communications; www.drkoop.com Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Healthnotes, Inc.; www.healthnotes.com Depression Source: Integrative Medicine Communications; www.drkoop.com Eating Disorders Source: Healthnotes, Inc.; www.healthnotes.com Hypochondriasis Source: Integrative Medicine Communications; www.drkoop.com Impotence Source: Prima Communications, Inc.www.personalhealthzone.com
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Irritable Bowel Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.drkoop.com Proctitis Source: Integrative Medicine Communications; www.drkoop.com Prostatitis Source: Healthnotes, Inc.; www.healthnotes.com PTSD Source: Integrative Medicine Communications; www.drkoop.com Rectal Inflammation Source: Integrative Medicine Communications; www.drkoop.com Sexual Dysfunction Source: Integrative Medicine Communications; www.drkoop.com Stress Source: Integrative Medicine Communications; www.drkoop.com Tension Headache Source: Healthnotes, Inc.; www.healthnotes.com •
Alternative Therapy A Course in Miracles Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Archetypal Psychology Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Arhatic Yoga Alternative names: Arhatic Yoga System Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html
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Art Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,671,00.html Astrological Counseling Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Biofeedback Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Biological Archeology Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html Body Oriented Emotional Release Psychotherapy Alternative names: Neo-Reichian emotional release work Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html Body-Centered Psychotherapy Alternative names: body-oriented psychotherapy body psychotherapy direct bodycontact psychotherapy humanistic body psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html BodyMind Centering Alternative names: BodyMind Centering Technique Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html BodyWisdom Alternative names: BodyWisdom Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html Bodywork Alternative names: Bodywork Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html
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Chi-therapy Alternative names: Gestalt energy work Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Combine Spirituality and Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Confluent Somatic Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Core Energetics Alternative names: Core Energetic Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Emotional-kinesthetic Psychotherapy Alternative names: EKP Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/e.html Energy Therapies Alternative names: energy psychotherapy Energy Therapies/Psychology energy therapy energy therapy methods Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/e.html Eutony Alternative names: eutonic therapy Eutony therapy Eutony training Eutony treatment Gerda Alexander method Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/e.html Focusing Alternative names: Focusing-Oriented Psychotherapy Focusing-Oriented Therapy Focusing Process Focusing Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/f.html
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Gestalt Therapy Alternative names: Gestalt Gestalt Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/g.html Hakomi Alternative names: Hakomi body-centered psychotherapy Hakomi Body-Mind Process Hakomi Body-Oriented Psychotherapy Hakomi Method Hakomi Method of Body/Mind Therapy Hakomi Therapy Hakomi work Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/h.html Hakomi Integrative Somatics Alternative names: formerly Hakomi Bodywork Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/h.html Holistic Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/h.html Inner Child Work Alternative names: Inner Child inner child therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/i.html Inner Self Healing Process Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/i.html Integral Counseling Psychology Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/i.html Kulkarni Naturopathy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/k.html Meta-therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/m.html
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Naturopathy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,722,00.html Organismic Psychotherapy Alternative names: humanistic body psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/o.html Passion-for-Life Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Past-Life Therapy Alternative names: Past Life Regression Therapy PLRT past lives therapy regression therapy transformational therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Pesso Boyden System/Psychomotor Alternative names: Pesso System psychomotor therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Phoenix Rising Yoga Therapy Alternative names: Phoenix Rising Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Pranic Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Primal Therapy Alternative names: primal scream therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Process Psychology Alternative names: Dreambody approach Dreambody Work process oriented psychology Process-Oriented Psychotherapy Process Work Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html
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Psychospiritual Holistic Healing Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Psychosynthesis Alternative names: psychosynthesis therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Radiance Breathing Meditation Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Radiance Prenatal Process Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Radix Alternative names: Neo-Reichian Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Reichian Therapies Alternative names: Reichian-based therapies Reichian-oriented therapies Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Repressed Memory Therapy Alternative names: RMT Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Rubenfeld Synergy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Scientology Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Self Expansion Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D.
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Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Shamanic Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Somatic Therapy Alternative names: somatic disciplines somatic methods somatics somatic techniques somatic therapies Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Somatoemotional Release Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Soul-centered Psychology Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Soul-Centered Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Spirit Releasement Therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Spiritual Psychotherapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Transformation-Oriented Bodywork Alternative names: transformational bodywork Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/t.html •
Herbs and Supplements Eleuthero Alternative names: Siberian Ginseng, Eleuthero; Acanthopanax/Eleutherococcus senticosus Rupr. & Maxim. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
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Kava Source: Prima Communications, Inc.www.personalhealthzone.com Zingiber Alternative names: Ginger; Zingiber officinale Roscoe Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON PSYCHOTHERAPY Overview In this chapter, we will give you a bibliography on recent dissertations relating to psychotherapy. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “psychotherapy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on psychotherapy, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Psychotherapy ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to psychotherapy. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Comparative Analysis of the Philosophical Origins of Major Theories of Counseling and Psychotherapy. by McNamara, Thomas Edward, PhD from University of Colorado at Boulder, 1977, 332 pages http://wwwlib.umi.com/dissertations/fullcit/7724264
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A Comparison of Concepts of the Healthy Personality in Contemporary Social and Phenomenological Psychotherapy and Representative Contemporary Theology by Wanzek, Robert Paul, PhD from The University of North Dakota, 1971, 126 pages http://wwwlib.umi.com/dissertations/fullcit/7301574
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A Comparison of Male and Female Professionals and Nonprofessionals Evaluations of the Use of Touch in Psychotherapy by Suiter, Robert Lawrence, PhD from Kansas State University, 1983, 112 pages http://wwwlib.umi.com/dissertations/fullcit/8328134
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A Comparison of the Effect of Two Forms of Group Psychotherapy on the Treatment of Marital Discord by Ziegler, Joseph Stephen, PhD from University of Pittsburgh, 1972, 142 pages http://wwwlib.umi.com/dissertations/fullcit/7313262
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A Comparison of the Effectiveness of Psychotherapy and Behaviour Therapy for Incarcerated Sex Offenders by Williams, Sharon M; PhD from Queen's University at Kingston (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK46415
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A Comparison of the Relative Effectiveness of Systematic Desensitization, Rational Emotive and Client-Centered Group Psychotherapy in the Reduction of Interpersonal Anxiety in Introverts and Extroverts by Di Loreto, Adolph O., PhD from Michigan State University, 1969, 326 pages http://wwwlib.umi.com/dissertations/fullcit/7009521
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A Controlled Study of Effectiveness and Patient Suitability for Short-Term Group Psychotherapy by McCallum, Mary; PhD from McGill University (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL57259
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A Critical Analysis of the Claim That Some Judgments of Psychotherapy Are Moral Judgments by Mullett, Sheila Ann Mason, PhD from Purdue University, 1972, 223 pages http://wwwlib.umi.com/dissertations/fullcit/7230933
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A Cross-Cultural Study of 'The Conference of the Birds': The Shaikh/Disciple and Therapist/Patient Relationship in Sufism and Psychotherapy by Jurich, Jack, PhD from New York University, 1998, 255 pages http://wwwlib.umi.com/dissertations/fullcit/9819778
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A Definitive Outcome Study of a Group Psychotherapy Program with Probationed Sex Offenders by Roether, Hermann A., PhD from University of Pennsylvania, 1972, 267 pages http://wwwlib.umi.com/dissertations/fullcit/7225662
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A Descriptive Study: Selection and Use of Art Mediums by Sexually Abused Adults: Implications in Counseling and Art Psychotherapy by Clukey, Frances Harlow; PhD from University of Maine, 2003, 344 pages http://wwwlib.umi.com/dissertations/fullcit/3087700
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A Descriptive Survey of Psychotherapy in Kurdistan and Western Cultures (Iran) by Gol-Anbar, Jalil, PhD from United States International University, 1983, 187 pages http://wwwlib.umi.com/dissertations/fullcit/8315098
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A Disease of One's Own: Psychotherapy, Addiction, and the Emergence of 'CoDependency' by Rice, John Steadman, PhD from University of Virginia, 1992, 552 pages http://wwwlib.umi.com/dissertations/fullcit/9237568
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A Factor Analytic Exploration of Connectedness and Separateness in the Marital Psychotherapy Literature by Aaronson, Jon Philip, PhD from The University of Wisconsin - Madison, 1986, 358 pages http://wwwlib.umi.com/dissertations/fullcit/8618254
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A Film Orientation for Psychotherapy Clients: Effects on Expectations, Anxiety, and Attendance by Beebe, Bradford Michael, PhD from University of Louisville, 1992, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9230083
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A Hermeneutic Investigation of Rogerian Empathy (Psychotherapy) by Kaiser, Kenneth Kim, EdD from University of San Francisco, 1990, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9325410
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A Jungian Interpretation of Feminine Development in 'The Girl without Hands' and Its Implications for Psychotherapy (GRIMM) by Copeland, Camille C., PhD from University of Pittsburgh, 1989, 322 pages http://wwwlib.umi.com/dissertations/fullcit/8921393
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A Longitudinal Study of Patient Perspective of the Curative Factors in Group Psychotherapy (Group Therapy, Group Work) by Brady, Judy, DSW from The University of Utah, 1984, 114 pages http://wwwlib.umi.com/dissertations/fullcit/8508668
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A Meta-Analysis of Component Studies in Counseling and Psychotherapy by Ahn, Hyun-Nie; PhD from The University of Wisconsin - Madison, 2001, 68 pages http://wwwlib.umi.com/dissertations/fullcit/3020859
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A Multidimensional Scaling Approach to the Study of Psychotherapy Strategies by Buser, Samuel Jackson, PhD from The University of Texas at Austin, 1986, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8700173
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A Qualitative Process of a Negative Outcome in Psychotherapy: The Suicide of Mr. X (X, Mr.) by Wildman, Julie J., PhD from State University of New York at Albany, 1994, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9504086
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A Socio-Cultural Analysis of the Ethical Standards of Care in Psychotherapy Professions in the United States: Psychiatry, Psychology and Social Work by Hazen, Cynthia Diane; PhD from Boston University, 2002, 411 pages http://wwwlib.umi.com/dissertations/fullcit/3031576
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A Spectrum of Approaches to Spirituality in Secular Psychotherapy: A Qualitative Study of Minnesota Licensed Psychologists by Carlson, Beth Ann, PhD from University of Minnesota, 1997, 227 pages http://wwwlib.umi.com/dissertations/fullcit/9734669
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A Study of Alienation among Students Receiving Counseling and Psychotherapy at a University Mental Health Clinic. by Romeo, William Deren, EdD from University of Georgia, 1975, 89 pages http://wwwlib.umi.com/dissertations/fullcit/7602260
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A Study of Changes in Schematic Apperception As a Function of Psychotherapy (Semantic Meaning, Counseling) by Cable, Robert Reuter, EdD from Idaho State University, 1984, 143 pages http://wwwlib.umi.com/dissertations/fullcit/8429710
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A Study of Client, Therapist, and Clinic Variables Associated with Treatment Rejection and Dropout in Outpatient Psychotherapy by Toia, Nicholas, PhD from University of Pittsburgh, 1989, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9010065
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A Study of Clients' Self-Reports of Their Experience of Personal Change in Direct Practice (Social Work, Symbolic Interaction, Phenomenology, Cognitive Psychotherapy) by Kunin, Roberta Shine, PhD from Case Western Reserve University, 1985, 329 pages http://wwwlib.umi.com/dissertations/fullcit/8601953
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A Study of Clinical Approaches to Long-Term Psychotherapy of Latency-Aged Children of Divorced and Separated Parents by Rappaport, David Morris; PhD from New York University, 2001, 232 pages http://wwwlib.umi.com/dissertations/fullcit/3008630
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A Study of Co-Therapy in Couple Psychotherapy by Siddall, Lawrence B., EdD from University of Massachusetts, 1981, 170 pages http://wwwlib.umi.com/dissertations/fullcit/8201400
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A Study of Group Psychotherapy Using Resocialization Counseling with Socially Withdrawn Institutionalized Geriatric Patients. by Kiley, Richard Harding, Jr., PhD from The University of Southern Mississippi, 1976, 104 pages http://wwwlib.umi.com/dissertations/fullcit/7705953
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A Study of Self-Perceived Intimacy, Behavioral Intimacy and Control Attitudes in the Initial Psychotherapeutic Interview (Psychotherapy) by Andreasson, Karl-Erik Johan, PhD from Temple University, 1993, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9316451
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A Study of the Attitudes toward Psychotherapy of American German Jews and Selected Groups of American East European Jews. by Shandler, Melvin Alan, DSW from The Catholic University of America, 1979, 218 pages http://wwwlib.umi.com/dissertations/fullcit/7918580
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A Study of the Correlation between Adult Psychotherapy Clients' Shame Affect and Unilateral Termination by Feldman, Philip B., PhD from Rutgers the State University of New Jersey - New Brunswick, 1996, 146 pages http://wwwlib.umi.com/dissertations/fullcit/9711048
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A Study of the Effects of Psychotherapy on Client-Perceived Power As a Dimension of Personality. by Simmermon, Robert David, EdD from Ball State University, 1976, 114 pages http://wwwlib.umi.com/dissertations/fullcit/7707317
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A Study of the Relative Effectiveness of Kinetic Psychotherapy with a Group of School-Aged Boys. by Schachter, Robert Stephen, EdD from Boston University School of Education, 1975, 163 pages http://wwwlib.umi.com/dissertations/fullcit/7602361
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A Study of the Working Alliance in Psychotherapy by Adler, Jean Vera; EdD from The University of British Columbia (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL47090
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A Survey of Counseling and Psychotherapy Supervisors to Identify Supervisor Skills. by Brewer, William David, PhD from The Florida State University, 1976, 350 pages http://wwwlib.umi.com/dissertations/fullcit/7629425
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A Survey of Counseling/Psychotherapy of Minority Students in Three Inner-City High Schools in Seattle, Washington. by Jones, Albert Lee, PhD from University of Washington, 1974, 133 pages http://wwwlib.umi.com/dissertations/fullcit/7504000
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A Survey Study of Drug and Non-drug Managements for the Hyperactive Child: Treatment Preferences of Parents, Teachers, Special Education Personnel and Physicians (Diet, Psychotherapy, Multidisciplinary, Behavior Modification) by Morris, George E., EdD from Brigham Young University, 1985, 102 pages http://wwwlib.umi.com/dissertations/fullcit/8522586
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A Synthesis of Moltmann's Archetypal Christology with Jung's God-image Archetype: A Theological Psychology for Pastoral Counseling and Psychotherapy (Juergen Moltmann, Carl Jung) by Camacho, Haroldo Samuel, PhD from School of Theology at Claremont, 1991, 209 pages http://wwwlib.umi.com/dissertations/fullcit/9135028
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A Task Analytic Approach to the Events of Psychotherapy by Greenberg, Leslie S; PhD from York University (Canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK26630
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A Validity and Reliability Study of Value Systems Analysis in Counseling and Psychotherapy. by Rishe, Harvey Lawrence, PhD from University of North Texas, 1977, 187 pages http://wwwlib.umi.com/dissertations/fullcit/7719679
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Acting and Psychotherapy: Applications of Kinetic and Imaging Techniques to Actor Training, an Empirical Study by Halperin, Ellen Irene, PhD from University of Oregon, 1988, 305 pages http://wwwlib.umi.com/dissertations/fullcit/8825743
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Adolescents' Willingness to Be Self-Disclosing in Psychotherapy by Roma, Diane Goldberg, DSW from Adelphi University, School of Social Work, 1987, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8725289
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African American Baptists' Attitudes toward Psychotherapy by McKindley-Alvarez, Carole Lynn; PsyD from The Wright Institute, 2003, 61 pages http://wwwlib.umi.com/dissertations/fullcit/3084493
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American Indian Teachings As a Philosophical Base for Counseling and Psychotherapy. by Zychowicz, Marlene Jane, EdD from Northern Illinois University, 1975, 100 pages http://wwwlib.umi.com/dissertations/fullcit/7604896
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An Analysis of an Atheoretical System of Psychotherapy: Ericksonian Approaches to Psychotherapy by Williams, Joseph Adrian, PhD from University of Illinois at UrbanaChampaign, 1982, 298 pages http://wwwlib.umi.com/dissertations/fullcit/8218589
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An Analysis of Therapeutic Work Behavior for Selection and Composition in Group Psychotherapy by Connelly, Jacquelyn Lois; PhD from McGill University (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL20828
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An Analysis of Variables Related to Client Dropout from Psychotherapy in a Community Mental Health Setting by TAYLOR, RUSSELL G., PhD from University of Illinois at Urbana-Champaign, 1994, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9512570
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An Application of a Theory of Process in Client-centered Psychotherapy to Counseling by Albright, Darryl R., EdD from Indiana University, 1967, 189 pages http://wwwlib.umi.com/dissertations/fullcit/6804701
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An Application of Taoist Thought in Short Term Psychotherapy by Knoblauch, David Leslie, EdD from Western Michigan University, 1982, 108 pages http://wwwlib.umi.com/dissertations/fullcit/8306531
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An Attempt to Modify Counselor Characteristics Which Have Significant Effects on Psychotherapy for Drug Users. by Matthews, Francis M., EdD from Temple University, 1973, 108 pages http://wwwlib.umi.com/dissertations/fullcit/7401811
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An Ethnic Comparison of the Ranked Value of Yalom's Therapeutic Factors among Chemically Dependent Incarcerated Adult Males in Group Psychotherapy by Burtenshaw, Roni P., PhD from St. Mary's University (San Antonio), 1997, 135 pages http://wwwlib.umi.com/dissertations/fullcit/9724039
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An Evaluation of Children's Services in Community Mental Health Centers (Psychotherapy, Outcomes) by Fabrick, Lewis A., II, PhD from University of Florida, 1984, 169 pages http://wwwlib.umi.com/dissertations/fullcit/8429206
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An Exploration of Change: Investigating the Experiences of Psychotherapy Trainees by Bertolino, Robert Anthony, PhD from Saint Louis University, 1998, 198 pages http://wwwlib.umi.com/dissertations/fullcit/9822853
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An Exploration of the Clinical Learning Process in a Time-Limited Psychotherapy Training Program by Fisher, Marybelle, PhD from Smith College School for Social Work, 1981, 107 pages http://wwwlib.umi.com/dissertations/fullcit/8129441
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An Historical Investigation of the Training Programs in Counseling and Psychotherapy in American Higher Education: 1880-1941 by Ewing, James Walter, PhD from Saint Louis University, 1972, 239 pages http://wwwlib.umi.com/dissertations/fullcit/7223924
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An Inquiry into the Role of Existential Philosophy in the Practice of Existential Psychotherapy by Bily, Susan Jean; PsyD from Alliant International University, San Diego, 2003, 305 pages http://wwwlib.umi.com/dissertations/fullcit/3073423
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An Integrative Approach to Expressive Psychotherapy: a Multiple Case Study Design of Preadolescent Identity Conflict by Zeller, Joanne Rae; PhD from Saybrook Graduate School and Research Center, 2003, 145 pages http://wwwlib.umi.com/dissertations/fullcit/3090213
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An Investigation into Interpersonal Strategies of Individual Psychotherapy by Cilliers, Nicoleen Swart, PhD from University of South Africa (South Africa), 1978 http://wwwlib.umi.com/dissertations/fullcit/f2152726
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An Investigation into the Compatibility of Existential-Humanistic Psychotherapy and Buddhist Meditation by Bacher, Paula Green, EdD from Boston University School of Education, 1981, 209 pages http://wwwlib.umi.com/dissertations/fullcit/8126672
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An Investigation of the Concepts of Rogerian Psychotherapy with Implication for Adult Educational Application in Spiritual Gifts by Cleary, Eugenia E.; EdD from New Orleans Baptist Theological Seminary, 1979, 403 pages http://wwwlib.umi.com/dissertations/fullcit/3089268
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An Investigation of the Effects of Focusing Ability upon Outcome in Group Psychotherapy. by Zuboy, John Walter, EdD from University of Northern Colorado, 1978, 95 pages http://wwwlib.umi.com/dissertations/fullcit/7910322
Dissertations 99
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An Object Relations Theoretical Contribution to the Understanding of the Psychopathology and Intensive Psychotherapy of the Borderline Personality Organization by SEINFELD, JEFFREY SETH, PhD from New York University, 1987, 217 pages http://wwwlib.umi.com/dissertations/fullcit/8803933
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An Outcome Study of Psychotherapy with Preschool Children. by CAYTON, JAMES DOUGLAS, PhD from The University of Utah, 1978, 201 pages http://wwwlib.umi.com/dissertations/fullcit/7905081
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Analysis of Interaction Sequences As a Method of Evaluating Marital Group Psychotherapy. by MCCARRICK, ANNE KNETTLES, PhD from University of Maryland College Park, 1978, 97 pages http://wwwlib.umi.com/dissertations/fullcit/7906642
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And Therapist Makes Three: the Experience of Having a Significant Other in Psychotherapy by Brown, Alexander Sloane; PhD from Institute for Clinical Social Work (Chicago), 2003, 154 pages http://wwwlib.umi.com/dissertations/fullcit/3107346
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Approaches to Counseling/psychotherapy: a Selected Examination for School Counselors by CUNNINGHAM, LOUIS MORRIS, PhD from The Ohio State University, 1969, 225 pages http://wwwlib.umi.com/dissertations/fullcit/7014002
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Appropriate and Inappropriate Uses of Humor in Psychotherapy As Perceived by Certified Reality Therapists: a Delphi Study (Delphi Method) by THOMSON, BRUCE ROBERT, PhD from University of Georgia, 1985, 333 pages http://wwwlib.umi.com/dissertations/fullcit/8606095
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Art As Visual Language for Awareness of Self (nature, Art Psychotherapy, Spiritual) by WOODWARD, CRYSTAL, PhD from The Union for Experimenting Colleges and Universities, 1984, 279 pages http://wwwlib.umi.com/dissertations/fullcit/8500805
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Aspects of Psychotherapy: Emotional Experiences and Personal Development by Lundblad, Suzanna Birgit Gunilla; Fildr from Goteborgs Universitet (Sweden), 2003, 60 pages http://wwwlib.umi.com/dissertations/fullcit/f474321
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Assessing Self Development Through Object Representational Descriptions in a Psychotherapy Group of Women with Borderline Personality Organization by REDINGER, BARBARA PHELPS RAINWATER, PhD from Smith College School for Social Work, 1995, 121 pages http://wwwlib.umi.com/dissertations/fullcit/9600358
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Assessment of a Therapist's Strategic Processing of Psychotherapy a Multivariate Single Case Procedure for Supervision by Gragg, Marcia N; PhD from University of Windsor (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL29308
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Attachment Behavior and Psychotherapy Supervision by Foster, Joel Timothy; PhD from University of Kansas, 2002, 307 pages http://wwwlib.umi.com/dissertations/fullcit/3082649
100 Psychotherapy
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Attending to the Spiritual Lives of Clients in Psychotherapy: an Integrative Approach to Treatment by Hammer, Dean Edward; PsyD from Antioch University/new England Graduate School, 2003, 106 pages http://wwwlib.umi.com/dissertations/fullcit/3077540
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Attitudinal Positions of Clients in Group Psychotherapy: a Function of Interpersonal Similarity and Message Type. by INGLE, GEORGE BALLARD, JR., DSW from Tulane University, School of Social Work, 1976, 133 pages http://wwwlib.umi.com/dissertations/fullcit/7711245
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Ayn Rand's Objectivist Philosophy, Psychology, and Psychotherapy Implications for Therapy. by DAVISSON, GARY, PhD from The Florida State University, 1974, 309 pages http://wwwlib.umi.com/dissertations/fullcit/7512634
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Being and Becoming: a Comparison of Client-centered and Existential Psychotherapy by ZUKER, RAYMOND FREDERICK, PhD from Duke University, 1982, 170 pages http://wwwlib.umi.com/dissertations/fullcit/8218869
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Belief and Psychotherapy in Banaras by BLACKFORD, FRANK ROBERTSON, JR., PhD from University of Pennsylvania, 1979, 367 pages http://wwwlib.umi.com/dissertations/fullcit/8009387
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Buddhist Moments in Psychotherapy by Daya, Roshni; PhD from University of Calgary (Canada), 2001, 148 pages http://wwwlib.umi.com/dissertations/fullcit/NQ64806
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Building Somatic Resources: the Theory and Practice of Sensorimotor Psychotherapy in the Treatment of Trauma by Ogden, Pat; PhD from Union Institute and University, 2003, 253 pages http://wwwlib.umi.com/dissertations/fullcit/3081058
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Challenges in a Psychotherapy Group: Reflections of Direct and Indirect Discourse Strategies by KRAINER, ELIZABETH ANNE, PhD from Stanford University, 1988, 277 pages http://wwwlib.umi.com/dissertations/fullcit/8826172
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Change and the Therapeutic Process: a Naturalistic Study of the Resolution of Chronic Non-attendance in Adolescents (psychotherapy, Truancy) by NEIWEEM, BERNARD MICHAEL, EdD from Northern Illinois University, 1986, 208 pages http://wwwlib.umi.com/dissertations/fullcit/8625566
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Change in Level of Defense: Its Relationship to Therapist Intervention and Therapy Outcome in Short-term Dynamic Psychotherapy by WINSTON, BEVERLY GREENBERG, PhD from New York University, 1993, 217 pages http://wwwlib.umi.com/dissertations/fullcit/9333711
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Changes in the Self-concept and Value System of Sensitizers, Neutrals, and Repressors: a Contemporary Counseling-psychotherapy Analogue Study by GLOVINSKY, MARVIN ALAN, PhD from The University of Utah, 1972, 187 pages http://wwwlib.umi.com/dissertations/fullcit/7222723
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Children's Conceptualization of Psychotherapy: a Comparison of Internalizing and Externalizing Syndromes by CUNNINGHAM, SUSAN EILEEN, PhD from Boston College, 1993, 132 pages http://wwwlib.umi.com/dissertations/fullcit/9329280
Dissertations 101
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Chinese and American Perceptions of Rogers', Perls', and Ellis' Approaches to Psychotherapy by LIN, CHIA-HSIN, PhD from University of Kentucky, 1986, 209 pages http://wwwlib.umi.com/dissertations/fullcit/8715934
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Christianity and Strong Values in Psychotherapy: Clinical Judgment and Supervision at University Counseling Centers by Hicks, Mitchell Wayne; PhD from University of Cincinnati, 2003, 76 pages http://wwwlib.umi.com/dissertations/fullcit/3103317
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Client Characteristics As Predictors of Early Response to Psychotherapy in a University Counseling Center by Haas, Eric C.; PhD from The University of Utah, 2003, 100 pages http://wwwlib.umi.com/dissertations/fullcit/3090785
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Client Self-exploration and Humor in Psychotherapy by PINEGAR, PAUL WAYNE, PhD from Kent State University, 1983, 99 pages http://wwwlib.umi.com/dissertations/fullcit/8400978
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Client-defined Problems and Problem Ratings As a Basis for Measuring Psychotherapy Outcome by ORME, JOHN GREGORY, PhD from Washington University, 1983, 273 pages http://wwwlib.umi.com/dissertations/fullcit/8402208
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College Students' Attitudes Regarding Confidentiality in Psychotherapy with Hivpositive Clients Who Are Engaging in High Risk Sexual Behavior (immune Deficiency) by FITZGERALD, CATHERINE ANN, PhD from Pacific Graduate School of Psychology, 1994, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9506514
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Communication Systems in Psychotherapy : an Empirical Investigation into Treatment Ideologies of Patients and Therapists by Cox, Beverlee Ann; PhD from Simon Fraser University (Canada), 1976 http://wwwlib.umi.com/dissertations/fullcit/NK35897
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Communication: the Social Matrix of Supervision of Psychotherapy by MCCORMICK, BRADFORD ROBERT, EdD from Columbia University Teachers College, 1994, 252 pages http://wwwlib.umi.com/dissertations/fullcit/9511056
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Complementarity and Antidotes in Psychotherapy an Interpersonal Conceptualization of Therapeutic Interactions by Tasca, Giorgio Angelo; PhD from The University of Saskatchewan (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL53076
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Conceptualizing the Place of Spirituality in Psychotherapy: Implications for Professional Education (social Work Education) by HAMMOND, RICHARD ALLON, PhD from Case Western Reserve University, 1991, 402 pages http://wwwlib.umi.com/dissertations/fullcit/9137069
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Confidentiality in the Professions of Law, Medicine, Psychotherapy and in the Roman Catholic Church by ROBINSON, BAMBI ELIZABETH STUART, PhD from The Ohio State University, 1988, 216 pages http://wwwlib.umi.com/dissertations/fullcit/8820343
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Consciousness Raising Groups for Women: Implications of Paulo Freire's Theory of Critical Consciousness for Psychotherapy and Education. by BAILEY, JANET PERRY, EdD from University of Massachusetts, 1977, 155 pages http://wwwlib.umi.com/dissertations/fullcit/7713773
102 Psychotherapy
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Continuance and Satisfaction in Outpatient Psychotherapy: an Exploration of Patient and Treatment Variables (psychotherapy, Attribution Theory) by MAVRIDES, GREGORY, DSW from Columbia University, 1990, 219 pages http://wwwlib.umi.com/dissertations/fullcit/9118612
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Contributions of Selected Feminist Theologians and Feminist Psychoanalytic Theorists to Pastoral Psychotherapy by DILLON, BONNY KAY, PhD from The Southern Baptist Theological Seminary, 1987, 170 pages http://wwwlib.umi.com/dissertations/fullcit/8805801
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Contributions to Pastoral Psychotherapy from George Macdonald and James Bugental (macdonald George, Bugental James) by GEELHOED, ROBERT KEITH, PhD from The Southern Baptist Theological Seminary, 1990, 334 pages http://wwwlib.umi.com/dissertations/fullcit/9125191
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Correlates between Effective Communication and Wellness in a Psychotherapy Group by ROBBINS, JAMES GAMBRELL, PhD from University of Colorado at Boulder, 1968, 98 pages http://wwwlib.umi.com/dissertations/fullcit/6904328
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Correlates of Reported Stress in Professional Situations: a Study of Trainees and Graduates of a Counseling Psychology Program (occupational, Supervision, Psychotherapy) by LERNER, JOAN RUTH, PhD from University of Pennsylvania, 1983, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8406688
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Critical Pastoral Reflection: an Analysis of Don S. Browning's Method As Applied to Strategic Interactional Family Psychotherapy (theology, Counseling, Correlational Method, Process Theism) by TOWNSEND, LOREN LLOYD, PhD from Graduate Theological Union, 1986, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8617044
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Cross-cultural Psychotherapy with Asian-american Clients: a Study of Psychotherapists' Achieving Styles and Their Implications in Psychotherapeutic Process by LU, YU-HWA EVA, PhD from The Claremont Graduate University and San Diego State University, 1992, 217 pages http://wwwlib.umi.com/dissertations/fullcit/9220604
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Cultural Identity, Worldview and Communication Style among Norwegianamericans: Implications for Counseling and Psychotherapy by Tonnessen, Lisa Marie; PhD from The University of Connecticut, 2001, 143 pages http://wwwlib.umi.com/dissertations/fullcit/3002677
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Culture and Self: a Study of Cultural Ideas in the Discourse of Five American Psychotherapy Patients by THICKSTUN, MARY SUSAN, PhD from University of California, San Diego, 1991, 265 pages http://wwwlib.umi.com/dissertations/fullcit/9130765
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Current Practices in General Hospital Group Psychotherapy by Farley, Patrick N., EdD from Virginia Polytechnic Institute and State University, 1998, 120 pages http://wwwlib.umi.com/dissertations/fullcit/9825655
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Death Anxiety and Psychotherapy: an Examination of Counselor Trainees' Reactions to Death-related Issues by Howze, Alisa Renee; PhD from Texas A&m University, 2001, 134 pages http://wwwlib.umi.com/dissertations/fullcit/3033796
Dissertations 103
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Degree of Choice in Clients' and Therapists' Language during Psychotherapy by McMullen, Linda M; PhD from The University of Saskatchewan (Canada), 1981 http://wwwlib.umi.com/dissertations/fullcit/NK49180
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Development of a Stratified Locus-of-control Scale and Its Use to Predict Resistance to Psychotherapy. by WHITMONT, ANDREW DOUGLAS, PhD from University of Washington, 1975, 160 pages http://wwwlib.umi.com/dissertations/fullcit/7617685
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Development of the Therapeutic Alliance in Cross-cultural Psychotherapy Dyads by Diaz, Nadia Macarena; PhD from New School University, 2003, 91 pages http://wwwlib.umi.com/dissertations/fullcit/3100865
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Dialogues at the Meeting Place of Psychotherapy and Spirituality: a Movement toward Integration by BODNAR, ANA, EdD from University of Toronto (Canada), 1992, 313 pages http://wwwlib.umi.com/dissertations/fullcit/NN78812
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Differences in Attitudes of Blacks and Whites toward Psychotherapy and Counseling by SUEL, GEORGE NAMEN, JR., EdD from University of Southern California, 1984 http://wwwlib.umi.com/dissertations/fullcit/f2133493
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Differential Perceptions of the Counselor As a Function of the Accuracy and Relevance of the Counselor's Recall of Detail from the Client's Narrative (counselor Memory, Memory in Psychotherapy) by WHITE, THOMAS BARNETT, PhD from The University of Utah, 1986, 108 pages http://wwwlib.umi.com/dissertations/fullcit/8623896
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Distant Intercessory Prayer As an Adjunct to Psychotherapy with Depressed Outpatients: a Small-scale Investigation by Connerley, Robert Clyde; PhD from Union Institute and University, 2003, 119 pages http://wwwlib.umi.com/dissertations/fullcit/3093342
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Dropout from Community-based, Hiv-related Psychotherapy: the Influence of Health Beliefs and Perceptions of Stigma by Reece, Michael Don; PhD from University of Georgia, 2000, 157 pages http://wwwlib.umi.com/dissertations/fullcit/9984195
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Dropping Out of Treatment in the 1980's: Factors Associated with Adult Client Continuance and Discontinuance in Outpatient Psychotherapy by COOMBS, MARY M., PhD from Rutgers the State University of New Jersey - New Brunswick, 1986, 205 pages http://wwwlib.umi.com/dissertations/fullcit/8704056
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Effects of a Structured Program about Psychotherapy on Low Income Psychiatric Inpatients by MIDGETTE, THOMAS EARL, PhD from Michigan State University, 1988, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9012032
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Effects of a Video-taped Psychotherapy Preparation Program for Parents of Identified Patients upon Initial Evaluation Attendance among Hispanic Families by JORGE, JOSE ARMANDO, PhD from United States International University, 1990, 120 pages http://wwwlib.umi.com/dissertations/fullcit/9024233
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Effects of Client- and Therapist-generated Metaphor on the Psychotherapy Process by Deger, Maureen Catherine, PhD from Arizona State University, 1999, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9929362
104 Psychotherapy
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Effects of Privileged Communications Law on Perceived Willingness to Disclose in Psychotherapy by Marsh, Jennifer Evans; PhD from Mcp Hahnemann University, 2001, 184 pages http://wwwlib.umi.com/dissertations/fullcit/3029678
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Effects of Session Frequency and Session Duration on Process and Outcome in Short Term Time-limited Psychotherapy by Caillier, Paul M; PhD from The University of Manitoba (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK47191
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Effects of Written Role Preparation on Attendance in Outpatient Psychotherapy by PALMER, SYDNEY NED, PhD from Arizona State University, 1979, 84 pages http://wwwlib.umi.com/dissertations/fullcit/8008582
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Efficacy of Cognitive Therapy for Adolescent Depression and the Relationship of Empathy to Outcome (psychotherapy) by BRENT, RICHARD P., EdD from The University of Rochester, 1987, 166 pages http://wwwlib.umi.com/dissertations/fullcit/8705919
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Engaging the Immediate: Applying Kierkegaard's Theory of Indirect Communication to the Practice of Psychotherapy by RAMSLAND, KATHERINE M., PhD from Rutgers the State University of New Jersey - New Brunswick, 1984, 180 pages http://wwwlib.umi.com/dissertations/fullcit/8507146
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Evaluating Compliance with Bipolar Disorder Patients Receiving Lithium and Psychotherapy Whose Treatment Regimen Is Monitored by Clinical Social Workers Trained in Psychopharmacology by TROY, CHARLES MCGREGOR, II, DSW from Boston College, 1988, 300 pages http://wwwlib.umi.com/dissertations/fullcit/8904212
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Evaluation of an Intensive Outpatient Psychotherapy Program for Delinquent, Substance-abusing Adolescents by Terry, Barbara Croft, PhD from The University of Utah, 1998, 251 pages http://wwwlib.umi.com/dissertations/fullcit/9913112
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Existential Group Psychotherapy with Mentally Retarded Adults. by DEAL, GRADY ALLEN, PhD from University of Pittsburgh, 1976, 169 pages http://wwwlib.umi.com/dissertations/fullcit/7700689
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Experiences in Psychotherapy by GONZALES, HELEN IRENE, PhD from University of California, Los Angeles, 1986, 164 pages http://wwwlib.umi.com/dissertations/fullcit/8606458
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Experiencing and Emotional Expression in Psychotherapy: an Investigation of Two In-session Client Processes by Rogan, Kieron M.; PhD from Mcgill University (Canada), 2001, 207 pages http://wwwlib.umi.com/dissertations/fullcit/NQ70137
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Experiencing Difficulty in Psychotherapy an Interpretative Study by Leibovitch, Howard Y; PhD from University of Alberta (Canada), 1987 http://wwwlib.umi.com/dissertations/fullcit/NL41079
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Experiencing Difficulty in Psychotherapy: an Interpretative Study by LEIBOVITCH, HOWARD YEHUDA, PhD from University of Alberta (Canada), 1987 http://wwwlib.umi.com/dissertations/fullcit/f364053
Dissertations 105
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Experiencing Scale Discrimination between More and Less Productive Psychotherapy Sessions by HAGER, DREVIS LEE, EdD from Western Michigan University, 1986, 171 pages http://wwwlib.umi.com/dissertations/fullcit/8703914
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Explaining Psychotherapist Satisfaction with Clinical Supervision of Psychotherapy: Impact of the Difference between Expressed and Perceived Psychotherapist Needs by HOFSTETTER, GREGORY PAUL, DED from Indiana University of Pennsylvania, 1992, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9217754
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Family Ideology As a Factor in Determining Spousal Reactions to a Partner's Psychotherapy by KAHN, CHARLOTTE, EdD from Columbia University, 1966, 91 pages http://wwwlib.umi.com/dissertations/fullcit/6610299
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Family Play Therapy: an Exploration of a Newly Emergent Field of Psychotherapy by EAKER-WEIL, BONNIE, PhD from The Union Institute, 1991, 90 pages http://wwwlib.umi.com/dissertations/fullcit/9204663
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Family-of-origin Acceptance of the Display of Emotion: Childhood Emotional Constraint and Becoming a Psychotherapy Client (family of Origin, Emotional Constraint) by WILSON, MARC ALAN, PhD from University of Minnesota, 1993, 139 pages http://wwwlib.umi.com/dissertations/fullcit/9317739
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Father-daughter Incest: a Sociocultural Analysis (social Work, Psychotherapy) by STORER, JOHN H., PhD from University of Missouri - Columbia, 1986, 171 pages http://wwwlib.umi.com/dissertations/fullcit/8625975
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Feedback in Short-term Married Couples Group Psychotherapy. by SOEKEN, DONALD RAY, PhD from University of Maryland College Park, 1978, 111 pages http://wwwlib.umi.com/dissertations/fullcit/7923804
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Feeding Identity: the Critical Hermeneutics of Contemporary Kleinian Psychoanalytically Oriented Psychotherapy from the Perspective of a Novice (melanie Klein) by Greco-Brooks, David M.; PhD from Duquesne University, 2003, 203 pages http://wwwlib.umi.com/dissertations/fullcit/3081610
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Feminist Perspectives of Individual Psychotherapy As an Agent of Social Change by Sawatzky, Sharon Ruth; EdD from University of Toronto (Canada), 2002, 233 pages http://wwwlib.umi.com/dissertations/fullcit/NQ69082
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Field Differentiation and Preferences for Two Approaches to Psychotherapy. by COFIELD, MICHAEL, PhD from Arizona State University, 1979, 94 pages http://wwwlib.umi.com/dissertations/fullcit/7911114
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Focusing in the Composing Process: the Development of a Theory of Rhetorical Invention Based on the Work in Psychotherapy of Eugene T. Gendlin by WHATLEY, CAROL ADAMS, EdD from Auburn University, 1983, 322 pages http://wwwlib.umi.com/dissertations/fullcit/8326350
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Forgiveness and Psychotherapy by STIPE, ANN MARIE, PhD from University of Maryland at Baltimore, 1995, 132 pages http://wwwlib.umi.com/dissertations/fullcit/9541558
106 Psychotherapy
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From Feelings to Words: Processes of Symbolization in Mother Infant Interaction and Their Implications for Adult Psychotherapy by Tingley, Elizabeth Catherine; PhD from City University of New York, 2003, 161 pages http://wwwlib.umi.com/dissertations/fullcit/3083712
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Functions of Meaning Clarification by Therapists in a Psychotherapy Group by JONES, BARBARA SCHINDLER, PhD from University of Colorado at Boulder, 1968, 110 pages http://wwwlib.umi.com/dissertations/fullcit/6904346
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Gay Affirmative Psychotherapy: a Phenomenological Study by Lebolt, Jonathan, PhD from The Union Institute, 1997, 254 pages http://wwwlib.umi.com/dissertations/fullcit/9805111
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Gender Role-related Behavior of Male Psychotherapy Patients (psychotherapy) by RAGLE, JOHN DOYLE, PhD from The University of Texas at Austin, 1993, 212 pages http://wwwlib.umi.com/dissertations/fullcit/9413578
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Group Psychotherapy for Wife Abusers: Client Variables That Affect Treatment Outcome by SHEPHERD, ROBERT H., PhD from University of Calgary (Canada), 1990, 287 pages http://wwwlib.umi.com/dissertations/fullcit/NN62000
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Guilt: a New Testament Exegesis with Implications for Psychotherapy by SLOAN, BOBBY NEIL, EdD from Northern Illinois University, 1988, 157 pages http://wwwlib.umi.com/dissertations/fullcit/8912527
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'healing Through Meeting': an Analysis of Martin Buber's Conception of the Psychotherapeutic Relationship in the Context of Existential Psychotherapy. by IVES, HOWARD ROLLIN, EdD from Boston University School of Education, 1975, 289 pages http://wwwlib.umi.com/dissertations/fullcit/7520955
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Heightened Sexual Attraction between Male and Female Co-leaders of Group Psychotherapy: a Training Issue in Group Psychotherapy by WHITE, ELEANOR MCNEELY, PhD from The University of North Carolina at Chapel Hill, 1985, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8527335
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Ideology, Leadership and Following : a Study in the Sociology of Group Psychotherapy by Wilmot, Marilyn Salutin; PhD from York University (Canada), 1973 http://wwwlib.umi.com/dissertations/fullcit/NK17149
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Ideology, Leadership and Following: a Study in the Sociology of Group Psychotherapy. by WILMOT, MARILYN SUSAN SALUTIN, PhD from York University (Canada), 1973 http://wwwlib.umi.com/dissertations/fullcit/f4547014
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Improving the Effects of Psychotherapy: the Use of Early Identification of Treatment Failure and Problem Solving Strategies in Outcome by Whipple, Jason L.; PhD from Brigham Young University, 2003, 111 pages http://wwwlib.umi.com/dissertations/fullcit/3056180
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Individual Psychotherapy with Deaf and Hard of Hearing Individuals: Perceptions of the Consumer by Cohen, Carol Barbara; PhD from Smith College School for Social Work, 2001, 257 pages http://wwwlib.umi.com/dissertations/fullcit/9995982
Dissertations 107
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Influence, Techniques, and Therapeutic Change: a Study of the Relative Efficacy of the Common Components in Psychotherapy by LYNAGH, IAN LAWRENCE, PhD from Oregon State University, 1982, 152 pages http://wwwlib.umi.com/dissertations/fullcit/8216649
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Influences on Personal Growth As Viewed by Former Psychotherapy Patients by Phillips, Jeffrey Robin; PhD from York University (Canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK64836
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Inner Healing and Secular Psychotherapy: Methodological Similarities (charismatic) by HARRISON, SANDRA MARLEEN, PhD from Emory University, 1987, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8716114
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Inner Working Models of Attachment, Experience of Psychotherapy, and Psychosocial Adjustment in Women with Early-stage Breast Cancer Receiving Postsurgical Follow-up Treatment by Exelbert, Renee Allison; PhD from New York University, 2003, 198 pages http://wwwlib.umi.com/dissertations/fullcit/3100789
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Insane Therapy: Case Study of the Social Organization of a Psychotherapy Cult (control) by AYELLA, MARYBETH FRANCINE, PhD from University of California, Berkeley, 1985, 259 pages http://wwwlib.umi.com/dissertations/fullcit/8524883
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Integrating Attachment Theory and Control Mastery Theory: Implications for Adult Psychotherapy by Walthall, Amy Dian; PsyD from The Wright Institute, 2003, 179 pages http://wwwlib.umi.com/dissertations/fullcit/3084477
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Integrating Spirituality and Psychotherapy: a Pastoral Counseling Paradigm for the Navy Chaplain (chaplain) by SANDERS, DAVID KENNETH, DMIN from School of Theology at Claremont, 1993, 118 pages http://wwwlib.umi.com/dissertations/fullcit/9334162
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Integration As a Process in Gestalt-oriented Psychotherapy: a Proposed Conceptualization. by BREWER, JOANNE STEWART, EdD from University of Massachusetts, 1976, 246 pages http://wwwlib.umi.com/dissertations/fullcit/7706373
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Interdisciplinary Competition and Role Performance in the Psychotherapy Helping Professions by TUCKMAN, GARY, PhD from New York University, 1970, 118 pages http://wwwlib.umi.com/dissertations/fullcit/7113669
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Interpersonal Perception in the Therapeutic Dyad As a Subsystem of Ongoing Psychotherapy Sessions. by WILMES, DONALD ALAN, PhD from Indiana State University, 1977, 149 pages http://wwwlib.umi.com/dissertations/fullcit/7731648
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Investigation of Attachment, Shame and Psychological Stress in Outpatient Psychotherapy Clients (stress) by AKASHI, AZARIA, PhD from The Ohio State University, 1994, 158 pages http://wwwlib.umi.com/dissertations/fullcit/9420928
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John Wesley's Order of Salvation As an Ontological Basis for Understanding the Process of Psychotherapy (wesley John) by CARTER, ROY ALLAN, PhD from School of Theology at Claremont, 1991, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9135029
108 Psychotherapy
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Kierkegaard's Philosophy of Freedom and Its Relevance for Psychotherapy by Spivak, Leslie Howard, PhD from New York University, 1996, 220 pages http://wwwlib.umi.com/dissertations/fullcit/9701530
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Languaging: the Linguistics of Psychotherapy. How Language Works Psychotherapeutically: an Exploration into the Art and Science of 'therapeutic Languaging' in Four Psychotherapies (neuro-linguistic Programming, Reality Therapy, Rationalemotive Behavior by Hall, Louis Michael, PhD from The Union Institute, 1996, 286 pages http://wwwlib.umi.com/dissertations/fullcit/9713088
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Lay Counseling in the Evangelical Christian Church: a Case Study (psychotherapy) by PHILLIPS, SUSAN SANDERS, PhD from University of California, Berkeley, 1985, 295 pages http://wwwlib.umi.com/dissertations/fullcit/8525089
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Length of Psychotherapy As Related to Client Gender and Participation/nonparticipation in an Encounter Group Experience by QUINN, KATHLEEN CABONE, EdD from Saint Louis University, 1993, 68 pages http://wwwlib.umi.com/dissertations/fullcit/9400340
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Low Self-esteem in Women: Short-term Psychotherapy Case Studies by CAMILLERI, JENNIFER, EdD from University of Toronto (Canada), 1995, 240 pages http://wwwlib.umi.com/dissertations/fullcit/NN07415
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Management of Confidentiality with Hiv-positive Male and Female Psychotherapy Clients by Kozlowski, Neal Francis; PhD from Loyola University of Chicago, 2003, 147 pages http://wwwlib.umi.com/dissertations/fullcit/3101645
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Martin Heidegger and Medard Boss: Dialogue between Philosophy and Psychotherapy. by MARSHALL, JOHN M., PhD from The University of Oklahoma, 1974, 348 pages http://wwwlib.umi.com/dissertations/fullcit/7515265
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Measuring Change in Short-term Psychotherapy Using the Sixteen Personality Factor Questionnaire As the Instrument by RHODES, ROY GEORGE, EdD from Indiana University, 1970, 83 pages http://wwwlib.umi.com/dissertations/fullcit/7023378
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Medical Utilization Change Following Brief Psychotherapy by SNOOKS, HOWARD DALE, PhD from Smith College School for Social Work, 1992, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9217374
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Medicalizing the Mind: the Invention of American Psychotherapy, 1800-1920. (volumes I and Ii) (mind Cure Movement, Emmanuel Movement) by CAPLAN, ERIC MICHAEL, PhD from The University of Michigan, 1994, 599 pages http://wwwlib.umi.com/dissertations/fullcit/9423155
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Meta-analysis of Meditation Outcomes in Counseling and Psychotherapy by Anyanwu, Leonard Chinaka, PhD from University of North Texas, 1998, 253 pages http://wwwlib.umi.com/dissertations/fullcit/9841024
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Metaphor and Psychotherapy: a Qualitative Study of Borderline and Non-borderline Psychotherapy Sessions by RASMUSSEN, BRIAN MICHAEL, PhD from Smith College School for Social Work, 1995, 229 pages http://wwwlib.umi.com/dissertations/fullcit/9600361
Dissertations 109
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Mind over Body: James Jackson Putnam and the Impact of Neurology on Psychotherapy in Late Nineteenth-century America. by WILKERSON, STEPHEN YOUNG, PhD from Duke University, 1978, 386 pages http://wwwlib.umi.com/dissertations/fullcit/7905379
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Mother-child Interaction: a Study of Allocation of Time Spent Within the Home in Families with a Child in Psychotherapy by WENNING, CLAIRE S., EdD from Columbia University, 1973, 167 pages http://wwwlib.umi.com/dissertations/fullcit/7325173
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Mythagnosis: a Jungian Perspective on Content Analytic Changes in Mythic Language Associated with Experience in Psychotherapy. by GIBSON, TERRILL LYNN, PhD from Boston University Graduate School, 1977, 344 pages http://wwwlib.umi.com/dissertations/fullcit/7721589
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Names and Relations in the Content of Counseling and Psychotherapy by KARCH, GREGORY ROBERT, PhD from The University of Utah, 1980, 293 pages http://wwwlib.umi.com/dissertations/fullcit/8109280
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Narrative Coherence in Brief Psychotherapy by Vail, Lucia; PhD from Long Island University, the Brooklyn Center, 2003, 172 pages http://wwwlib.umi.com/dissertations/fullcit/3086811
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Narrative Means to Sober Ends: Language, Interpretation, and Letter Writing in Psychotherapy and Recovery by Diamond, Jonathan P., PhD from Smith College School for Social Work, 1996, 269 pages http://wwwlib.umi.com/dissertations/fullcit/9706677
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Object Representations in Clients' Verbal Discourse: an Exploratory Study (psychotherapy Research) by FILAK, JOHN, PhD from Michigan State University, 1985, 133 pages http://wwwlib.umi.com/dissertations/fullcit/8603408
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Openness and Awareness of Communication during Psychotherapy by Wilkinson, William Charles; PhD from University of Windsor (Canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK14798
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Outcomes of Intensive Psychotherapy Changes Consequent to the Intensive Period in Primal Therapy by Caspary, Arthur C; PhD from University of Waterloo (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK45973
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Overcoming Shame Through Psychotherapy: Insights from Women Clients by ROSANDER, TERRY ANN, DSW from Loyola University of Chicago, 1993, 264 pages http://wwwlib.umi.com/dissertations/fullcit/9333701
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Paradoxical Outcome in Psychotherapy. by BLAIR, DANIEL MILLER, PhD from Southern Illinois University at Carbondale, 1979, 111 pages http://wwwlib.umi.com/dissertations/fullcit/7916067
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Parent Participation in Child Psychotherapy: Predictors of Attrition and Evaluation of a Participation Enhancement Intervention by Nock, Matthew Kelley; PhD from Yale University, 2003, 64 pages http://wwwlib.umi.com/dissertations/fullcit/3084344
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Pastoral Variables in Psychotherapy: an Instrument for Assessment (pastoral Counseling, Phenomenology, Hope) by STANCIL, DAVID CRITTENDEN, PhD from The Southern Baptist Theological Seminary, 1991, 394 pages http://wwwlib.umi.com/dissertations/fullcit/9205771
110 Psychotherapy
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Patient and Therapist Correlates of Change during Group Psychotherapy by McLachlan, John F.C.; PhD from University of Toronto (Canada), 1971 http://wwwlib.umi.com/dissertations/fullcit/NK12087
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Patient Perceptions of Therapeutic Factors in Outpatient Psychotherapy Groups (psychotherapy) by LANDAU, JOEL MEYER, EdD from University of Toronto (Canada), 1991, 237 pages http://wwwlib.umi.com/dissertations/fullcit/NN69375
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Patterns of Group Development and Leadership Style in Involuntary Psychotherapy Groups for Alcohol Abusers by O'CONNELL, DAVID FRANCIS, PhD from Temple University, 1986, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8627493
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Paul Tillich and Psychotherapy by HARRISON, JACK BARHAM, THD from School of Theology at Claremont, 1967, 210 pages http://wwwlib.umi.com/dissertations/fullcit/6809427
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Perceived Changes in the Theory and Practice of Individual Psychotherapy by the Year 2000: a Delphi Study of American Board of Professional Psychology Diplomates in Counseling Psychology by COUCH, ROBERT DAVID, EdD from University of Arkansas, 1989, 120 pages http://wwwlib.umi.com/dissertations/fullcit/8925694
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Perceptions of Early Parental Bonding As Related to Group Cohesion, Working Alliance and Treatment Outcome among Female Sexual Abuse Survivors in Group Psychotherapy by Cortez-Ison, Elizabeth Ann, PhD from University of California, Santa Barbara, 1997, 163 pages http://wwwlib.umi.com/dissertations/fullcit/9823392
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Personality Factors of Committed Christians in Outpatient Psychotherapy by MISJA, MICHAEL CARL, PhD from Kent State University, 1992, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9310077
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Positive Critical Incidents in Group Psychotherapy: a Communication Analysis (volumes I and Ii) by SCANDRETT, SHARON LOUISE, PhD from The University of Iowa, 1979, 614 pages http://wwwlib.umi.com/dissertations/fullcit/8012418
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Predicting the Rejection of Psychotherapy Using the Psi, Scl-90-r and Demographic Variables at a University Counseling Center in the Midwest (premature Termination) by JONES, PREMALA TARA, PhD from Kent State University, 1993, 76 pages http://wwwlib.umi.com/dissertations/fullcit/9405925
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Predictors of Psychiatry Resident Psychotherapy Competence by Coon, Kim Annette; EdD from Oklahoma State University, 2003, 250 pages http://wwwlib.umi.com/dissertations/fullcit/3105753
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Premature Termination from Psychotherapy--a Continuing Problem. by MCGROGAN, DONALD THOMAS, PhD from University of Illinois at Urbanachampaign, 1976, 143 pages http://wwwlib.umi.com/dissertations/fullcit/7624213
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Premature Termination in Individual Psychotherapy: a Demographic and Process Analysis (psychotherapy) by TIETBOHL, PHILLIP JEFFREY, PhD from University of Virginia, 1994, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9400787
Dissertations 111
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Presence As a Theological-psychological Paradigm for Pastoral Psychotherapy (juergen Moltmann, Heinz Kohut) by HARDY, BRUCE WAYNE, PhD from The Southern Baptist Theological Seminary, 1992, 319 pages http://wwwlib.umi.com/dissertations/fullcit/9310419
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Preventative Psychotherapy: Implementation of an Intervention Strategy to Raise Self-esteem. by MOSER, KATHRYN, EdD from Indiana University, 1973, 76 pages http://wwwlib.umi.com/dissertations/fullcit/7402689
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Principles and Methods for Understanding and Attaining Self-realization: a Core Element of a System of Transpersonal Psychotherapy Derived from the Philosophy and Psychology of Paramahansa Yogananda by JOHANS, JAMES FRANCIS, PhD from Walden University, 1993 http://wwwlib.umi.com/dissertations/fullcit/f2784451
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Providing Psychotherapy As a Related Service in Public School Districts of Connecticut by KRAWIECKI, BEATRICE M., EdD from Columbia University Teachers College, 1987, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8721135
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Providing Psychotherapy to Older Adults Therapist Reluctance and Societal Opinions by Larsen, William W; PhD from York University (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NK66187
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Psychological Factors Relating to Infertility of Couples and the Implications for Counseling and Psychotherapy. by DUNNE, DANIEL EDWARD, PhD from University of Southern California, 1975 http://wwwlib.umi.com/dissertations/fullcit/f3816950
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Psychotherapists' Personal Psychotherapy and Its Perceived Influence on Clinical Practice by Bellows-Blakely, Karen F.; PhD from Smith College School for Social Work, 1999, 329 pages http://wwwlib.umi.com/dissertations/fullcit/9945612
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Psychotherapy and Its Effect on Depression, Sick-role Identification and Rehabilitation Outcome for Stroke Victims by LATOW, JACK F., PhD from University of Southern California, 1982 http://wwwlib.umi.com/dissertations/fullcit/f98774
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Psychotherapy and Spirituality: a Narrative Exploration of the Therapeutic Uses of Theories, Strategies, and Techniques Derived from the Spiritual Traditions, Or, If You See the Buddha on the Road, Invite Him into Your Session by FIRMAN, DOROTHY TALCOTT, EdD from University of Massachusetts, 1994, 289 pages http://wwwlib.umi.com/dissertations/fullcit/9420624
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Psychotherapy and Spirituality: Techniques, Interventions and Inner Attitudes by JOHNSON, LINDA MAY HAAPANEN, EdD from University of Massachusetts, 1989, 430 pages http://wwwlib.umi.com/dissertations/fullcit/9011748
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Psychotherapy and the Teaching of Writing: Practical and Ethical Dilemmas in the Composition Classroom (theory) by WOLF, THIA, PhD from Miami University, 1986, 278 pages http://wwwlib.umi.com/dissertations/fullcit/8619689
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Psychotherapy As Hermeneutics the Client's Story by Sellick, Margaret; PhD from University of Alberta (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL52845
112 Psychotherapy
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Psychotherapy As Hermeneutics: the Client's Story by SELLICK, MARGARET ANNE, PhD from University of Alberta (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/f3122964
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Psychotherapy Dropouts from a Psychological Training Clinic by RICHMOND, RAYMOND LLOYD, PhD from California School of Professional Psychology Berkeley/alameda, 1991, 140 pages http://wwwlib.umi.com/dissertations/fullcit/9132148
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Psychotherapy or Active Focused Problem-solving for Persons in Crisis. by ZIPPER, RICHARD STEVEN, PhD from Michigan State University, 1976, 155 pages http://wwwlib.umi.com/dissertations/fullcit/7627167
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Psychotherapy with Hiv/aids Patients: a Preliminary Study Comparing the Experiences and Outcomes of Inner-city Patients with Their Urban Counterparts by Storey, Joan Eda, PhD from New York University, 1997, 389 pages http://wwwlib.umi.com/dissertations/fullcit/9717731
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Psychotherapy: 'an African-american Male Experience' by Washington, Frank; PhD from Union Institute and University, 2003, 125 pages http://wwwlib.umi.com/dissertations/fullcit/3079023
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Psychotherapy: a Process and Outcome Study in the Treatment of Hyperaggressive Pre-adolescents by ISRAEL, DAVID ALLEN, PhD from The University of Utah, 1970, 144 pages http://wwwlib.umi.com/dissertations/fullcit/7103169
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Reactions to 'empathy': Analysis of Therapist Responses across Three Orientations of Psychotherapy. by ROBERTSON, NANCY GARLAND, PhD from University of Missouri - Kansas City, 1974, 82 pages http://wwwlib.umi.com/dissertations/fullcit/7423788
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Recovery-oriented Psychotherapy with a Jewish, Female, Substance-abusing Adolescent: a Case Study by Brenner, Jamie Lynn; PsyD from Chicago School of Professional Psychology, 2000, 114 pages http://wwwlib.umi.com/dissertations/fullcit/3003531
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Relationship between Congruence of Client and Therapist: Expectations and Preferences and Continuation in Psychotherapy (treatment, Dropout) by RAWLINGS, WILLIAM J., PhD from The University of Michigan, 1986, 209 pages http://wwwlib.umi.com/dissertations/fullcit/8621359
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Relationships between Iq and Emotional Adjustment in Gifted, Latency-age Children (psychotherapy - Gifted) by GROSSBERG, INGRID NORENE, PhD from Wayne State University, 1985, 184 pages http://wwwlib.umi.com/dissertations/fullcit/8604999
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Repetition and Identity: a Hermeneutic Investigation of Narratives in Psychotherapy by Pomichalek, Milan; PhD from York University (Canada), 2001, 247 pages http://wwwlib.umi.com/dissertations/fullcit/NQ67923
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Sartre's Theory of Existential Psychoanalysis and Its Implications for Existential Psychotherapy by MEDLOCK, GORDON EDWARD, JR., PhD from Yale University, 1986, 381 pages http://wwwlib.umi.com/dissertations/fullcit/8628733
Dissertations 113
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Second Order Cybernetics and the Psychotherapy Process by Lawrence, John E; PhD from University of Alberta (Canada), 1987 http://wwwlib.umi.com/dissertations/fullcit/NL41078
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Selected Aspects of Counseling and Psychotherapy with Nonvoluntary Clients by WRIGHT, ROY T., EdD from East Texas State University, 1985, 157 pages http://wwwlib.umi.com/dissertations/fullcit/8515125
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Selected Personality Variables among Marital Individuals Who Seek Psychotherapy. by TIERNEY, GEORGE PATRICK, PhD from St. John's University (New York), 1979, 132 pages http://wwwlib.umi.com/dissertations/fullcit/7920964
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Self-disclosure in Counseling and Psychotherapy by MATHEWS, BERNADETTE SMITH, PhD from University of Colorado at Boulder, 1985, 186 pages http://wwwlib.umi.com/dissertations/fullcit/8522684
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Shamanism among the Tamag of Nepal: Folk Curing and Psychotherapy. by PETERS, LARRY G., PhD from University of California, Los Angeles, 1978, 258 pages http://wwwlib.umi.com/dissertations/fullcit/7820276
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Short-term Psychotherapy: Nonspecific and Specific Therapist Variables That Influence Outcome by Guthrie, Brian; PhD from University of Calgary (Canada), 2000, 226 pages http://wwwlib.umi.com/dissertations/fullcit/NQ49551
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Sociological Analysis of Psychotherapy with an Application to Gestalt Therapy by RIVERA, MIGUEL ANGEL, EdD from University of Massachusetts, 1980, 193 pages http://wwwlib.umi.com/dissertations/fullcit/8012639
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Spirit: Divine and Human. the Theology of the Holy Spirit of Heribert Muehlen and Its Relevance for Evaluating the Data of Psychotherapy. by SEARS, ROBERT THOMAS, PhD from Fordham University, 1974, 518 pages http://wwwlib.umi.com/dissertations/fullcit/7425083
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Spiritual Growth Through Small Groups: a Synthesis of Group Psychotherapy and Spiritual Direction to Enhance Christian Wholeness by DOSS, JAMES LEE, DMIN from Drew University, 1995, 57 pages http://wwwlib.umi.com/dissertations/fullcit/9612548
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Spontaneous Facial Expression of Anxiety in Psychotherapy by Blythe, Paul W; PhD from York University (Canada), 1977 http://wwwlib.umi.com/dissertations/fullcit/NK30886
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Stimulated Recall with Videotape and Simulation in Counseling and Psychotherapy: a Comparison of Effects of Two Methodologies with Undergraduate Student Clients by VAN NOORD, ROBERT WILLIAM, PhD from Michigan State University, 1973, 239 pages http://wwwlib.umi.com/dissertations/fullcit/7329791
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Structures of Innocence: Sexual Abuse, Psychotherapy, and the Construction of Moral Meanings by Davis, Joseph Eugene, PhD from University of Virginia, 1998, 456 pages http://wwwlib.umi.com/dissertations/fullcit/9840385
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Subjectivity and Healing Ontoanthropological Foundations of Psychotherapy by O'Connell, Dennis Sean; PhD from University of Alberta (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK49054
114 Psychotherapy
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Success or Failure in Psychotherapy: the Effects of Comparable Client-therapist and Client-significant Other Interaction Patterns upon the Process and Outcome of Psychotherapy by SPIERLING, THOMAS WAYNE, PhD from Michigan State University, 1972, 147 pages http://wwwlib.umi.com/dissertations/fullcit/7305493
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Symbolic Interactionist Perspectives on Negative Outcomes in Psychotherapy by BRINKERHOFF, L. JOHN, PhD from Bowling Green State University, 1988, 179 pages http://wwwlib.umi.com/dissertations/fullcit/8911126
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Symbolism: Approaches to Its Study and Use in Counseling and Psychotherapy. by ZINSER, THOMAS JOSEPH, EdD from East Texas State University, 1977, 127 pages http://wwwlib.umi.com/dissertations/fullcit/7805478
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Test of the Dose-effect and Phase Models of Psychotherapy Outcome by Callahan, Jennifer Lynn; PhD from The University of Wisconsin - Milwaukee, 2003, 144 pages http://wwwlib.umi.com/dissertations/fullcit/3100890
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The Acceleration of Client Progress in Counseling and Psychotherapy Through Interpersonal Process Recall (ipr) by SCHAUBLE, PAUL G., PhD from Michigan State University, 1970, 226 pages http://wwwlib.umi.com/dissertations/fullcit/7020527
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The Adjunctive Use of Videotape Feedback in Group Psychotherapy. by PROEDROU, REGINA DEMETRE, PhD from Washington State University, 1974, 76 pages http://wwwlib.umi.com/dissertations/fullcit/7507665
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The Adult Ideology As Practical Reasoning : a Study of Child Psychotherapy by Parkinson, Gary; PhD from The University of British Columbia (Canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK25960
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The Adult Ideology As Practical Reasoning: a Study of Child Psychotherapy. by PARKINSON, GARY CHARLES, PhD from The University of British Columbia (Canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/f4189062
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The Aged's Demand for Psychotherapy: an Economic Analysis by MABEE, MARCIA S., PhD from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1983, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8313210
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The Applicability of American Counseling and Psychotherapy in Vietnamese Culture by HUYNH, QUANG VAN, PhD from Southern Illinois University at Carbondale, 1972, 206 pages http://wwwlib.umi.com/dissertations/fullcit/7222484
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The Application of Gestalt Psychotherapy Principles to Learning: a Case Study of Resistance in Adult Education by OKERE, NICHOLAS SUNDAY, EdD from Pepperdine University, 1984, 103 pages http://wwwlib.umi.com/dissertations/fullcit/8507637
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The Arts with Psychotherapy: 'i've Been There Too.' Poetry As Healer and Friend (original Writing) by Makin, Susan Ruth, PhD from The Union Institute, 1996, 213 pages http://wwwlib.umi.com/dissertations/fullcit/9704762
Dissertations 115
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The Assessment of Fairy Tales As an Innovative Technique in the Counseling Process (psychotherapy) by DIAMANT, HARRY R., DSW from Adelphi University, School of Social Work, 1985, 146 pages http://wwwlib.umi.com/dissertations/fullcit/8602724
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The Cosmocentric Model of Pastoral Psychotherapy: a Contextualized Holistic Model from a Bantu African Worldview, a Perspective for Post-modern Pastoral Psychotherapy by RUKUNGAN, PETER MWITI, PhD from School of Theology at Claremont, 1994, 256 pages http://wwwlib.umi.com/dissertations/fullcit/9509837
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The Development and Delivery of a Training Program for the Construction and Use of Informed Consent in Psychotherapy by Frost, Lucinda Zuck; PsyD from Our Lady of the Lake University, 2000, 196 pages http://wwwlib.umi.com/dissertations/fullcit/3076285
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The Development of a Theoretical Rationale for the Use of the Contract in Individual Psychotherapy. by YALE, JO-ELLEN, PhD from Ohio University, 1974, 150 pages http://wwwlib.umi.com/dissertations/fullcit/7503563
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The Development of an Adolescent Females' Psychotherapy Group: a Feminist Psychological Orientation by DOWNES, MARGARET A., EdD from Boston University, 1987, 380 pages http://wwwlib.umi.com/dissertations/fullcit/8716080
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The Differential Effects of Psychotherapy Practicum Training upon the Valueorientations of Counseling Psychology Trainees. by CERU, DENNIS JAMES, PhD from University of Southern California, 1978 http://wwwlib.umi.com/dissertations/fullcit/f2161670
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The Differential Effects of the Length of Intervals between Sessions on the Process and Outcome of Time Limited Group Psychotherapy with Incarcerated Males by SWETZ, ANTHONY, JR., PhD from University of Maryland College Park, 1983, 222 pages http://wwwlib.umi.com/dissertations/fullcit/8323593
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The Economics of Expanding Health Insurance Benefits: Direct Reimbursement to Social Workers for Psychotherapy by FAIRBANK, ALAN W. H., PhD from Boston University, 1987, 387 pages http://wwwlib.umi.com/dissertations/fullcit/8707063
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The Effect of Audio-taped Psychotherapy Pre-training upon Client Self-exploration. by SHERY, MICHAEL EDMUND, EdD from University of Southern California, 1975 http://wwwlib.umi.com/dissertations/fullcit/f3839318
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The Effect of Brief Psychotherapy on the Level of the Patient's Object Relations (psychotherapy) by SCHNEIDER, ELIZABETH LYNN, PhD from New York University, 1990, 241 pages http://wwwlib.umi.com/dissertations/fullcit/9023056
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The Effect of Couples' Psychotherapy Treatment on Parents Whose Children Misbehave in School by SNOW, DORIS JEAN, DSW from The Catholic University of America, 1988, 370 pages http://wwwlib.umi.com/dissertations/fullcit/8820010
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The Effect of Dissonance Reduction in Psychotherapy: a Reexamination by MITCHELL, DAVID CLARK, PhD from The University of Oklahoma, 1981, 90 pages http://wwwlib.umi.com/dissertations/fullcit/8129416
116 Psychotherapy
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The Effect of Family Support on the Working Alliance in Psychotherapy with Psychiatrically Disturbed Parents by Canning, James Jay, PhD from Smith College School for Social Work, 1997, 106 pages http://wwwlib.umi.com/dissertations/fullcit/9805882
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The Effect of Negative Self-referential Mood and Depression upon Creative Processes Related to Change in Psychotherapy (therapeutic Change) by BLUNDO, ROBERT GEORGE, PhD from University of Maryland at Baltimore, 1992, 200 pages http://wwwlib.umi.com/dissertations/fullcit/9231494
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The Effect of Similarity of Therapist and Client Preferences for Therapy Approach on Premature Termination and Satisfaction with Psychotherapy by CARLSON, MARK STANLEY, PhD from Wayne State University, 1980, 149 pages http://wwwlib.umi.com/dissertations/fullcit/8107196
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The Effectiveness of Group Psychotherapy and Study Skills Training on Academic Achievement of Mexican American Freshmen by BARRERA, ADOLFO RAMON (SONNY), EdD from Texas Tech University, 1981, 115 pages http://wwwlib.umi.com/dissertations/fullcit/8121880
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The Effects of a Group Psychotherapy Intervention on Clients with an External Locus-of-control. by REINFELD, WILBUR VEL, PhD from University of Georgia, 1975, 145 pages http://wwwlib.umi.com/dissertations/fullcit/7602257
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The Effects of a Training Module Portraying Sex Bias and Sex-role Stereotyping in Psychotherapy on Counselor Trainee Attitudes toward Women by STEIER, FREDERICK ALBERT, EdD from Ball State University, 1980, 91 pages http://wwwlib.umi.com/dissertations/fullcit/8121990
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The Effects of an Anticipatory Socialization Interview on Patient and Therapist Behavior in Psychotherapy. by BIRNBAUM, ISRAEL NATHAN, EdD from Boston University School of Education, 1975, 90 pages http://wwwlib.umi.com/dissertations/fullcit/7520915
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The Effects of Antecedent, Consequence, and Antecedent - Plus - Consequence Treatments on Behavioral Change (behavior Management, Pediatric Psychotherapy) by SCHLEY, AMY MARGARET GLOE, PhD from Marquette University, 1984, 98 pages http://wwwlib.umi.com/dissertations/fullcit/8516283
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The Effects of Group Psychotherapy on Mental Status, Social Adaptation, and Depression in Elderly Persons in Long-term Care with Age-onset Organic Brain Syndrome by CHRISTOPHER, FRIMA, PhD from New York University, 1986, 161 pages http://wwwlib.umi.com/dissertations/fullcit/8706305
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The Effects of Group Psychotherapy on the Self-actualization of Male Inmates in a Federal Penitentiary by CHANCE, GEORGE REDDING, PhD from University of Missouri - Kansas City, 1981, 103 pages http://wwwlib.umi.com/dissertations/fullcit/8126568
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The Effects of Psychological Reactance and Paradoxical and Self-directive Forms of Brief Psychotherapy on Procrastination by GUILFOYLE, EDMUND CLYDE, PhD from Texas A&m University, 1986, 157 pages http://wwwlib.umi.com/dissertations/fullcit/8707417
Dissertations 117
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The Effects of Role Preparation for Psychotherapy on Immigrant Clients Seeking Mental Health Services in Hawaii by LAMBERT, RIKI GEORGE, DSW from The University of Utah, 1982, 207 pages http://wwwlib.umi.com/dissertations/fullcit/8129929
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The Effects of School-based Group Psychotherapy on At-risk Adolescents' Psychological Well-being and School Adjustment by Caty, Caren; PhD from Alliant International University, Los Angeles, 2003, 137 pages http://wwwlib.umi.com/dissertations/fullcit/3087075
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The Effects of Structured Physical Interactions in Psychotherapy on Anxiety and Specific Behavioral Variables in Children. by ANDERSON, JUDITH RAE, EdD from Boston University School of Education, 1974, 198 pages http://wwwlib.umi.com/dissertations/fullcit/7419062
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The Effects on Children's (k-6) Test Anxiety, Attention Span, Oral Reading Rate and School Grades of a Short Term, Individual Technique in Self Correction Psychotherapy Utilizing Parents As Monitors by KIRK, ROBERT DAVID, EdD from University of Massachusetts, 1981, 166 pages http://wwwlib.umi.com/dissertations/fullcit/8110338
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The Efficacy of Structured Reminiscence Group Psychotherapy As an Intervention to Decrease Depression and Increase Psychological Well-being in Female Nursing Home Residents by TAYLOR-PRICE, CONNIE, PhD from Mississippi State University, 1995, 85 pages http://wwwlib.umi.com/dissertations/fullcit/9604876
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The Evolution of the Therapeutic Representation Through the Course of Psychotherapy by MONTGOMERY, SETH HUNT, PhD from Smith College School for Social Work, 1988, 317 pages http://wwwlib.umi.com/dissertations/fullcit/8819784
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The Exploration of Nonsexual Boundary Crossings in Psychotherapy Via the Critical Incidents Technique by Sherack, Kelly J.; PhD from Loyola University of Chicago, 2003, 195 pages http://wwwlib.umi.com/dissertations/fullcit/3085101
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The Group Process of Time-limited Psychotherapy (tlp) with Divorcing Adults by GOULD, JAMES MICHAEL, PhD from Temple University, 1989, 197 pages http://wwwlib.umi.com/dissertations/fullcit/9007351
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The Immediate Effects of Transference Interpretations on Patients' Progress in Brief, Psychodynamic Psychotherapy by FRETTER, POLLY B., EdD from University of San Francisco, 1984, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8512112
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The Impact of Gestalt Group Psychotherapy on Parents' Perceptions of Children Identified As Problematic by LITTLE, LINDA FAYE, PhD from University of Kentucky, 1981, 246 pages http://wwwlib.umi.com/dissertations/fullcit/8116912
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The Impact of Long-term Psychotherapy on the Social Activism of Social Activists by Davis, Leslie Karen, EdD from University of Toronto (Canada), 1998, 228 pages http://wwwlib.umi.com/dissertations/fullcit/NQ35398
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The Impact of Psychotherapy Clients on Marriage and Family Therapists by Masi, Maria Victoria; PhD from Kansas State University, 2003, 308 pages http://wwwlib.umi.com/dissertations/fullcit/3090375
118 Psychotherapy
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The Impact of Shame on Supervisee Openness in Psychotherapy Supervision by Chorinsky, Beatrice Clarissa; PsyD from California Institute of Integral Studies, 2003, 206 pages http://wwwlib.umi.com/dissertations/fullcit/3093555
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The Impact of Termination in Individual Psychotherapy on the Social Work Practitioner by Smith, Yolanda Elaine; PhD from Barry University School of Social Work, 2001, 180 pages http://wwwlib.umi.com/dissertations/fullcit/3035747
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The Impact of Written Treatment Plans on the Effectiveness of Psychotherapy in a University-based Community Clinic by Neal, Andrea Christine; PhD from University of Montana, 2003, 136 pages http://wwwlib.umi.com/dissertations/fullcit/3094874
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The Influence of Acculturation of African-americans on Referral for Psychotherapy and Utilization of Other Help Systems by Alexander, Jacqueline Ruth; PhD from The University of Texas at Arlington, 1998, 91 pages http://wwwlib.umi.com/dissertations/fullcit/9937692
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The Influence of Ethnicity, Gender, Previous Therapy Experience, and Acculturation on Attitudes towards Mental Illness and Psychotherapy by Aguilar-Villatoro, Christina Isabel; MS from California State University, Fullerton, 2003, 83 pages http://wwwlib.umi.com/dissertations/fullcit/1413320
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The Influence of the Social Interactional Approach to Counselling/psychotherapy on Career Indecision (counselling, Psychotherapy) by CURTIS, DAVID W., EdD from University of Toronto (Canada), 1990, 200 pages http://wwwlib.umi.com/dissertations/fullcit/NN65802
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The Integrationists: a Study of Patient Variables in Psychotherapy. by LAMBDIN, JOHN HALE, EdD from Boston University School of Education, 1976, 269 pages http://wwwlib.umi.com/dissertations/fullcit/7621239
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The Language of Psychotherapy: a Conversational Analysis of Disagreement by SEPERSON, SUSANNE BLEIBERG, PhD from City University of New York, 1981, 193 pages http://wwwlib.umi.com/dissertations/fullcit/8119675
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The Level of Referential Activity in Time-limited Dynamic Psychotherapy (psychotherapy) by NORTHCUT, TERRY BRUMLEY, PhD from Smith College School for Social Work, 1991, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9205521
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The Mentoring Tradition in Psychotherapy: a Review of the Past; a Look toward the Future by LASSAK, PATRICIA ANN, PSYD from Widener University, Institute for Graduate Clinical Psychology, 1996, 231 pages http://wwwlib.umi.com/dissertations/fullcit/9620911
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The Mutual Influence of Spiritual and Psychosocial Growth in the Development of a Roman Catholic's Sense of Religious Vocation (psychotherapy, Spiritual, Formation) by BRIDGE, PETER J., DMIN from Lancaster Theological Seminary, 1984, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8429814
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The Nature of Psychotherapy Natural Science or Human Science? by Eriksen, Maria Kristina; PhD from University of Calgary (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK52370
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The Paradox in Humanistic Existential Psychotherapy by BLONSLEY, KENNETH MICHAEL, PhD from University of Southern California, 1982 http://wwwlib.umi.com/dissertations/fullcit/f98710
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The Place of Humour in Adult Psychotherapy by Killinger, Barbara; PhD from York University (Canada), 1977 http://wwwlib.umi.com/dissertations/fullcit/NK30914
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The Poetics of Folly: a Reading of Anne Sexton (psychotherapy, Surrealism, Confessional) by MARRAS, EMMA GIUSEPPINA, PhD from State University of New York at Binghamton, 1984, 217 pages http://wwwlib.umi.com/dissertations/fullcit/8508853
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The Practice of Psychotherapy: Occupational Determinants, Personal Reactions and Coping Strategies for Clinical and Counseling Psychologists by GILROY, PAULA JEAN, EdD from West Virginia University, 1988, 159 pages http://wwwlib.umi.com/dissertations/fullcit/8905110
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The Process and Outcome of Stress Psychotherapy: a Case Study. by BEBELAAR, JOHN, DSW from University of California, Berkeley, 1977, 453 pages http://wwwlib.umi.com/dissertations/fullcit/7812459
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The Psychotherapy Treatment Dosage Required to Yield Single and Multiple Ratings of 'cured' and the Influence of Initial Problem Severity by Simon, Lori; EdD from University of Cincinnati, 2000, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9973115
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The Recovery of Story As a Way of Knowing in Postmodern Approaches to Psychotherapy and Scripture: a Study of Epistemologies, Paradigms, Theory, and Practice by BRADT, KEVIN MICHAEL, PhD from Graduate Theological Union, 1994, 389 pages http://wwwlib.umi.com/dissertations/fullcit/9426243
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The Reduction of Negative Affect in Human Subjects: a Laboratory Investigation of Rational-emotive Psychotherapy by BURKHEAD, DAVID EDWARD, EdD from Western Michigan University, 1970, 137 pages http://wwwlib.umi.com/dissertations/fullcit/7021858
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The Relationship between Adult Children of Alcoholics, Psychotherapy, and Problems with Interpersonal Relationships by STOLLMAN, GARY D., PhD from University of Southern California, 1991 http://wwwlib.umi.com/dissertations/fullcit/f1394068
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The Relationship between Client Involvement in Psychotherapy Evaluation and Effectiveness of Short-term Psychotherapy: a Pilot Study. by UPDYKE, PATRICIA RESEK, PhD from Michigan State University, 1975, 143 pages http://wwwlib.umi.com/dissertations/fullcit/7605660
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The Relationship between Counselor Conceptual Level and Supervisory Style in the Supervision of Brief Psychotherapy by HANSCOM, KAREN LUCILLE, PhD from University of Maryland College Park, 1989, 172 pages http://wwwlib.umi.com/dissertations/fullcit/9021507
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The Relationship of Afro-american Psychotherapists' Perceptions of Afro-american Clients and the Psychotherapeutic Activities Engaged in by Afro-american Psychotherapists in the Delivery of Psychotherapy to Afro-american Clients by HARVEY, RICHARD HENRY, DSW from Howard University School of Social Work, 1983, 197 pages http://wwwlib.umi.com/dissertations/fullcit/8422723
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The Relationship of Client Values and Client-therapist Value Similarity to Continuation in Psychotherapy at a Veterans Administration Outpatient Clinic. by PRUETT, MILDRED MARY, PhD from Northwestern University, 1979, 121 pages http://wwwlib.umi.com/dissertations/fullcit/7927427
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The Role of Emotional Repression in Chronic Back Pain: a Study of Chronic Back Pain Patients Undergoing Psychodynamically Oriented Group Psychotherapy As Treatment for Their Pain by Hawkins, Jeffrey R.; PhD from New York University, 2003, 222 pages http://wwwlib.umi.com/dissertations/fullcit/3100792
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The Role of Emotions in the Theory and the Practice of Psychotherapy by BEATON, HUGH ARTHUR, PhD from University of Southern California, 1981 http://wwwlib.umi.com/dissertations/fullcit/f459958
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The Role of Humor in Psychotherapy by KANEKO, SYLVIA YELTON, DSW from Smith College School for Social Work, 1971, 171 pages http://wwwlib.umi.com/dissertations/fullcit/7208402
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The Role of the Therapist's Pet in Initial Psychotherapy Sessions with Adolescents; an Exploratory Study by PEACOCK, CAROL ANTOINETTE, PhD from Boston College, 1984, 201 pages http://wwwlib.umi.com/dissertations/fullcit/8522289
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The Roles of Modeling Theory and Transformational Grammar in the Development of a Theory of Verbal Intervention in Psychotherapy: a Critical Analysis of Bandler and Grinder's 'the Structure of Magic' by TOBIN, BRUCE ARTHUR, PhD from University of Washington, 1983, 204 pages http://wwwlib.umi.com/dissertations/fullcit/8326924
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The Self- and Interactive Regulation and Coordination of Vocal Rhythms, Interpretive Accuracy, and Progress in Brief Psychodynamic Psychotherapy by Holtz, Paula Jean; PhD from Fielding Graduate Institute, 2003, 268 pages http://wwwlib.umi.com/dissertations/fullcit/3099387
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The Supervisee's Satisfaction with Supervision of Psychotherapy (counselor Training) by WILSON, MARC R., PhD from Boston College, 1991, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9118438
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The Therapist's and Clients' Perspectives of Mental Imagery Interventions in Psychotherapy by BERGMAN, RICHARD A., PhD from Temple University, 1989, 263 pages http://wwwlib.umi.com/dissertations/fullcit/8920214
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The Treatment of Tension Headaches with a Change Model of Psychotherapy by Paulson, Barbara Lynn; PhD from University of Alberta (Canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK67272
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The Unacceptability of Marathon Psychotherapy for Some Residents of Rural Maine by NAPIER, ANNE H., EdD from Boston University School of Education, 1983, 197 pages http://wwwlib.umi.com/dissertations/fullcit/8319926
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The Use of Hypnosis in Psychotherapy: Does Self-efficacy Theory Apply? by BRADBURY, HOLLY RAE, PhD from University of California, Santa Barbara, 1986, 280 pages http://wwwlib.umi.com/dissertations/fullcit/8709099
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The Use of Interaction Process Analysis in Non-directive Group Psychotherapy by RATNER, ROBERT STEPHEN, PhD from Yale University, 1969, 307 pages http://wwwlib.umi.com/dissertations/fullcit/6915999
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The Use of Self Correction Psychotherapy to Alter Test Anxiety, Attention Span, Oral Reading, Reading Comprehension and Academic Achievement in Children by LACROSS, SUZANNE, PhD from Boston College, 1985, 195 pages http://wwwlib.umi.com/dissertations/fullcit/8604111
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The Use of Spontaneous Drawing with Chromatic Colors As a Facilitator for Group Psychotherapy: the Development and Exploration of a Technique. by NORRIS, JOEL WALLACE, PhD from University of Georgia, 1975, 289 pages http://wwwlib.umi.com/dissertations/fullcit/7602249
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The Use of the Interpersonal Process Recall (ipr) Model Videotape and Stimulus Film Techniques in Short-term Counseling and Psychotherapy. by TOMORY, ROBERT ERNEST, PhD from Michigan State University, 1979, 211 pages http://wwwlib.umi.com/dissertations/fullcit/7921205
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The Use or Non-use of Art Therapy - Art Psychotherapy by General Hospitals and Psychiatric Facilities in the United States by WITLIN, ROY, EdD from Temple University, 1987, 199 pages http://wwwlib.umi.com/dissertations/fullcit/8711429
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The Usefulness of Metacognition in Psychotherapy for Children (pedotherapy). (afrikaans Text) by ENGELBRECHT, PETRA, PhD from University of Pretoria (South Africa), 1991 http://wwwlib.umi.com/dissertations/fullcit/f1385156
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The Visibility of Therapist Values and the Convergence of Client-therapist Values during Psychotherapy. by BRADBURY, ROY WILLIAM, PhD from University of Southern California, 1978 http://wwwlib.umi.com/dissertations/fullcit/f2161638
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Therapists Vs. Clients: Dimensions of Change Associated with Global Ratings of Satisfaction with Short-term Psychotherapy by HAMERLING, LYNN ALEXANDRA, PhD from The George Washington University, 1990, 146 pages http://wwwlib.umi.com/dissertations/fullcit/9020298
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Time-limited Psychotherapy with Patients Who Have Experienced a Loss: a Qualitative Study by FISCHER-FENNESSEY, CHRISTINE, PhD from New York University, 1995, 228 pages http://wwwlib.umi.com/dissertations/fullcit/9603311
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Touch in Psychotherapy: a Survey of Psychologists' Attitudes, Values, and Practices by Cassatly, Jennifer D.; PsyD from Pepperdine University, 2003, 96 pages http://wwwlib.umi.com/dissertations/fullcit/3105816
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Toward a Home for Family Therapy in a Community of Meaning: Josiah Royce and an Ethically Based Psychotherapy by KARPELL, MERRILY BOYD, PhD from Temple University, 1987, 310 pages http://wwwlib.umi.com/dissertations/fullcit/8716377
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Towards a Further Integration of Analytical Psychology with Other Forms of Psychotherapy: C. G. Jung and Harold Searles Compared by SEDGWICK, DAVID WILLIAMS, PhD from University of Colorado at Boulder, 1983, 295 pages http://wwwlib.umi.com/dissertations/fullcit/8400930
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Towards a Theory of Technique: Aspects of the Therapeutic Relationship in Adolescent Psychotherapy (psychotherapy) by CHURCH, ELIZABETH A., PhD from University of Toronto (Canada), 1989, 235 pages http://wwwlib.umi.com/dissertations/fullcit/NN69194
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Trainee Uses of Reciprocal Peer Supervision and of Faculty Supervision in Psychotherapy Training by BYRNE, BRENDA, PhD from Temple University, 1983, 228 pages http://wwwlib.umi.com/dissertations/fullcit/8311715
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Transference Tests of Unconscious Pathogenic Beliefs in Therapy: the Application of the San Francisco Psychotherapy Research Group's Plan Formulation Method to Group Psychotherapy (california) by COURTNEY, DANIEL JOSEPH, PhD from Smith College School for Social Work, 1992, 264 pages http://wwwlib.umi.com/dissertations/fullcit/9305444
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Transitions in Psychotherapy: the Pregnant Psychotherapist by NAPOLI, MARIA C., PhD from New York University, 1988, 208 pages http://wwwlib.umi.com/dissertations/fullcit/8826552
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Transparency As a Prognostic Variable in Psychotherapy by FORREST, GARY GRAN, EdD from The University of North Dakota, 1970, 90 pages http://wwwlib.umi.com/dissertations/fullcit/7104491
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Two Views of the Self and the Conceptual Foundations of Psychotherapy by LAMBERT, FRANK BASIL, PhD from The University of Texas at Austin, 1984, 289 pages http://wwwlib.umi.com/dissertations/fullcit/8508297
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Unstructured and Structured Group Psychotherapy, Geriatric Patients, and Decision to Leave the Hospital by NEVRUZ, NADYA, EdD from Oklahoma State University, 1967, 120 pages http://wwwlib.umi.com/dissertations/fullcit/6808470
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Use of Rorschach Variables in the Assessment of Psychotherapy Progress by Clemence, Amanda Jill; PhD from The University of Tennessee, 2003, 67 pages http://wwwlib.umi.com/dissertations/fullcit/3104380
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Uses of Microcomputers by Psychotherapists and Counselors in Private Practice: an Example of Technology Transfer Applied to the Practice of Psychotherapy by DICKERSON, JOAN PATRICIA, PhD from University of Pittsburgh, 1989, 258 pages http://wwwlib.umi.com/dissertations/fullcit/8921428
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Validity of the Computerized Assessment System for Psychotherapy Evaluation and Research (casper) in a Psychiatric Outpatient Population by St. Martin, Samantha Rachel; PhD from Virginia Commonwealth University, 2003, 151 pages http://wwwlib.umi.com/dissertations/fullcit/3096560
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Value Language Analysis and Carl Rogers' Psychotherapy: Two Approaches to Questions about the Human Person by REIDY, JEANNE, PhD from University of Notre Dame, 1969, 229 pages http://wwwlib.umi.com/dissertations/fullcit/6909454
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Values and Psychotherapy. (afrikaans Text) by VAN VUUREN, REX JANSEN, DPHIL from University of Pretoria (South Africa), 1985 http://wwwlib.umi.com/dissertations/fullcit/f1551893
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Values in Psychotherapy: a Philosophical Analysis of the Normative Assumptions in Freud's Psychoanalysis, Sullivan's Interpersonal Theory of Psychiatry and Frankl's Logotherapy by Kowalkowski, Sally Rose, PhD from Loyola University of Chicago, 1998, 245 pages http://wwwlib.umi.com/dissertations/fullcit/9819616
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Variables Affecting Treatment Acceptability of Child Psychotherapy at an Urban Community Mental Health Clinic by Patel, Jyotsnaben; MS from California State University, Fullerton, 2003, 65 pages http://wwwlib.umi.com/dissertations/fullcit/1413230
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Verbal Interaction in Psychotherapy: Prematurely Terminating Versus Continuing Dyads (prematurely Terminating Dyads) by CAMERON, ALAN SPENCER, PhD from The University of North Carolina at Chapel Hill, 1992, 144 pages http://wwwlib.umi.com/dissertations/fullcit/9234945
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Verbal Prayer in Psychotherapy: a Model for Pastoral Counselors (prayer) by WEBSTER, JAMES PATRICK, STD from San Francisco Theological Seminary, 1992, 207 pages http://wwwlib.umi.com/dissertations/fullcit/9300124
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Videotape Feedback Variables in Psychotherapy by Syer, David D; PhD from York University (Canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK12607
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Videotape Self-confrontation in Group Psychotherapy by Davis, Teresa Mina Anne; PhD from University of Alberta (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK36368
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Views of Women in Theories of Counseling and Psychotherapy. by SHERMAN, JANE CAROLYN, EdD from Idaho State University, 1977, 176 pages http://wwwlib.umi.com/dissertations/fullcit/7730626
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What Predicts Change in Psychotherapy? the Influence of Impairment, Diagnosis, Coping Style, and Resistance on Individual Rates of Change by Malik, Mary Loretta; PhD from University of California, Santa Barbara, 2003, 164 pages http://wwwlib.umi.com/dissertations/fullcit/3093297
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When Consonance Is Not Enough. a Survey of the Use of Dissonant Music in Psychotherapy, with Special Focus upon the Spiritual Dimensions by SOLOMON, ELIDE M., PhD from The Union Institute, 1993, 95 pages http://wwwlib.umi.com/dissertations/fullcit/9318601
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Yoga As Psychotherapy: a Distillation of the Essential Principles of Patanjala Yoga Theory into a Counseling and Psychotherapy Model by ANJALI, PREM, PhD from The Union Institute, 1994, 270 pages http://wwwlib.umi.com/dissertations/fullcit/9514694
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You Are Healing Souls: a History of Psychotherapy Within the Modern Latter-day Saint Community by Swedin, Eric Gottfrid, PhD from Case Western Reserve University, 1996, 519 pages http://wwwlib.umi.com/dissertations/fullcit/9720452
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND PSYCHOTHERAPY Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning psychotherapy.
Recent Trials on Psychotherapy The following is a list of recent trials dedicated to psychotherapy.8 Further information on a trial is available at the Web site indicated. •
Clinician Managed Interpersonal Psychotherapy Condition(s): Depression, Postpartum Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: This study will compare the long-term effectiveness of ClinicianManaged Interpersonal Psychotherapy (CM-IPT) and standard IPT for treatment of postpartum depression. It will also evaluate the acute effectiveness of CM-IPT for postpartum depression. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00043602
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Meaning-Centered Psychotherapy in Advanced Cancer Condition(s): Lymphoma, Non-Hodgkin; Neoplasms Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: We have developed an 8-week Meaning-Centered Group Psychotherapy designed to help patients with advanced cancer sustain or enhance a
8
These are listed at www.ClinicalTrials.gov.
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sense of meaning, peace and purpose despite the limitations of their cancer illness. This project's overall aim is to explore the feasibility and efficacy of this new and unique psychotherapy intervention for advanced cancer patients in enhancing psychological and spiritual well-being and quality of life by comparing it with a standard supportive group psychotherapy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00067288 •
Preventing the Recurrence of Depression with Drugs and Psychotherapy Condition(s): Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to determine whether the addition of Cognitive Therapy (CT) to antidepressant medication (ADM) enhances treatment for depression. This study will also test whether the addition of CT to ADM will prevent recurrences of depression after therapy is over. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057577
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Research Evaluating the Value of Augmenting Medication with Psychotherapy (REVAMP) Condition(s): Depression; Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to determine whether psychotherapy is an effective treatment for patients with chronic depression who have not completely responded to antidepressant medication. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057551
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Treatments for Depression: Drug vs. Psychotherapy Condition(s): Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to compare supportive expressive psychodynamic therapy to antidepressant medication plus Clinical Management for the treatment of patients with Major Depressive Disorder (MDD). A second goal is to evaluate the long-term effects of these 2 treatments on the recurrence of depression.
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Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00043550
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “psychotherapy” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON PSYCHOTHERAPY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “psychotherapy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on psychotherapy, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Psychotherapy By performing a patent search focusing on psychotherapy, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on psychotherapy: •
Apparatus and process for interactive psychotherapy Inventor(s): Frankel; Kenneth (P.O. Box 1351, Ross, CA 94957) Assignee(s): None Reported Patent Number: 5,718,247 Date filed: May 30, 1996 Abstract: A process and apparatus for interactive psychotherapy in which information produced during a patient's therapy is categorized according to data type. The information is then stored to a series of interconnected databases stored in a computer. Empirical Data and Historical Data are developed first, and stored. Then Generalizations (patterns) are derived from this Data, and stored. After Generalizations have been stored, Hypotheses (Explanations of Generalizations) are developed and stored. The Hypotheses are evaluated and tested to determine their truth or falsity. Simultaneously with the derivation of Hypotheses, Goals are derived from the Generalizations, and stored. These Goals are periodically evaluated to assess the patient's progress. Finally, possible Actions to accomplish the Goals are Derived, each Action being based on a Hypothesis. The patient and therapist are provided with simultaneous access to the computer for entry and retrieval of information. The computer has a means of data entry and a means of display for both therapist and patient. Storage is provided for the databases. These databases are accessed jointly by the patient and therapist during the therapy sessions, as well as by the therapist before, during, or after therapy sessions, thereby promoting interactive psychotherapy. Excerpt(s): The invention relates to psychotherapy. More particularly, the invention relates to an apparatus for interactive psychotherapy for simultaneous use in real time therapy by a patient and therapist. In conventional psychotherapy, a patient and a therapist meet to discuss issues of concern. The therapist often takes notes during the therapy session and generates a report afterwards. In some cases, the therapist does not take notes, but writes a report after the session has concluded. Disorganized or incorrect notes may affect the accuracy of the therapist's report. As the therapist must direct his/her attention to the patient, it is difficult to record all of the information from a therapy session. Furthermore, it is not possible to know when a statement made during a particular session will later generate a significant therapy issue. Web site: http://www.delphion.com/details?pn=US05718247__
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Apparatus for measuring psychotherapy outcomes Inventor(s): Brill; Peter L. (Radnor, PA) Assignee(s): Compass Information Services, Inc. (radnor, Pa) Patent Number: 5,435,324 Date filed: May 25, 1994 Abstract: A method and apparatus for measuring a patient's psychotherapy progress is provided. Initial patient mental health is measured by administering a questionnaire measuring three psychological variables. The three psychological variable measures are combined into a mental health index. Following a number of sessions of psychotherapy,
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the patient's subsequent psychological condition is again measured using the three psychological variables. Patient session records are stored in a large database. Patient progress can thus be compared versus patient initial psychological condition, typical patient outcomes as stored in the database, and patient improvement as a function of a number of sessions of psychotherapy can be determined. The system further provides a case manager with a measure of the effectiveness of continued psychotherapy sessions, and a basis of comparison of various psychotherapy providers. Excerpt(s): This invention relates to psychotherapy. More particularly, this invention relates to a system for measuring and quantifying a patient's psychological condition and the progress, stasis, or retrogression thereof, and for administering pyschotherapy based on such measurements. Costs in the health care field have grown at an alarming rate. Efforts to contain these costs through devices such as DRGs have slowed the growth of inpatient care, but total health care costs continue to escalate as the inpatient cost savings have shifted into expenditures for outpatient treatment. Meanwhile, the cost of mental health treatment has greatly outpaced general health care costs. Prior cost containment efforts have focused on inpatient costs. A case management approach has been applied to cost containment efforts. Often, much of a company's mental health costs are for inpatient treatment. However, recent trends are forcing a shift toward outpatient care. Furthermore, simply decreasing the amount of mental health coverage is not an attractive alternative, since poorly treated employees typically work less effectively and have increased absenteeism. Moreover, the families of such employees typically use the general health care system at an increased rate. Mental health care may be characterized by two characteristics of overriding importance: the cost of the care, and the results or benefits of the care. Although cost is easily measured, treatment outcomes and the benefits of mental health care have been difficult if not impossible to measure. Accordingly, efforts to improve the system for delivering mental health care have focused on cost, the only measured variable in the system. Since the cost parameter can be measured, systems which minimize cost tend to be rewarded without regard to the unknown effect of cost minimizing measures on patient care. Efforts to control costs include restricting access to mental health care; a case manager may encourage providers to deny care altogether or to terminate care as early as possible. However, without a reasonably accurate and objective method of evaluating cases, a case manager or other interested person is unable to rationally allocate the limited resources for psychotherapy among those who demand it. For instance, extensive resources may be allocated to patients who would show limited or no improvement even after extended treatment, while resources may be denied to patients who would show substantial improvement with limited treatment. Moreover, without such a method the case manager or other interested person cannot rationally determine which providers should be engaged to provide the most cost-effective and appropriate treatment in an individual case or on an overall basis. Lacking an ability to measure psychotherapy outcomes, efforts to select a provider and a course of therapy have focused on process measures, i.e. measures which attempt to infer the effect of therapy from characteristics of the therapy process such as the credentials of the provider. Too often the therapy approved and provided to a patient is made to fit the insurance or other benefits available to the patient, rather than the patient's condition. In contrast, in physical health care there are numerous lab tests which can accurately diagnose a physical illness and may be used to determine patient response, individually or on a group statistical basis, to particular courses of medical or surgical treatment. Although physical health care costs have continued to rise, the availability of such tests and outcome measures have enabled case managers in that field to more rationally determine when a treatment is
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necessary or appropriate for a condition and allocate limited physical health care resources. Web site: http://www.delphion.com/details?pn=US05435324__ •
Imagescope Inventor(s): Frenkel; Barbara I. (33 Park Rd., Scarsdale, NY 10583), Frenkel; Richard E. (33 Park Rd., Scarsdale, NY 10583) Assignee(s): None Reported Patent Number: 4,327,712 Date filed: December 3, 1979 Abstract: Apparatus is provided to facilitate viewing of one's facial image under controlled illumination patterns for purpose of either psychotherapy or merchandise selection. Excerpt(s): This invention relates to a novel device, hereinafter called an imagescope, which utilizes controlled viewing of one's facial image under selected conditions. In one subgeneric embodiment, the device can assist an individual in treating his emotional disorders. In another subgeneric embodiment, the device can serve as a merchandising aide to assist an individual in choosing or purchasing an item with a greater prospect he will later be satisfied with it. Conventional psychotherapy generally consists of prearranged periodic conferences between the therapist (e.g. psychiatrist, psychologist) and the patient. Such conferences are expensive, inconvenient and generally do not occcur at the time when the patient is experiencing acute distress, e.g. anxiety, depression. Although a psychiatrist can prescribe various psychopharmaceuticals for the patient, chronic reliance on drugs is undesirable. A technique for psychiatric observation purposes had previously been disclosed in Frenkel et al, U.S. Pat. No. 3,326,204. Therein, in the course of a session with a therapist, the patient is instructed to view his facial expressions under natural or colored lighting. The patentees teach a rather cumbersome device to facilitate this technique comprising a local light source focused on the patient and color filters situated in one embodiment between the patient and a mirror, and in another embodiment between the light source and the patient viewing the mirror. The therapist varies the color by rotating a roller on which is wound the colored lenses. In still another variant, the colored filter surrounds the main light source for room illumination permitting the patient to view himself in a wall mirror while bathed in such light. Web site: http://www.delphion.com/details?pn=US04327712__
•
Method for automated collection of psychotherapy patient information and generating reports and treatment plans Inventor(s): Burke; Phil (Wanaque, NJ), Lonski; Michael (112 Shore Rd., Old Greenwich, CT 06870) Assignee(s): Lonski; Michael (old Greenwich, Ct) Patent Number: 6,338,039 Date filed: July 20, 1999
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Abstract: The method and apparatus automatedly generates various reports for a psychotherapy provider. These reports include Treatment Plans, progress reports, scheduling reports and billing reports. The progress reports include a Progress Note which incorporates various selected data into a report for the insurance company. As much of the data is selected from menus, the resulting report can maintain much patient privacy while being satisfactory to the insurance company. More private information can be stored separately in Expanded Text. A Treatment Plan is generated using the various selected data with respect to subsets of emotional factors, intellectual factors, physical factors, social factors, and spiritual factors. These subsets may be chosen randomly or with some periodic selection. Excerpt(s): This invention relates to the practice of psychotherapy in an environment whereby insurance companies and HMOs govern, by their payment rules, how patients are cared for. More particularly, this invention deals with a method for automating the gathering of patient information as well as automating documentation, Treatment Plans, and reports required by insurance companies. In the United States, especially in the last eight years with the explosive growth of managed care and increasingly where Medicare or Medicaid pays for treatment, the administration of psychotherapy is driven by insurance companies. These companies seek to minimize the cost of treatment and demand rigorous documentation by the care provider. As a result, care providers are forced to spend less time with patients and to spend more time generating documentation. As might be expected, patient care has deteriorated with caregivers increasing spending more time, money and energy interacting with managed care companies seeking approval and providing justification for initial concurrent and ongoing treatment. Despite time constraints, the caregiver is expected to interact with a patient, and to make and record observations about patients and their behavior. At some later point, the caregiver must define patient Treatment Plans and generate detailed patient progress reports, typically two pages in length. Treatment Plans and status reports are derived from observations made while the caregiver sees patients. It is not uncommon for a caregiver to see thirty to fifty patients per day. Web site: http://www.delphion.com/details?pn=US06338039__ •
Patient-user interactive psychotherapy apparatus and method Inventor(s): Putnam; Mark D. (50 Mission Trail, Woodside, CA 94062) Assignee(s): None Reported Patent Number: 5,619,291 Date filed: September 1, 1995 Abstract: A patient-user interactive psychotherapy apparatus for use in Eye Movement Desensitization and Reprocessing treatment is disclosed. The psychotherapy apparatus includes a pair of visual displays, each for displaying an image having an emotional impact on a particular patient-user. The visual displays are positioned horizontally spaced from one another in the patient-user's field of view. The visual displays are each operable between two operational states including: a first operational state, wherein the image is highly, visually perceptible by the patient-user; and a second operational state, wherein the image is less visually perceptible by the patient-user. A pair of hand held switch inputs for switching between the two operational states of each visual display is also provided. In use, the patient-user alternately actuates the hand held switch inputs which causes the image to be alternately displayed as a highly, visually perceptible image in a back and forth manner on the two visual displays. The invention allows the
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patient-user to self-induce a comfortable rate and duration of saccadic eye movement as the patient visually tracks the highly, visually perceptible image displayed on the two visual displays. In accordance with a method aspect of the invention, the patient-user may generate additional competing or distracting input stimulus by incorporating up and down arm movement and actuating the hand held switch inputs by directly physically contacting an actuator mechanism of the switch inputs to parts of their anatomy, such as their knees. Excerpt(s): The present invention relates to an interactive psychotherapy apparatus for providing Eye Movement Desensitization and Reprocessing (EMDR) treatment to a patient-user and a method of use of such interactive psychotherapy apparatus. Eye Movement Desensitization and Reprocessing (EMDR) has recently emerged as one of the hottest trends in clinical psychology. Supporters of EMDR report dramatic results when used as a treatment for patients suffering from Post Traumatic Stress Disorder (PTSD) and other related disorders wherein the patient experiences recurring high levels of anxiety due to the painful and emotional memories associated with a particular traumatic experience or a series of traumatic events which occur over a period of time. Such trauma-based disorders are common to war veterans, rape and assault victims, and survivors of natural disasters, such as earthquakes, fires, hurricanes, and the like. The EMDR technique is described in a paper by Francine Shapiro, Ph.D., entitled "Eye Movement Desensitization: A New Treatment For Post-Traumatic Stress Disorder", J. Behav. Ther. & Exp. Psychiat. Vol. 20, No. 3, pp. 211-217 (1989). In accordance with the teachings of this paper, the patient is instructed to hold three things in his or her mind including: a single image of the traumatic incident; the associated emotion and body sensation; and the related negative thought. During this time, the patient's eyes visually track the therapist's hand, with two fingers raised, while the hand is swept rhythmically back and forth along the line of vision of the patient. After each set or "saccade" of eye movements, the patient is asked to rate their level of anxiety or other discomfort. It has been found that the above described EMDR technique has been successful in treating cases of PTSD and other trauma disorders. Web site: http://www.delphion.com/details?pn=US05619291__ •
Psychotherapy apparatus and method for treating undesirable emotional arousal of a patient Inventor(s): Weathers; Lawrence R. (West 1525 - 8th Ave., Spokane, WA 99204) Assignee(s): None Reported Patent Number: 5,219,322 Date filed: June 1, 1992 Abstract: A psychotherapy apparatus and method provides treating of an undesirable emotional arousal of a patient through coordinated and controlled presentation of visual and auditory stimuli to the patient. The operative steps of the psychotherapy apparatus and method include presenting visual stimuli observable by a stationarily-positioned patient at right and left extremes of the patient's range of lateral eye movement, alternately switching the visual stimuli laterally between the right and left extremes of the patient's range of lateral eye movement, presenting auditory stimuli to the patient's ears, alternately switching the auditory stimuli between the patient's ears synchronously with alternately switching of the visual stimuli between the right and left extremes of the patient's range of lateral eye movement, monitoring physiological responses of the patient to the visual and auditory stimuli, and, in response to such monitoring,
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controlling the presenting and switching of the visual and auditory stimuli so as to elict a mental imagery of a negative experience of the patient and to eliminate the undesirable emotional arousal evoked by the negative experience and to substitute a positive experience reinforcing a desired new behavior. Excerpt(s): The present invention generally relates to psychotherapy techniques for treating emotional problems and, more particularly, to a psychotherapy apparatus and method for treating undesirable emotional arousal of a patient. Many members of society currently demonstrating various undesirable (both pathological and nonpathological) behaviors are burdened with various emotional problems and emotionally-aggravated physical problems. Some examples of these problems are anxiety disorders, asthma, panic attacks, depression, anger, impotence, fears and phobias, grief, headaches, marriage problems, post Electro-Convulsive Therapy confusion, anxiety and memory loss, and post traumatic stress disorder (Vietnam and police service and child abuse and incest). The current undesirable behavior of a person provides connection of a current experience with a historical or more recent negative experience. Heretofore, the primary mode of conducting psychotherapy for treatment of these problems has been by the use of one therapist with one patient or one or more therapists with a small group of patients. This mode of psychotherapy has been carried out mainly through verbal communication between therapists and patients. A significant drawback of relying primarily on verbal communication to conduct psychotherapy is that a large number of treatment sessions are needed to adequately deal with these problems. An unfortunate consequence of this is that the greater the overall quantity of time consumed in treatment the greater the cost and the fewer the number of persons that can be treated by a given population of therapists with proper qualification and clinical training. Another significant drawback is that some adults and many children are not verbal enough to successfully profit from verbal therapies. Web site: http://www.delphion.com/details?pn=US05219322__ •
Psychotherapy device Inventor(s): Woods; Ruth E. (2041 N.W. 12th Rd., Gainesville, FL 32605) Assignee(s): None Reported Patent Number: 4,762,494 Date filed: March 18, 1987 Abstract: A psychotherapy device comprising a body member, a pair of arms, legs, and a head connected to the body member wherein said pyschotherapy device is in the general configuration of a child-like human figure. The head includes a pair of expressionless eyes and nose which are permanently affixed to the face and means are connected to the face adjacent to and generally below each of the permanent eyes for releasably receiving indicia of tears wherein during pyschotherapy of a child patient, the patient may be invited to apply or remove tears to reflect a current or past metal state. Excerpt(s): This invention relates to a device for use by psychologists and psychiatrists in connection with evaluation of pre-school and childhood patients in a psychotherapeutic milieu. More particularly the invention relates to a novel psychotherapeutic device which may be advantageously utilized to facilitate communication between a child and a therapist. Psychotherapy may be thought of in its broadest context as a conversation with a therapeutic purpose. The ultimate goals of psychotherapy include: release of a patient's pent-up feelings; conditioning or
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reconditioning of particular responses; examination of a patient's values, concepts and attitudes; muscular relaxation; identification of unconscious impulses; etc. Success in attaining such goals depends upon the particular attitude of the patient with respect to the therapist and an ability of the therapist to communicate with the patient. In this connection, at its core is a unique relationship between a clinician and a patient in which there is communication which can relieve distress and set conditions for relearning and personal growth. Broadly speaking, psychotherapy describes an intentional application of psychological techniques by a clinician to the end of effecting sought after personality, attitude or behavioral changes. Web site: http://www.delphion.com/details?pn=US04762494__
Patent Applications on Psychotherapy As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to psychotherapy: •
Method for automating collection of psychotherapy patient information and generating reports and treatment plans Inventor(s): Burke, Phil; (Wanaque, NJ), Lonski, Michael; (Old Greenwich, CT) Correspondence: Ronald E. Brown; Pitney, Hardin, Kipp & Szuch Llp; 711 Third Avenue, 20th Floor; New York; NY; 10017; US Patent Application Number: 20020128868 Date filed: January 8, 2002 Abstract: The method and apparatus automatedly generates various reports for a psychotherapy provider. These reports include Treatment Plans, progress reports, scheduling reports and billing reports. The progress reports include a Progress Note which incorporates various selected data into a report for the insurance company. As much of the data is selected from menus, the resulting report can maintain much patient privacy while being satisfactory to the insurance company. More private information can be stored separately in Expanded Text. A Treatment Plan is generated using the various selected data with respect to subsets of emotional factors, intellectual factors, physical factors, social factors, and spiritual factors. These subsets may be chosen randomly or with some periodic selection. Excerpt(s): This invention relates to the practice of psychotherapy in an environment whereby insurance companies and HMOs govern, by their payment rules, how patients are cared for. More particularly, this invention deals with a method for automating the gathering of patient information as well as automating documentation, Treatment Plans, and reports required by insurance companies. In the United States, especially in the last eight years with the explosive growth of managed care and increasingly where Medicare or Medicaid pays for treatment, the administration of psychotherapy is driven by insurance companies. These companies seek to minimize the cost of treatment and demand rigorous documentation by the care provider. As a result, care providers are forced to spend less time with patients and to spend more time generating
10
This has been a common practice outside the United States prior to December 2000.
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documentation. As might be expected, patient care has deteriorated with caregivers increasingly spending more time, money and energy interacting with managed care companies seeking approval and providing justification for initial, concurrent and ongoing treatment. Despite time constraints, caregiver is expected to interact with a patient, and to make and record observations about patients and their behavior. At some later point, the caregiver must define patient Treatment Plans and generate detailed patient progress reports, typically two pages in length Treatment Plans and status reports are derived from observations made while the caregiver sees patients. It is not uncommon for a caregiver to see thirty to fifty patients per day. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method of psychotherapeutic influence Inventor(s): Semenov, Sergei Petrovich; (Sankt Petersburg, RU) Correspondence: Henry M Feiereisen; 350 Fifth Avenue; Suite 3220; New York; NY; 10118; US Patent Application Number: 20020077571 Date filed: December 12, 2001 Abstract: The use: medicine, particularly psychotherapy, correction of psychoemotional and psychosomatic disorders. The essence: in order to consolidate the desired alterations anchoring is used, in so doing basic suggestion formulae are related by way of association to the patient's feeling of pulsation. Using patient's own feeling of pulsation as a stimulus increases the efficiency of the treatment because pulsations are always felt by patient, they intensify in frustration and, being semantically linked to suggested alterations, they can unconsciously evoke and produce new patterns of behaviour. Before inducing trance squeezing bands are applied on patient's right and left fingers and/or toes, the extent of squeezing is adjusted until the patient can feel the pulsation under the bands, in the process of suggestion before pronouncing a formula the patient's attention is drawn to the feeling of pulsation and the alteration being suggested is verbally linked to the feeling of pulsation. Excerpt(s): This application claims the priority of Russian Patent Application, Serial No. 2000130933, filed Dec. 14, 2000, the subject matter of which is incorporated herein by reference. The present invention relates to the field of medicine, particularly to psychotherapy and may be used in correction of psychoemotional and psychosomatic disorders. Nowadays the number of psychologically caused disorders has increased significantly. The accelerated tempo of modern living and complicated interpersonal communication lead to higher stress risks resulting in increased psychic disorders, alcoholism, drug addiction etc. In view of this the creation of methods of psychotherapeutic correction is actual. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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•
Visible light modifier and method Inventor(s): Barnhurst, Jeffrey E.; (Henderson, NV) Correspondence: Weiss & Moy PC; 4204 North Brown Avenue; Scottsdale; AZ; 85251; US Patent Application Number: 20030058413 Date filed: September 26, 2001 Abstract: A visible light modifier and method provide a new visual display. A projection is generated by the visible light modifier that includes a chromatically separated light beam having variations generating a stunning visual display. The display may be used in advertising, entertainment, psychotherapy and anywhere that attention-getting or mood-altering visual displays are desired. The visible light modifier includes a fluid refractive medium bounded by a reflective surface so that an angular chromatic separation is achieved in a beam reflected from the reflective surface through the refractive medium. Motion of the fluid generates variations in the chromatic distribution within of the reflected beam, which can be projected on a screen or other suitable background. Motion of the fluid may be induced externally, for example, by placing the visible light modifier on an audio speaker, or an internal transducer may be included that may be coupled to an audio source or another source of stimulus. Excerpt(s): The present invention relates generally to visible lighting systems, and more specifically, to a projection device for generating visual displays. Visible light displays are in use in a multitude of applications. Laser displays are used for entertainment, advertising, education and anywhere that an attention-getting display is desired. In home use, devices such as "Lava Lamps" and small laser or pseudo-laser halogen lampbased devices provide entertaining displays that may be synchronized to music, enhancing their effect. Part of the value of the above-mentioned displays lies in the motion of the light, which is generally projected on a screen or other background. The motion of the light provides an effect that may be soothing (slow, curved paths) or stimulating (fast, sharp paths). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with psychotherapy, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “psychotherapy” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on psychotherapy. You can also use this procedure to view pending patent applications concerning psychotherapy. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON PSYCHOTHERAPY Overview This chapter provides bibliographic book references relating to psychotherapy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on psychotherapy include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “psychotherapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on psychotherapy: •
Psychotherapy with Deaf and Hard-of-hearing Persons: A Systemic Model, Second Edition Source: Framingham, MA. Boston University. Contact: Available from Lawrence Erlbaum Associates, Inc. 10 Industrial Avenue, Mahwah, NJ 07430-2262. 800-926-6579. Fax: 201-760-3753. E-mail:
[email protected]. Web site: www.erlbaum.com. Fed ID: 22-2043137. PRICE: $49.95 plus shipping and handling. ISBN: 0-8058-4375-2 (cloth). 248pp. Summary: In this 2nd edition, the author elaborates on his original biopsychosocial model of the effective assessment and treatment of deaf and hard-of-hearing clients in individual and family therapy. He examines the influences of larger networks on the individual and vice versa, and illuminates the overt and covert conflicts among family
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members, school, vocational rehabilitation personnel, and friends that often exacerbate problems. Spiritual issues are addressed, and theory is balanced with practical advice. •
AIDS - Related Psychotherapy Contact: Pergamon Press, 660 White Plains Rd, Tarrytown, NY, 10591, (914) 524-9200. Summary: This book provides information to help psychotherapists anticipate and prepare for the complexities and challenges of working with Persons with AIDS (PWA's). It is introduced as a subspecialty that has some things in common with other types of therapy, but is also unique because of emotional, physical, and sociopolitical aspects of the AIDS epidemic. Seventeen chapters are grouped under the headings of introduction; mechanics of therapy; the therapist's feelings; other related issues (such as screening, prevention counseling, injection drug use, worried well, and spirituality), and rethinking service delivery.
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Psychotherapy and Counseling in the Treatment of Drug Abuse Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: This monograph assembles a collection of papers delineating the methodological problems in doing psychotherapy and counseling research in the area of drug abuse treatment, and describing strategies researchers can use in dealing with those problems. The first two papers are reviews of research findings. One discusses psychotherapy and counseling in opiate abuse, and the other examines retention of cocaine abusers in individual supportive- expressive therapy and structural-strategic family therapy. The second group of papers focuses exclusively on methodological and design issues in carrying out psychotherapy and counseling research, with emphases on problems in doing this kind of research with drug abusers. The final paper explores research priorities and future directions.
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Guide to Counseling: Perspective on Psychotherapy, Prevention, and Therapeutic Practice Contact: Jossey - Bass Publishers, PO Box 44305, San Francisco, CA, 94144-4305, (415) 433-1767. University of California San Francisco, AIDS Health Project, 1855 Folsom St Ste 670, San Francisco, CA, 94103-4241, (415) 502-8378, http://www.ucsf-ahp.org. Summary: This monograph, for mental health professionals, provides comprehensive guidelines for counseling individuals at risk for and infected with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and their loved ones. It is arranged into four parts that define the role of counselors working in the HIV epidemic: risk and behavior, psychotherapy and transformation, distress and disorder, and countertransference and therapeutic practice. It discusses HIV prevention by helping clients identify and implement achievable risk-reduction goals; the psychosocial concerns that are arising in the context of new treatment successes, and the effect of stereotypes and assumptions on the psychotherapeutic process; disorders that might arise from HIV including psychiatric disorders that did not exist before; and the ways in which therapists undertake and respond to the process of practicing psychotherapy, the difficult decisions HIV requires therapists to make, and the monumental effect of grief and loss on burnout and care. The monograph presents the unique experiences of individuals affected and infected by HIV/AIDS.
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Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “psychotherapy” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “psychotherapy” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “psychotherapy” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Primer of Transference Focused Psychotherapy for the Borderline Patient by Otto Kernberg, et al; ISBN: 0765703556; http://www.amazon.com/exec/obidos/ASIN/0765703556/icongroupinterna
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Adult Attachment and Couple Psychotherapy: The 'Secure Base' in Practice and Research by Christopher Clulow (Editor); ISBN: 0415224160; http://www.amazon.com/exec/obidos/ASIN/0415224160/icongroupinterna
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Anatomy of the Psyche: Alchemical Symbolism in Psychotherapy by Edward F. Edinger; ISBN: 0812690095; http://www.amazon.com/exec/obidos/ASIN/0812690095/icongroupinterna
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Art Psychotherapy in Groups: Between Picture and Words by Sally Skaife (Editor), et al; ISBN: 0415150736; http://www.amazon.com/exec/obidos/ASIN/0415150736/icongroupinterna
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Bergin and Garfield's Handbook of Psychotherapy and Behavior Change by Michael J. Lambert (Author); ISBN: 0471377554; http://www.amazon.com/exec/obidos/ASIN/0471377554/icongroupinterna
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Case Approach to Counseling and Psychotherapy by Gerald Corey; ISBN: 0534348203; http://www.amazon.com/exec/obidos/ASIN/0534348203/icongroupinterna
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Changing Character: Short-Term Anxiety-Regulating Psychotherapy for Restructuring Defenses, Affects, and Attachment by Leigh McCullough Vaillant; ISBN: 0465077927; http://www.amazon.com/exec/obidos/ASIN/0465077927/icongroupinterna
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College Psychotherapy by Paul A. Grayson (Editor), Kate Cauley (Editor); ISBN: 0898627478; http://www.amazon.com/exec/obidos/ASIN/0898627478/icongroupinterna
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Comprehensive Guide to Interpersonal Psychotherapy (Basic Behavioral Science Books) by Myrna M. Weissman, et al; ISBN: 0465095666; http://www.amazon.com/exec/obidos/ASIN/0465095666/icongroupinterna
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Counseling and Psychotherapy Theories in Context and Practice : Skills, Strategies, and Techniques by John Sommers-Flanagan (Author), Rita Sommers-Flanagan (Author); ISBN: 0471211052; http://www.amazon.com/exec/obidos/ASIN/0471211052/icongroupinterna
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Counseling and Psychotherapy with Children and Adolescents: Theory and Practice for School and Clinical Settings by H. Thompson Prout (Editor), Douglas T. Brown (Editor); ISBN: 0471182362; http://www.amazon.com/exec/obidos/ASIN/0471182362/icongroupinterna
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Despair and the Return of Hope: Echoes of Mourning in Psychotherapy by Peter C. Shabad; ISBN: 0765703157; http://www.amazon.com/exec/obidos/ASIN/0765703157/icongroupinterna
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Doing Psychotherapy by Michael Franz Basch; ISBN: 0465016847; http://www.amazon.com/exec/obidos/ASIN/0465016847/icongroupinterna
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Escape from Babel: Toward a Unifying Language for Psychotherapy Practice by Scott D. Miller, et al; ISBN: 0393702197; http://www.amazon.com/exec/obidos/ASIN/0393702197/icongroupinterna
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Ethics in Counseling and Psychotherapy: Standards, Research, and Emerging Issues by Elizabeth Reynolds Welfel; ISBN: 0534367526; http://www.amazon.com/exec/obidos/ASIN/0534367526/icongroupinterna
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Ethics in Psychotherapy and Counseling: A Practical Guide by Kenneth S. Pope (Author), Melba J. T. Vasquez (Author); ISBN: 0787943061; http://www.amazon.com/exec/obidos/ASIN/0787943061/icongroupinterna
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Existential Psychotherapy by Irvin, M.D. Yalom, Irvin D. Yalom; ISBN: 0465021476; http://www.amazon.com/exec/obidos/ASIN/0465021476/icongroupinterna
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Gaslighting, the Double Whammy, Interrogation, and Other Methods of Covert Control in Psychotherapy and Analysis by Theodore L. Dorpat, Theo L. Dorpat; ISBN: 1568218281; http://www.amazon.com/exec/obidos/ASIN/1568218281/icongroupinterna
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Group Psychotherapy With Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory (Haworth Addictions Treatment) by Philip J. Flores; ISBN: 0789060019; http://www.amazon.com/exec/obidos/ASIN/0789060019/icongroupinterna
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Handbook of Counseling and Psychotherapy with Older Adults by Michael Duffy (Editor); ISBN: 0471254614; http://www.amazon.com/exec/obidos/ASIN/0471254614/icongroupinterna
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Harm Reduction Psychotherapy: The New Treatment for Drug and Alcohol Problems by Andrew Tatarsky (Editor); ISBN: 0765703521; http://www.amazon.com/exec/obidos/ASIN/0765703521/icongroupinterna
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Heinz Kohut and the Psychology of the Self (Makers of Modern Psychotherapy) by Allen M. Siegel; ISBN: 0415086388; http://www.amazon.com/exec/obidos/ASIN/0415086388/icongroupinterna
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How to Build a Thriving Fee-For-Service Practice: Integrating the Healing Side with the Business Side of Psychotherapy by Laurie Kolt (Author); ISBN: 0124179452; http://www.amazon.com/exec/obidos/ASIN/0124179452/icongroupinterna
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Human Change Processes: The Scientific Foundations of Psychotherapy by Michael J. Mahoney; ISBN: 0465031188; http://www.amazon.com/exec/obidos/ASIN/0465031188/icongroupinterna
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If You Meet the Buddha on the Road, Kill Him : The Pilgrimage Of Psychotherapy Patients by Sheldon Kopp (Author); ISBN: 0553278320; http://www.amazon.com/exec/obidos/ASIN/0553278320/icongroupinterna
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Individual Psychotherapy and the Science of Psychodynamics by David H. Malan; ISBN: 075062387X; http://www.amazon.com/exec/obidos/ASIN/075062387X/icongroupinterna
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Inpatient Group Psychotherapy by Irvin D. Yalom; ISBN: 0465032982; http://www.amazon.com/exec/obidos/ASIN/0465032982/icongroupinterna
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Interpersonal Process in Psychotherapy: A Relational Approach by Edward Teyber; ISBN: 0534362958; http://www.amazon.com/exec/obidos/ASIN/0534362958/icongroupinterna
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Interpersonal Psychotherapy of Depression (The Master Work Series) by Gerald L. Klerman (Editor), et al; ISBN: 1568213506; http://www.amazon.com/exec/obidos/ASIN/1568213506/icongroupinterna
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Love's Executioner : & Other Tales of Psychotherapy by Irvin D. Yalom (Author); ISBN: 0060958340; http://www.amazon.com/exec/obidos/ASIN/0060958340/icongroupinterna
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Moving Psychotherapy: Theory and Application of Pesso System/Psychomotor Therapy by Albert Pesso (Editor), John Crandell (Editor); ISBN: 0914797727; http://www.amazon.com/exec/obidos/ASIN/0914797727/icongroupinterna
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On Becoming a Person: A Therapist's View of Psychotherapy by Carl Rogers (Author), Peter D. Kramer (Introduction); ISBN: 039575531X; http://www.amazon.com/exec/obidos/ASIN/039575531X/icongroupinterna
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Psychoanalytic Psychotherapy : A Practitioner's Guide by Nancy McWilliams (Author); ISBN: 1593850093; http://www.amazon.com/exec/obidos/ASIN/1593850093/icongroupinterna
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Psychotherapy Relationships That Work: Therapists Contributions and Responsiveness to Patients by John C. Norcross (Editor); ISBN: 0195143469; http://www.amazon.com/exec/obidos/ASIN/0195143469/icongroupinterna
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Rent Two Films and Let's Talk in the Morning: Using Popular Movies in Psychotherapy, 2nd Edition by John W. Hesley (Author), Jan G. Hesley (Author); ISBN: 0471416592; http://www.amazon.com/exec/obidos/ASIN/0471416592/icongroupinterna
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Systems of Psychotherapy: A Transtheoretical Analysis by James O. Prochaska, John C. Norcross; ISBN: 0534590853; http://www.amazon.com/exec/obidos/ASIN/0534590853/icongroupinterna
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The Adolescent Psychotherapy Progress Notes Planner by Arthur E. Jongsma (Author), et al; ISBN: 0471459798; http://www.amazon.com/exec/obidos/ASIN/0471459798/icongroupinterna
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The Adolescent Psychotherapy Treatment Planner by Arthur E. Jongsma Jr. (Author), et al; ISBN: 0471270490; http://www.amazon.com/exec/obidos/ASIN/0471270490/icongroupinterna
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The Adult Psychotherapy Progress Notes Planner by Arthur E. Jongsma (Author), David J. Berghuis (Author); ISBN: 047145978X; http://www.amazon.com/exec/obidos/ASIN/047145978X/icongroupinterna
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The Child and Adolescent Psychotherapy Treatment Planner by L. Mark Peterson (Contributor), et al; ISBN: 0471156477; http://www.amazon.com/exec/obidos/ASIN/0471156477/icongroupinterna
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The Child Psychotherapy Progress Notes Planner by Arthur E. Jongsma (Author), et al; ISBN: 0471459801; http://www.amazon.com/exec/obidos/ASIN/0471459801/icongroupinterna
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The Child Psychotherapy Treatment Planner by Arthur E. Jongsma Jr. (Author), et al; ISBN: 0471270504; http://www.amazon.com/exec/obidos/ASIN/0471270504/icongroupinterna
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The Complete Adult Psychotherapy Treatment Planner by Arthur E. Jongsma Jr. (Author), L. Mark Peterson (Author); ISBN: 0471271136; http://www.amazon.com/exec/obidos/ASIN/0471271136/icongroupinterna
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The Couples Psychotherapy Treatment Planner by K. Daniel O'Leary (Author), et al; ISBN: 0471247111; http://www.amazon.com/exec/obidos/ASIN/0471247111/icongroupinterna
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The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain by Louis Cozolino; ISBN: 0393703673; http://www.amazon.com/exec/obidos/ASIN/0393703673/icongroupinterna
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The Practice of Supportive Psychotherapy by David S. Werman; ISBN: 0876303653; http://www.amazon.com/exec/obidos/ASIN/0876303653/icongroupinterna
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The Present Moment in Psychotherapy and Everyday Life by Daniel N. Stern; ISBN: 0393704297; http://www.amazon.com/exec/obidos/ASIN/0393704297/icongroupinterna
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The Psychotherapy Documentation Primer by Donald E. Wiger (Author); ISBN: 0471289906; http://www.amazon.com/exec/obidos/ASIN/0471289906/icongroupinterna
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The Therapist's Notebook: Homework, Handouts, and Activities for Use in Psychotherapy (Haworth Marriage and the Family) by Lorna L. Hecker, Sharon A. Deacon; ISBN: 0789004003; http://www.amazon.com/exec/obidos/ASIN/0789004003/icongroupinterna
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Theories of Counseling and Psychotherapy: A Multicultural Perspective (5th Edition) by Allen E. Ivey (Author), et al; ISBN: 0205340725; http://www.amazon.com/exec/obidos/ASIN/0205340725/icongroupinterna
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Theories of Psychotherapy & Counseling With Infotrac: Concepts and Cases by Richard S. Sharf, Richard S. Scharf; ISBN: 0534531040; http://www.amazon.com/exec/obidos/ASIN/0534531040/icongroupinterna
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Theory and Practice of Counseling and Psychotherapy by Gerald Corey; ISBN: 0534348238; http://www.amazon.com/exec/obidos/ASIN/0534348238/icongroupinterna
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Theory and Practice of Group Psychotherapy by Irvin D. Yalom; ISBN: 0465084486; http://www.amazon.com/exec/obidos/ASIN/0465084486/icongroupinterna
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Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective by Mark Epstein; ISBN: 0465085857; http://www.amazon.com/exec/obidos/ASIN/0465085857/icongroupinterna
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Time-Limited Dynamic Psychotherapy: A Guide to Clinical Practice by Hanna Levenson; ISBN: 0465086519; http://www.amazon.com/exec/obidos/ASIN/0465086519/icongroupinterna
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Toward a Psychology of Awakening : Buddhism, Psychotherapy, and the Path of Personal and Spiritual Transformation by John Welwood (Author); ISBN: 1570628238; http://www.amazon.com/exec/obidos/ASIN/1570628238/icongroupinterna
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Transforming Aggression : Psychotherapy With the Difficult-to-Treat Patient by Frank M. Lachmann; ISBN: 0765702932; http://www.amazon.com/exec/obidos/ASIN/0765702932/icongroupinterna
Chapters on Psychotherapy In order to find chapters that specifically relate to psychotherapy, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and psychotherapy using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “psychotherapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on psychotherapy: •
Psychotherapy for Inflammatory Bowel Disease: New Prospects Source: in Williams, C.N., et al., eds. Trends in Inflammatory Bowel Disease Therapy 1999. Boston, MA: Kluwer Academic Publishers. 2000. p. 185-193. Contact: Available from Kluwer Academic Publishers. Customer Service Deparment, P.O. Box 358, Accord Station, Hingham, MA 02018-0358. (781) 871-6600. Fax (781) 6819045. E-mail:
[email protected]. Website: www.wkap.nl. PRICE: 145.00 plus shipping and handling. ISBN: 0792387627. Summary: Psychotherapeutic approaches to inflammatory bowel disease (IBD) have come in two historical ways. In the first, psychoanalysis assumed a model of psychogenic etiology (cause) and aimed for cure. A second wave aimed to improve coping and reduce the psychosocial consequences of IBD. This chapter on psychotherapy for inflammatory bowel disease (IBD) is from a monograph that reprints the presentations given at the Trends in Inflammatory Bowel Disease Therapy Symposium, held in Vancouver, British Columbia, Canada, in August 1999. The general objective of the conference was to provide an update in the etiology, pathogenesis, and treatment of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and CD. In this chapter, the author reports on two new psychotherapeutic approaches for IBD. Supportive expressive (SE) group psychotherapy was originally described for women with metastatic breast cancer. An adaptation for use in IBD has been tested in four 20 week groups (n = 30). The group discussion is grounded in major IBD concerns including uncertainty, personal control and burden on others, physician-patient relationship, medication concern, and body image. The expressive aspect of SE refers to facing the challenges and limitations imposed by illness honestly, and expressing the feelings that result. The supportive aspect of SE refers to the emphasis on interpersonal support as a buffer against the negative psychosocial consequences of disease. Results demonstrate that among those who complete the group (n = 24), improvement in maladaptive coping behaviors occurs concurrently with improvement in IBD related quality of life in subjects who improve with therapy (67 percent). A second approach to psychotherapy follows from recent data suggesting that a personality trait which results in stress vulnerability (insecure attachment) may be relevant to disease course in a
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biologically identified subgroup of UC patients. The author describes the model of interaction between individual differences in stress response and biological subtypes of UC which predicted this finding. These data, pending replication, imply that screening of UC patients to identify stress-vulnerable individuals may be useful. The author also discusses the selective application of psychotherapy to modify an interpersonal style which increases stress vulnerability, with respect to therapeutic technique and goals. 2 figures. 36 references. •
Integrated Approach to Psychotherapy with the ESRD Population: A Case Presentation Source: in Hardy, M.A., et al., eds. Psychosocial Aspects of End-Stage Renal Disease: Issues of Our Times. Binghamton, NY: Haworth Press. 1991. p. 77-82. Contact: Available from Haworth Press. 10 Alice Street, Binghamton, NY 13904-1580. (607) 722-2493. PRICE: $32.95 plus $2.75 shipping and handling. ISBN: 1560241497. Summary: This chapter, from a book about the psychosocial aspects of end-stage renal disease (ESRD), uses a case presentation to suggest an integrated approach to psychotherapy with the ESRD population. The author shows how this approach helped an ESRD patient to regain control and autonomy of both his health and his life. Sections include the case presentation, a psychodynamic formulation, a behavioral formulation, intervention, and outcome. 6 references.
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Use and Application of Cognitive-Behavioral Psychotherapy With Deaf Persons Source: in Nowell, R.C.; Marshak, L.E., eds. Understanding Deafness and the Rehabilitation Process. Needham Heights, MA: Allyn and Bacon. 1994. p. 155-187. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02194-2310. (617) 455-1200. PRICE: $44.95 plus shipping and handling. ISBN: 0205156282. Summary: This chapter, from a book on deafness and the rehabilitation process, discusses the use and application of cognitive-behavioral psychotherapy with deaf persons. Topics covered include the historical perspective, identification of mental health needs, the phases of individual cognitive-behavioral psychotherapy, the use of group counseling, and cognitive-behavioral group counseling. A large section of the chapter describes practical intervention considerations, including reducing resistance to treatment, the identification of qualified counselors, and the use of interpreters in psychotherapy and counseling sessions. The author provides anecdotal support for the effectiveness of a cognitive-behavioral intervention that indicates that deaf people are able to benefit from a therapeutic approach emphasizing the ability to use and/or changes one's cognitions for adaptive functioning. 4 tables. 132 references.
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CHAPTER 8. MULTIMEDIA ON PSYCHOTHERAPY Overview In this chapter, we show you how to keep current on multimedia sources of information on psychotherapy. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on psychotherapy is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “psychotherapy” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “psychotherapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on psychotherapy: •
Recognizing and Managing Erectile Dysfunction Source: Kansas City, MO: American Academy of Family Physicians. 2000. (videocassette). Contact: Available from American Academy of Family Physicians. 8880 Ward Parkway, Kansas City, MO 64114-2797. (800) 274-2237. PRICE: $17.95 for members; $25.00 for nonmembers, plus shipping and handling. Summary: Sexual dysfunction affects about 31 percent of men in the United States. The most common of these problems are erectile dysfunction (ED, formerly called impotence), premature ejaculation, inability to achieve orgasm or ejaculation, and decreased libido. This continuing education program focuses on ED, which is defined as the inability to achieve or maintain penile erection sufficient for sexual intercourse. The program includes a videotape program and study guide and covers the causes of ED, including vascular, neurologic, endocrine, anatomical, and medications and substance abuse; the evaluation of ED, including patient history, a focused physical examination,
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the indications for laboratory tests, and the role of referral; therapeutic options, including medical (drug) therapy, vacuum constriction devices, psychotherapy or sex therapy, intraurethral therapy, intracavernosal injection, and surgery; and patient education. The program stresses that any patient with a complaint of erectile problems should be thoroughly evaluated before treatment recommendations are made. The first step in treatment is addressing modifiable causes or exacerbating factors. If further treatment is necessary, a number of safe and effective options are available. Patients can be assured that ED is treatable. Men and their partners may also benefit from counseling to address related emotional and relationship issues. The program comes with a patient information fact sheet (which can be photocopied and distributed), and a form with which readers can qualify for continuing education credits. 11 tables. 13 references. •
Learning to Care: An Introduction to HIV Psychiatry Contact: Canadian Public Health Association, Canadian HIV/AIDS Clearinghouse, 4001565 Carling Ave Ste 400, Ottawa, (613) 725-3434, http://www.cpha.ca. Canadian Psychiatric Association, 260-441 MacLaren St, Ottawa, http://cpa.medical.org. Summary: This video, for mental health professionals, examines treating individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) for psychiatric disorders. The objectives of the video are to review the basic principles of psychiatric intervention with individuals living with HIV/AIDS, including drug therapy and psychotherapy strategies; to build on the viewer's existing knowledge; and to suggest ways of augmenting specific learning. The video features four patients affected by HIV/AIDS to illustrate how common psychiatric disorders and their treatment differ compared to regular psychiatric patients. It covers anxiety disorder, mood disorder, mania/bipolar disorders, psychosis, delirium, cognitive/motor disorders, and bereavement. It provides suggestions for specific psychotherapy and medications for each disorder.
Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “psychotherapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on psychotherapy: •
Group Therapy for HIV Infected Sexually Compulsive Gay Men; the 16th National Lesbian & Gay Health Conference & 12th Annual AIDS/HIV Forum, New York, NY, June 21 - 26, 1994 Contact: Encore Cassettes, PO Box 231340, San Diego, CA, 92194, (619) 596-8402. Summary: This audio cassette recording discusses group and individual outpatient psychotherapy, sexual and chemical addictions, the AIDS Mental Health Project of Greenwich House, HIV-infected and affected substance abusers, and twelve-step recovery programs. The speaker outlines a paper to be published in the Journal of Psychology and Human Sexuality on group therapy for HIV-infected sexually compulsive gay men. She offers an historical view of the group, an explanation of the intake process, a description of the group population, a summary of group membership,
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and six case histories from the group. Details of Benison Shepard's group theory are referenced. The scarcity of research on sexual compulsivity and its relation to HIV is mentioned. •
Plenary Presentation Sessions on AIDS Update. The Second International Lesbian and Gay Health Conference and AIDS Forum, Boston, MA, July 20-26, 1988 Contact: Audio Video Transcripts, 250 W 49th St, New York, NY, 10019, (212) 586-1972. Summary: This sound recording of the Second International Lesbian and Gay Health Conference and AIDS Forum, on July 20-26, 1988, in Boston, MA, presents a session on the neuropsychiatric aspects of Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV) infection. Dr. Marshall Forstein, co-director of an outpatient psychiatric hospital in Cambridge, examines the broad spectrum of concerns, clinical issues, and treatment modalities for the mental illnesses associated with AIDS. The organic basis for behavioral changes, primary infection of HIV in brain tissue, and primary dementing illness are explained in reference to differential diagnosis from delirium, toxoplasmosis and other infections, and drug effects. Compliance; management of pain syndromes; suicide; psychopharmacology, particularly with ritalin; and psychotherapy are also discussed. Dr. David Ostrow, associate professor of psychiatry at the University of Michigan, discusses the natural history of HIV-related brain disease and related ethical problems as evident from a general opinion survey regarding AIDS policies: Employment-based policies, social programs, and mandatory public health policies.
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CHAPTER 9. PERIODICALS AND NEWS ON PSYCHOTHERAPY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover psychotherapy.
News Services and Press Releases One of the simplest ways of tracking press releases on psychotherapy is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “psychotherapy” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to psychotherapy. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “psychotherapy” (or synonyms). The following was recently listed in this archive for psychotherapy: •
Psychotherapy, hypnosis may bring period back Source: Reuters Health eLine Date: October 13, 2003
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Raging on the road? Psychotherapy may help Source: Reuters Health eLine Date: August 22, 2002
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UK agency rejects computerised psychotherapy Source: Reuters Health eLine Date: May 17, 2002
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Antidepressants and psychotherapy produce similar changes in brain activity Source: Reuters Industry Breifing Date: July 23, 2001
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Psychotherapy equals drugs for depression Source: Reuters Health eLine Date: December 04, 1998
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Psychotherapy helps stress disorder Source: Reuters Health eLine Date: July 28, 1998
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Triptorelin Plus Psychotherapy Effective For Men With Severe Paraphilia Source: Reuters Medical News Date: February 12, 1998
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Psychotherapy's Role in Cancer Survival Source: Reuters Health eLine Date: July 15, 1997
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Psychotherapy Helps Workers Find Jobs Source: Reuters Health eLine Date: July 11, 1997
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Psychotherapy Aids Disaster Victims Source: Reuters Health eLine Date: April 04, 1997
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Brief Psychotherapy Improves Outcome In Traumatized Adolescents Source: Reuters Medical News Date: April 04, 1997
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Bulimia Nervosa: Role Of Medication And Psychotherapy Elucidated Source: Reuters Medical News Date: April 03, 1997
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Sleep Patterns Predict Response To Psychotherapy In Depression Source: Reuters Medical News Date: April 02, 1997
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Virtual Reality Psychotherapy Curative In Arachnophobia Case Source: Reuters Medical News Date: January 28, 1997
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Supreme Court Backs Psychotherapy Confidentiality Source: Reuters Medical News Date: June 17, 1996 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date
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at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “psychotherapy” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “psychotherapy” (or synonyms). If you know the name of a company that is relevant to psychotherapy, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “psychotherapy” (or synonyms).
Newsletters on Psychotherapy Find newsletters on psychotherapy using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “psychotherapy.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “psychotherapy” (or synonyms) into the “For these words:” box. The following list was generated using the options described above:
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Relieving the Psychological Symptoms of IBD and IBS Source: Intestinal Fortitude. 4(3): 2-3. Fall 1993. Contact: Available from Intestinal Disease Foundation, Inc. 1323 Forbes Avenue, Suite 200, Pittsburgh, PA 15219. (412) 261-5888. Summary: This newsletter article considers the psychological symptoms of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), focusing on impaired emotional functioning and social limitations. The author encourages readers to discuss any concerns about emotional or social symptoms with their health care providers. Such discussion results in patients who are more active participants in health care and in the education of physicians about psychological symptoms. Other topics include how one determines if psychological problems warrant a referral to a mental health professional and treatment options, including hypnosis, biofeedback, psychotherapy, and support groups. One table summarizes the research findings of one study on this topic. 1 table.
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “psychotherapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on psychotherapy: •
Excessive Exercise: Understanding the Addiction Source: SCAN's Pulse. 20(1):16-17. Winter 2001. Contact: Sports, Cardiovascular, and Wellness Nutritionists, HOD/Practice Operations Team, the American Dietetic Association, 216 W. Jackson Blvd., Suite 800, Chicago, IL 60606-6995. Summary: Although there is not a standard definition for excessive exercise, this term is included in the diagnostic criteria for anorexia nervosa and bulimia. How much exercise is 'too much' depends on the individual. Elite athletes are known for their strenuous and prolonged workouts. This article states that those who exercise for more than an hour each day for the 'sole purpose of burning calories' may be exercising for the wrong reasons. A consistent feature of excessive exercise is mood disorder, manifested by depression, anger, and irritability brought about when a person is unable to exercise. Another trait that distinguishes a person who exercises compulsively from one who exercises for good health is the physical price (in injury or pain) the excessive exerciser pays. The authors explore the link between excessive exercise and disordered eating and note research suggesting that excessive physical activity should be carefully examined as a forerunner to anorexia nervosa. Excessive exercising may be treated with cognitive behavioral therapy, interpersonal psychotherapy, and medication. The role of the dietetics professional includes evaluating the client's food intake, providing nutrition guidance and support, identifying disordered eating patterns, and dispelling misconceptions about diet and exercise. Dietetic practitioners may have little knowledge
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of complex exercise behaviors and should seek advice from an allied professional who specializes in this area. A sidebar lists the components of the Exercise Habits Inventory, an instrument to measure exercise dependence. •
Antidepressants and Functional Gastrointestinal Disorders Source: Participate. 9(4): 1-3. Winter 2000. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail:
[email protected]. Website: www.iffgd.org. Summary: Antidepressants are commonly prescribed for the treatment of functional gastrointestinal (GI) disorders; they are unique drugs that have a number of properties that make them particularly useful. This article reviews three factors regarding antidepressants and functional GI disorders. The first is the mechanism of action of antidepressants, or how they exert their effect. The second is the relationship between the brain and the gut, also known as the 'brain gut axis.' Finally is the role of antidepressants in treating the various symptoms of functional GI disorders. The author first offers a history of the development of antidepressant drugs and their use for GI disorders, notably irritable bowel syndrome (IBS) and noncardiac chest pain (NCCP). Patients with IBS treated with the tricyclic desipramine (Norpramin) demonstrated improvement in their GI symptoms as well as a better sense of overall well being. Patients with NCCP on imipramine (Tofranil) reported a significant improvement in their gastrointestinal symptoms as well as improvement in their overall sense of well being. The author concludes with a brief discussion of the biopsychosocial model, where multiple dimensions of the patient's life, including gut function, overall well being, overall quality of life, and emotional status, are considered in patient treatment strategies. The use of dietary modification, antispasmodics, antidiarrheals, antidepressants, and behavioral interventions such as biofeedback, psychotherapy, and relaxation therapy all play a synergistic and important role in improving outcomes in functional gastrointestinal disorders. The author also stresses the importance of adequate patient education and patients participating as active members of their own health care team. One sidebar discusses the use of drugs based on serotonin for treating IBS.
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Medication Treatments for Binge Eating Disorder Source: Weight Control Digest. 7(4):633, 636-639; July/Aug 1997. Contact: Weight Control Digest, 1555 W. Mockingbird Lane, Suite 203, Dallas, TX 75235. (800) 736-7323. Summary: This article examines the use of medications in treating overweight individuals with binge eating disorder. The authors first describe what binge eating disorder (BED) is, and how it differs from the bingeing and purging syndrome. They then review studies done with antidepressants, appetite suppressants, combinations of these medications and psychotherapy, and behavior modification. The authors then offer guidelines for the use of medications in the treatment of BED and suggest what the future treatment of BED might be. They conclude that any treatment plan for BED should include medication, behavior modification, and diet and lifestyle changes.
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Dyspepsia in Children Source: Digestive Health Matters. 2(3): 2-3. Fall 2000.
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Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. Website: www.iffgd.org. Summary: This health newsletter article reviews the condition of dyspepsia (pain or discomfort in the upper abdomen) in children. Individuals often describe the pain of dyspepsia as occurring around eating, after eating, or at night. The discomfort can be a sensation of fullness after meals, an early feeling of having had enough to eat (satiety), bloating, belching, nausea, retching, vomiting, regurgitation, anorexia (lack of appetite), or food refusal. Each of these symptoms can be due to either an organic disease or a functional gastrointestinal disease; the author offers guidelines to distinguishing between these. The list of causes that must be ruled out before a diagnosis of functional dyspepsia is lengthy and includes upper gastrointestinal inflammation, motility disorders, pancreatic, biliary or urinary disease, and psychiatric disease. Functional dyspepsia is divided into three subgroups: ulcer like dyspepsia, dysmotility like dyspepsia, and non specific dyspepsia. As with many other conditions, a thorough and detailed history taken by a physician is the most important component of the assessment and often leads to the correct diagnosis. The author notes that controversy exists regarding the extent of diagnostic tests that should be performed in a child who seems to have functional dyspepsia. Urine evaluation and blood evaluation to screen for organic are usually necessary. The management of dyspepsia revolves around determining the cause and treating it (for organic disease) or to providing symptomatic relief (for functional disease). In addition, H2 blockers and prokinetic agents are used in children when continued dyspepsia symptoms interfere with normal daily activities and school. For children who may have a behavioral or psychological base to their complaint, treatment that involves environmental modification, relaxation techniques, psychotherapy, stress reduction, hypnotherapy, or biofeedback have been used with variable success. One sidebar defines some of the diagnostic tests that may be used, including endoscopy, ultrasonography, and gastroduodenal manometry. •
Stuttering and Singing: Is There a Connection? Source: Voice Foundation Newsletter. 5(1): 3-4. January 1999. Contact: Available from Voice Foundation. 1721 Pine Street, Philadelphia, PA 19103. (215) 735-7999. Fax (215) 735-9293. E-mail:
[email protected]. Summary: This newsletter article ponders the connection between stuttering and singing. The author comments that people who stutter often do not stutter when singing. The author then reports on her findings from a study to determine why this is so. The author begins by defining stuttering and noting that the cause of the problem is still unknown. The best method of treatment is also an area of considerable disagreement. Many factors including the age of the person who stutters and the type of stuttering are important in choosing appropriate therapy. Treatment approaches include psychotherapy, fear reduction, relaxation, more efficient vocal technique, new ways of stuttering, negative reinforcements in the form of time outs as well as positive reinforcement, reducing rate of speech, increasing syllable duration, biofeedback techniques, reading aloud and in unison with others, and even masking the sound of the person's voice (so that the individual cannot hear himself or herself while speaking). Circumstances such as singing, speaking rhythmically, and choral speaking can markedly decrease stuttering. The author concludes by posing some possible reasons why stuttering often disappears with singing.
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Academic Periodicals covering Psychotherapy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to psychotherapy. In addition to these sources, you can search for articles covering psychotherapy that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
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These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
12
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “psychotherapy” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 100671 9149 779 257 106 110962
HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “psychotherapy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
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Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
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The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
19 Adapted 20
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on psychotherapy can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to psychotherapy. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to psychotherapy. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “psychotherapy”:
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Child Mental Health http://www.nlm.nih.gov/medlineplus/childmentalhealth.html Mental Health http://www.nlm.nih.gov/medlineplus/mentalhealth.html Teen Mental Health http://www.nlm.nih.gov/medlineplus/teenmentalhealth.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on psychotherapy. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Diabetes and Impotence-New Options for Treatment Source: Washington, DC: Impotence Institute of America, Inc. 199x. 3 p. Contact: Available from Impotence Institute of America. 10400 Little Pawtuxent Parkway, Suite 485, Columbia, MD 21044. (410) 715-9605. PRICE: Contact organization directly. Summary: Diabetes mellitus is the most common abnormality associated with impotence, affecting approximately two million men in the United States. This fact sheet discusses diabetes and impotence, with a focus on treatment options. Topics include the causes of erectile dysfunction; diagnostic tests and evaluative procedures; the role of optimal diabetes control; lifestyle habits that might affect impotence, such as smoking or drinking alcohol; external vacuum erection assistance devices; self-injection therapy; surgical management, including vascular surgery and penile prostheses; and the role of psychotherapy.
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Men and IC Source: Rockville, MD: Interstitial Cystitis Association (ICA). 2003. [1 p.]. Contact: Available from Interstitial Cystitis Association (ICA). 110 North Washington Street, Suite 340, Rockville, MD 20850. (301) 610-5300. Fax (301) 610-5308. E-mail:
[email protected]. Website: www.ichelp.org. PRICE: $1.00 for members; $1.25 for nonmembers; plus shipping and handling. Item number: RFM01. Summary: Interstitial cystitis (IC) is characterized by painful bladder symptoms in the absence of infection or other identifiable conditions. This fact sheet reviews the problem
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of IC in men, a much less common occurrence than in women. Estimates indicate that about 10 percent of all IC patients are men. Symptoms are similar to those experienced by women: urinary frequency and urgency, often accompanied by suprapubic pain, in the absence of any bacterial infection or carcinoma. Men may also experience scrotal and anal pain. Men have often experienced the same difficulty as many women have in obtaining an accurate diagnosis of IC, but for slightly different reasons. In men, IC mimics nonbacterial prostatitis (prostate infection) or prostatodynia (painful prostate). The fact sheet reviews the standard diagnostic approach for men, the impact of IC on erectile function, treatment options, and self help treatments including self relaxation, visualization, self hypnosis, massage, acupuncture, physical therapy, diet modification, bladder retraining, pelvic floor exercises, biofeedback, and psychotherapy. Standard IC treatments for males include medications instilled in the bladder, such as DMSO, heparin, and BCG (experimental); oral medications such as Elmiron or hydroxyzine; anti depressants such as Elavil; hydrodistention; and, as a last resort, surgery. The fact sheet concludes with the contact information for the Interstitial Cystitis Association (ICA, www.ichelp.org). •
Children and AIDS Contact: American Psychiatric Press, Inc., 1400 K St NW, Washington, DC, 20005, (800) 368-5777. Summary: This book provides an extensive overview of the medical, social, and psychological issues affecting children with AIDS by examining the differences between adult AIDS and pediatric AIDS. Regarding clinical issues related to children and AIDS from expert perspectives in such varied disciplines as law, social work, nursing, psychology, anthropology, neurology, obstetrics, neuropsychology, neonatology, psychiatry, and child psychiatry, this book presents a glimpse of what health care professionals encounter when providing for the needs of HIV-infected children and their families. The book separates material into three sections to examine specific issues on pediatric HIV and AIDS. Section one addresses management of HIV-infected pregnant women designed to meet the needs of African-American and Mexican-Latino children, ways in which health care professionals responsible for adolescents must recognize the distinctive developmental characteristics of adolescence, and the issues faced by HIV-infected children and adolescents with hemophilia. The next section explores neuropsychological assessment, illustrates the right of an HIV-infected child to an appropriate education, and analyzes the family perspective of parents and children who are HIV-positive or who have pediatric AIDS. Section three features issues of comprehensive care delivery for children and families with HIV infection, the development and use of community resources to assist HIV-infected women and children, caregiver and institutional issues in clinical care of HIV spectrum disease, and psychotherapy issues in pediatric HIV and AIDS.
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Care for Your Aging Relatives Far Away Source: Bethesda, MD: Aging Network Services. Contact: Available from Aging Network Services. Topaz House, 4400 East-West Highway, Suite 907, Bethesda, MD 20814. (301) 657-4329. Summary: This brochure describes psychotherapy services for older persons and their families who live in different cities. It explains the introductory consultation, linkage with local geriatric social worker, and follow-up contacts. Other services include 24-
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hour emergency message coverage, home visits, coordination of medical and other services, and future planning. •
Impotence Is Treatable Source: Bowie, MD: Impotence Institute of America. 199x. [4 p.]. Contact: Available from Impotence Institute of America. P.O. Box 410, Bowie, MD 20718-0410. (800) 669-1603 or (301) 262-2400. Fax (301) 262-6825. E-mail:
[email protected]. Website: www.impotenceworld.org. PRICE: Single copy free. Summary: This brochure encourages readers to seek treatment for erectile dysfunction (impotence), a problem that responds well to a variety of treatments. Erectile dysfunction (ED) is defined by the National Institutes of Health as the inability to achieve or to maintain an erection adequate for sexual intercourse. The author emphasizes that men must seek treatment for impotence, whether or not they intend to resume sexual activity because it may be a symptom of a more serious undiagnosed medical illness. The brochure also emphasizes the importance of including one's partner in the effort to diagnose and treat ED. The brochure outlines causes of 'temporary impotence,' including fatigue, tension, excessive drinking, and certain medications. Age in and of itself does not cause impotence; however, the illnesses associated with the aging process can cause ED. These diseases include diabetes, cardiovascular disease, kidney disease, and liver disease. Proper diagnosis will determine whether the cause of ED is physical or psychological or a combination of both; appropriate treatment can then be undertaken. The brochure outlines treatment options, including pharmaceutical (oral medication, urethral inserts, injection therapy, transdermal therapy), surgery (penile prostheses or implants, and vascular surgery), psychotherapy, and external management (vacuum therapy, support sleeves). The brochure includes quotations from men and their partners as they deal with ED. The brochure concludes with a brief description of two organizations, Impotents Anonymous (IA), for men with ED, and IANON for partners of men with ED.
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Depression in Lupus Source: Washington, DC: Lupus Foundation of America. 2000. 6 p. Contact: Available from Lupus Foundation of America. 2000 L. St., Suite 710, Washington, DC 20036-4916. (202) 349-1155 or (800) 558-0121. (800) 558-0231 (information in Spanish). Fax: (202) 349-1156. Website: www.lupus.org. Summary: This brochure examines the occurrence of depression in individuals with lupus. The physical and psychological symptoms of clinical depression are discussed. In individuals with lupus, clinical depression may be the result of the stress of having a chronic condition or of various medications used to treat lupus. Depression can be treated with psychotropic medication, psychotherapy, or a combination of the two. The brochure also discusses cognitive changes that may occur in individuals with lupus as well as the prognosis for individuals with lupus who are treated for their depression.
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Counseling Consultation Care Management for Families and Aging Relatives Source: Bethesda, MD: Aging Network Services. 1987. Contact: Available from Aging Network Services. Topaz House, 4400 East-West Highway, Suite 907, Bethesda, MD 20814. (301) 657-4329.
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Summary: This brochure provides information for older persons and their families on care management services available from Aging Network Services. These include psychotherapy, resource finding, workshops, support groups, and assistance with daily life activities. •
Women's Recovery Center, P.C Source: Narberth, PA: Women's Recovery Center, N.D. Contact: Women's Recovery Center, P.C., 110 North Essex Avenue, Narberth, PA 19072. (610) 664-5858. Summary: This center was created to meet the special needs of women with eating disorders. It offers psychotherapy, nutrition counseling, and family therapy. Treatment emphasizes the importance of women becoming active decision-makers in their lives. The center also provides resource materials and a book shop.
•
Depression and HIV : Assessment and Treatment Contact: Project Inform, HIV Treatment Hotline, 205 13th St Ste 2001, San Francisco, CA, 94103, (415) 558-8669, http://www.projectinform.org. Summary: This fact sheet discusses the treatment of persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) who also suffer from depression. The fact sheet defines depression and explains how it affects persons with HIV/AIDS and their medical treatments. It identifies the symptoms of depression and outlines the various options that can be used to treat depression in conjunction with HIV/AIDS treatment. The treatment options discussed include psychotherapy, which consists of counseling, peer support, and/or group counseling, as well as pharmacotherapy. The fact sheet makes recommendations concerning the safe administration of pharmacotherapy to persons with HIV/AIDS.
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Impotence Source: Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 1998. 6 p. Contact: Available from National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 3 Information Way, Bethesda, MD 20892-3580. (301) 654-4415. Fax (301) 907-8906. E-mail:
[email protected]. Also available at http://www.niddk.nih.gov/. PRICE: Full-text available online at no charge; single copy free; bulk copies available. Summary: This fact sheet provides information about impotence, which is a consistent inability to sustain an erection sufficient for sexual intercourse; impotence is also known as erectile dysfunction. The fact sheet, written in question and answer format, covers how an erection occurs; the causes of impotence; diagnostic techniques, including the physical examination, laboratory tests, monitoring for nocturnal erections, and a psychosocial examination; and treatment options for erectile dysfunction, including psychotherapy, drug therapy, vacuum devices, and surgery. The fact sheet concludes with a brief description of the National Kidney and Urologic Diseases Information Clearinghouse, and a short list of resources for more information. 3 figures. The fact sheet is available in English and Spanish.
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Erectile Dysfunction Source: Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 2002. 8 p. Contact: Available from National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 3 Information Way, Bethesda, MD 20892-3580. (800) 891-5390 or (301) 654-4415. Fax (301) 634-0716. E-mail:
[email protected]. Website: http://www.niddk.nih.gov/health/kidney/nkudic.htm. PRICE: Full-text available online at no charge; single copy free; bulk orders available. NIH Publication number: 033923. Summary: This fact sheet reviews erectile dysfunction (ED), the repeated inability to get or keep an erection firm enough for sexual intercourse. The fact sheet first reviews the anatomy and physiology of erection and the penis, then discusses the causes of ED, diagnostic strategies to confirm the condition, treatment options, and research studies in this area. Most physicians suggest that treatments proceed from least to most invasive. Treatments outlined include psychotherapy, drug therapy, mechanical vacuum erection devices, and surgery (including penile implants). The fact sheet includes the contact information for resource organizations for readers wishing to obtain more information about ED. The fact sheet concludes with a brief description of the National Kidney and Urologic Diseases Information Clearinghouse. 3 figures.
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Stress: What Stress Does to Diabetes Control Source: Alexandria, VA: American Diabetes Association. 1994. 4 p. Contact: Available from American Diabetes Association, Inc. Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. PRICE: $9.95 (members), $11.95 (nonmembers) for 50 copies; single copy free. Order number CDBD30. Summary: This fact sheet, which is one in a series of 42 fact sheets about living and coping with diabetes, provides information on fighting stress. Although stress is a normal part of life, it can make controlling blood glucose levels more difficult. Topics include a definition of stress, the effect of stress on diabetes, stress and personality, relaxation techniques, and other recommendations for reducing mental stress. Although a stressful lifestyle alone cannot cause diabetes, it can induce symptoms in a person already headed for diabetes. The fact sheet suggests lifestyle changes, breathing exercises, progressive relaxation therapy, physical exercise, distraction, and psychotherapy as methods for alleviating stress. (AA-M). The National Guideline Clearinghouse™
The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “psychotherapy” (or synonyms). The following was recently posted:
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(1) Best practice evidence-based guideline for the appropriate prescribing of hormone replacement therapy. (2) Guideline update: hormone replacement therapy Source: Effective Practice Institute, University of Auckland - Academic Institution; 2001 May (revised information released on 2002 September 30); 185 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3107&nbr=2333&a mp;string=psychotherapy
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American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple's problem--2003 update Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1998 (revised 2003); 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3725&nbr=2951&a mp;string=psychotherapy
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American Gastroenterological Association medical position statement on anorectal testing techniques Source: American Gastroenterological Association - Medical Specialty Society; 1998 July 24 (reviewed 2001); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3066&nbr=2292&a mp;string=psychotherapy
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American Gastroenterological Association medical position statement on obesity Source: American Gastroenterological Association - Medical Specialty Society; 2002 September; 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3490&nbr=2716&a mp;string=psychotherapy
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American Gastroenterological Association medical position statement: guidelines on constipation Source: American Gastroenterological Association - Medical Specialty Society; 2000 May 21 (reviewed 2001); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3061&nbr=2287&a mp;string=psychotherapy
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American Gastroenterological Association medical position statement: irritable bowel syndrome Source: American Gastroenterological Association - Medical Specialty Society; 1996 November 10 (revised 2002 Dec); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3685&nbr=2911&a mp;string=psychotherapy
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Assessment and management of acute pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 2000 October (revised 2002 Oct); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3500&nbr=2726&a mp;string=psychotherapy
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Assessment and management of pain Source: Registered Nurses Association of Ontario - Professional Association; 2002 November; 142 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3720&nbr=2946&a mp;string=psychotherapy
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Behavioral counseling in primary care to promote physical activity: recommendation and rationale Source: United States Preventive Services Task Force - Independent Expert Panel; 1996 (revised 2002 August 6); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3278&nbr=2504&a mp;string=psychotherapy
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Brief interventions and brief therapies for substance abuse Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2541&nbr=1767&a mp;string=psychotherapy
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Cancer pain Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2003 March; 88 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3748&nbr=2974&a mp;string=psychotherapy
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Cardiac rehabilitation Source: Agency for Healthcare Research and Quality - Federal Government Agency [U.S.]; 1995 October (reviewed 2000); 202 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1049&nbr=93& ;string=psychotherapy
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Cardiac rehabilitation. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2002 January; 32 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3185&nbr=2411&a mp;string=psychotherapy
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Cardiovascular disease in women: a guide to risk factor screening, prevention and management Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3487&nbr=2713&a mp;string=psychotherapy
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Chronic pain management in the long-term care setting Source: American Medical Directors Association - Professional Association; 1999; 34 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2158&nbr=1384&a mp;string=psychotherapy
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Clinical challenges of perimenopause: consensus opinion of The North American Menopause Society Source: The North American Menopause Society - Private Nonprofit Organization; 2000 January; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2564&nbr=1790&a mp;string=psychotherapy
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Clinical practice guideline for the management of postoperative pain Source: Department of Defense - Federal Government Agency [U.S.]; 2001 July (revised 2002 May); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3284&nbr=2510&a mp;string=psychotherapy
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Clinical practice guideline: treatment of the school-aged child with attentiondeficit/hyperactivity disorder Source: American Academy of Pediatrics - Medical Specialty Society; 2001 October; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3072&nbr=2298&a mp;string=psychotherapy
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Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult Source: American College of Critical Care Medicine - Professional Association; 1995 (revised 2002); 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3171&nbr=2397&a mp;string=psychotherapy
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Common gynecologic problems: a guide to diagnosis and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3486&nbr=2712&a mp;string=psychotherapy
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Congestive heart failure in adults Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1997 October (revised 2002 Jan); 71 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3165&nbr=2391&a mp;string=psychotherapy
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Crisis intervention Source: Registered Nurses Association of Ontario - Professional Association; 2002 August; 55 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3718&nbr=2944&a mp;string=psychotherapy
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Depression in older adults Source: The John A. Hartford Foundation Institute for Geriatric Nursing - Academic Institution; 2003; 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3512&nbr=2738&a mp;string=psychotherapy
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Depression. A guide to diagnosis and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2001; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3432&nbr=2658&a mp;string=psychotherapy
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Diagnosis and management of attention deficit hyperactivity disorder in primary care for school age children and adolescents Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1997 January (revised 2003 Mar); 66 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3761&nbr=2987&a mp;string=psychotherapy
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Diagnosis and management of headache Source: National Committee on Neuroscience (Singapore) - National Government Agency [Non-U.S.]; 2000 November; 25 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2838&nbr=2064&a mp;string=psychotherapy
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Enhancing motivation for change in substance abuse treatment Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2542&nbr=1768&a mp;string=psychotherapy
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Evaluation of dyspepsia Source: American Gastroenterological Association - Medical Specialty Society; 1997 November 8 (reviewed 2001); 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1295&nbr=529&am p;string=psychotherapy
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Evidence-based clinical practice guideline. Continence for women Source: Association of Women's Health, Obstetric, and Neonatal Nurses - Professional Association; 2000 January; 27 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2925&nbr=2151&a mp;string=psychotherapy
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Evidence-based guidelines for weaning and discontinuation of ventilatory support Source: American Association for Respiratory Care - Professional Association; 2001 December; 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3214&nbr=2440&a mp;string=psychotherapy
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Evidence-based protocol. Elderly suicide: secondary prevention Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2002 June; 56 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3308&nbr=2534&a mp;string=psychotherapy
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Evidence-based protocol. Individualized music Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1996 (revised 2001 Feb); 35 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3073&nbr=2299&a mp;string=psychotherapy
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Evidence-based protocol. Wandering Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2002 March; 45 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3250&nbr=2476&a mp;string=psychotherapy
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Family involvement in care for persons with dementia (FIC) Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1999; 40 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1723&nbr=949&am p;string=psychotherapy
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Guideline for the management of acute and chronic pain in sickle cell disease Source: American Pain Society - Professional Association; 1999 August; 96 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2621&nbr=1847&a mp;string=psychotherapy
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Guideline for the prevention of falls in older persons Source: American Academy of Orthopaedic Surgeons - Medical Specialty Society; 2001 May; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2973&nbr=2199&a mp;string=psychotherapy
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Health professional's guide to rehabilitation of the patient with osteoporosis Source: American Academy of Orthopaedic Surgeons - Medical Specialty Society; 2003; 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3863&nbr=3074&a mp;string=psychotherapy
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Lung cancer. Palliative care Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3653&nbr=2879&a mp;string=psychotherapy
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Major depression in adults for mental health care providers Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 February (revised 2002 May); 43 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3354&nbr=2580&a mp;string=psychotherapy
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Major depression, panic disorder and generalized anxiety disorder in adults in primary care Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 January (revised 2002 May); 55 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3350&nbr=2576&a mp;string=psychotherapy
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Migraine headache Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 November (revised 2002 Jul); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3441&nbr=2667&a mp;string=psychotherapy
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North American Spine Society Phase III: clinical guidelines for multidisciplinary spine care specialists. Spinal stenosis version 1.0. Source: North American Spine Society - Medical Specialty Society; 2002; 91 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3609&nbr=2835&a mp;string=psychotherapy
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Pain in osteoarthritis, rheumatoid arthritis, and juvenile chronic arthritis Source: American Pain Society - Professional Association; 2002; 179 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3691&nbr=2917&a mp;string=psychotherapy
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Postnatal depression and puerperal psychosis. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2002 June; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3360&nbr=2586&a mp;string=psychotherapy
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Practice guideline for psychiatric evaluation of adults. Source: American Psychiatric Association - Medical Specialty Society; 1995 (reviewed 2000); 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1407&nbr=665&am p;string=psychotherapy
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Practice guideline for the treatment of patients with bipolar disorder (revision) Source: American Psychiatric Association - Medical Specialty Society; 1994 December (revised 2002 Apr); 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3302&nbr=2528&a mp;string=psychotherapy
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Practice guideline for the treatment of patients with borderline personality disorder Source: American Psychiatric Association - Medical Specialty Society; 2001 October; 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2972&nbr=2198&a mp;string=psychotherapy
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Practice guideline for the treatment of patients with delirium Source: American Psychiatric Association - Medical Specialty Society; 1999 May; 41 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2180&nbr=1406&a mp;string=psychotherapy
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Practice guideline for the treatment of patients with eating disorders Source: American Psychiatric Association - Medical Specialty Society; 1993 (updated 2000 Jan); 51 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2194&nbr=1420&a mp;string=psychotherapy
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Practice guideline for the treatment of patients with HIV/AIDS Source: American Psychiatric Association - Medical Specialty Society; 2000 November; 62 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2604&nbr=1830&a mp;string=psychotherapy
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Practice guideline for the treatment of patients with major depressive disorder Source: American Psychiatric Association - Medical Specialty Society; 1993 (revised 2000); 45 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2605&nbr=1831&a mp;string=psychotherapy
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Practice guidelines for the management of constipation in adults Source: Association of Rehabilitation Nurses - Professional Association; 2002; 51 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3687&nbr=2913&a mp;string=psychotherapy
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Practice parameter for the assessment and treatment of children and adolescents with schizophrenia Source: American Academy of Child and Adolescent Psychiatry - Medical Specialty Society; 2000 June 6; 40 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3017&nbr=2243&a mp;string=psychotherapy
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Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior Source: American Academy of Child and Adolescent Psychiatry - Medical Specialty Society; 2000 October 17; 55 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3019&nbr=2245&a mp;string=psychotherapy
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Practice parameter: evidence-based guidelines for migraine headache (an evidencebased review). Report of the Quality Standards Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 September; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2820&nbr=2046&a mp;string=psychotherapy
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Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2001 May; 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2818&nbr=2044&a mp;string=psychotherapy
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Practice parameters for the assessment and treatment of children and adolescents who are sexually abusive of others Source: American Academy of Child and Adolescent Psychiatry - Medical Specialty Society; 1999 June 27; 72 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2142&nbr=1368&a mp;string=psychotherapy
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Practice parameters for the assessment and treatment of children, adolescents, and adults with autism and other pervasive developmental disorders Source: American Academy of Child and Adolescent Psychiatry - Medical Specialty Society; 1999 June 27; 69 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2141&nbr=1367&a mp;string=psychotherapy
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Practice parameters for the assessment and treatment of children, adolescents, and adults with mental retardation and comorbid mental disorders Source: American Academy of Child and Adolescent Psychiatry - Medical Specialty Society; 1999 June 27; 77 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2140&nbr=1366&a mp;string=psychotherapy
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Practice parameters for the nonpharmacologic treatment of chronic insomnia Source: American Academy of Sleep Medicine - Professional Association; 1999; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2275&nbr=1501&a mp;string=psychotherapy
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Pressure ulcer prevention and treatment following spinal cord injury Source: Consortium for Spinal Cord Medicine - Private Nonprofit Organization; 2000 August; 80 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2589&nbr=1815&a mp;string=psychotherapy
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Prevention and treatment of violence against women: systematic review and recommendations Source: Canadian Task Force on Preventive Health Care - National Government Agency [Non-U.S.]; 2001 September; 62 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3657&nbr=2883&a mp;string=psychotherapy
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Preventive health care, 2000 update: prevention of child maltreatment Source: Canadian Task Force on Preventive Health Care - National Government Agency [Non-U.S.]; 1993 (updated 2000); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2701&nbr=1927&a mp;string=psychotherapy
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Prompted voiding for persons with urinary incontinence Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1999; 47 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1724&nbr=950&am p;string=psychotherapy
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Reflex sympathetic dystrophy/complex regional pain syndrome clinical practice guidelines - third edition Source: International Research Foundation for RSD/CRPS - Private Nonprofit Research Organization; 2003 January 1; 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4117&nbr=3162&a mp;string=psychotherapy
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Schizophrenia Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2003 February; 40 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3750&nbr=2976&a mp;string=psychotherapy
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Screening for depression: recommendations and rationale Source: United States Preventive Services Task Force - Independent Expert Panel; 1996 (revised 2002 May); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3176&nbr=2402&a mp;string=psychotherapy
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Smoking cessation Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2002 April; 33 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3437&nbr=2663&a mp;string=psychotherapy
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Substance abuse treatment for persons with child abuse and neglect issues Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 2000; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2543&nbr=1769&a mp;string=psychotherapy
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The diagnosis and treatment of adult asthma Source: New Zealand Guidelines Group - Private Nonprofit Organization; 2002 September; 101 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3462&nbr=2688&a mp;string=psychotherapy
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Treatment for stimulant use disorders Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2540&nbr=1766&a mp;string=psychotherapy
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VHA/DOD clinical practice guideline for the management of major depressive disorder in adults Source: Department of Defense - Federal Government Agency [U.S.]; 1997 (updated 2000); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2585&nbr=1811&a mp;string=psychotherapy
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VHA/DoD clinical practice guideline for the management of substance use disorders Source: Department of Defense - Federal Government Agency [U.S.]; 2001 September; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3169&nbr=2395&a mp;string=psychotherapy
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Weight management counseling of overweight adults Source: American College of Preventive Medicine - Medical Specialty Society; 2001 July; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3154&nbr=2380&a mp;string=psychotherapy Healthfinder™
Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:
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Group Psychotherapy Summary: Group psychotherapy is a special form of therapy in which a small number of people meet together under the guidance of a professionally trained therapist to help themselves and one another. Source: American Group Psychotherapy Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7779
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Mood Charts: Child and Adolescent Bipolar Foundation Summary: The Child & Adolescent Bipolar Foundation recommends that parents keep a daily chart of their child's mood, sleep, energy, medications, psychotherapy sessions, and statements or events of concern. Source: Child & Adolescent Bipolar Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=8020 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to psychotherapy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to psychotherapy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with psychotherapy. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about psychotherapy. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “psychotherapy” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “psychotherapy”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “psychotherapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “psychotherapy” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
22
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
23
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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PSYCHOTHERAPY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Absenteeism: Chronic absence from work or other duty. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actualization: Possibilities of realizing fully one's personal (e. g. intellectual) potential. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adolescent Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in individuals 13-18 years. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the
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complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Aldehyde Dehydrogenase: An enzyme that oxidizes an aldehyde in the presence of NAD+ and water to an acid and NADH. EC 1.2.1.3. Before 1978, it was classified as EC 1.1.1.70. [NIH]
Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH]
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Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Anthropology: The science devoted to the comparative study of man. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antidiarrheals: Miscellaneous agents found useful in the symptomatic treatment of diarrhea. They have no effect on the agent(s) that cause diarrhea, but merely alleviate the condition. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with
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specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antispasmodics: Medicines that help reduce or stop muscle spasms in the intestines. Examples are dicyclomine (dy-SY-klo-meen) (Bentyl) and atropine (AH-tro-peen) (Donnatal). [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Art Therapy: The use of art as an adjunctive therapy in the treatment of neurological, mental, or behavioral disorders. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH]
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Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Behavioral Sciences: Disciplines concerned with the study of human and animal behavior. [NIH]
Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]
Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Bereavement: Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. [NIH] Bibliotherapy: A form of supportive psychotherapy in which the patient is given carefully selected material to read. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning
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technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breathing Exercises: Therapeutic exercises aimed to deepen inspiration or expiration or even to alter the rate and rhythm of respiration. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Cancer Information Service: CIS. The Cancer Information Service is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the
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pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cetirizine: A potent second-generation histamine H1 antagonist that is effective in the treatment of allergic rhinitis, chronic urticaria, and pollen-induced asthma. Unlike many traditional antihistamines, it does not cause drowsiness or anticholinergic side effects. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH]
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Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Child Behavior: Any observable response or action of a child from 24 months through 12 years of age. For neonates or children younger than 24 months, infant behavior is available. [NIH]
Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening,
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prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codons: Any triplet of nucleotides (coding unit) in DNA or RNA (if RNA is the carrier of primary genetic information as in some viruses) that codes for particular amino acid or signals the beginning or end of the message. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted thinking and to replace it with more rational, adaptive thoughts and beliefs. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [NIH] Colitis: Inflammation of the colon. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin
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system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Compulsions: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells,
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adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Cost-benefit: A quantitative technique of economic analysis which, when applied to radiation practice, compares the health detriment from the radiation doses concerned with the cost of radiation dose reduction in that practice. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans)
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end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Criterion: A standard by which something may be judged. [EU] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU]
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Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dicyclomine: A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [NIH] Dietetics: The study and regulation of the diet. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Disulfiram: A carbamate derivative used as an alcohol deterrent. It is a relatively nontoxic substance when administered alone, but markedly alters the intermediary metabolism of
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alcohol. When alcohol is ingested after administration of disulfiram, blood acetaldehyde concentrations are increased, followed by flushing, systemic vasodilation, respiratory difficulties, nausea, hypotension, and other symptoms (acetaldehyde syndrome). It acts by inhibiting aldehyde dehydrogenase. [NIH] Diurnal: Occurring during the day. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH]
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Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electroconvulsive Therapy: Electrically induced convulsions primarily used in the treatment of severe affective disorders and schizophrenia. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emetic: An agent that causes vomiting. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local
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anesthetics. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Family Characteristics: Size and composition of the family. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Family Therapy: A form of group psychotherapy. It involves treatment of more than one member of the family simultaneously in the same session. [NIH]
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Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Free Association: Spontaneous verbalization of whatever comes to mind. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Counseling: Advising families of the risks involved pertaining to birth defects, in order that they may make an informed decision on current or future pregnancies. [NIH]
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Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestures: Movement of a part of the body for the purpose of communication. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Happiness: Highly pleasant emotion characterized by outward manifestations of gratification; joy. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or
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as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemicrania: An ache or a pain in one side of the head, as in migraine. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH]
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Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Home Care Services: Community health and nursing services providing coordinated multiple service home care to the patient. It includes home-offered services provided by a visiting nurse, home health agencies, hospitals, or organized community groups using professional staff for care delivery. It differs from home nursing which is provided by nonprofessionals. [NIH] Home Nursing: Nursing care given to an individual in the home. The care may be provided by a family member or a friend. Home nursing as care by a non-professional is differentiated from home care services provided by professionals: visiting nurse, home health agencies, hospital, or other organized community group. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydroxyzine: A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite cetirizine, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotherapy: Sleeping-cure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral
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walls of the third ventricle. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunogenic: Producing immunity; evoking an immune response. [EU] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incest: Sexual intercourse between persons so closely related that they are forbidden by law to marry. [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant Behavior: Any observable response or action of a neonate or infant up through the age of 23 months. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the
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microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. [NIH] Intravenous: IV. Into a vein. [NIH] Introns: Non-coding, intervening sequences of DNA that are transcribed, but are removed from within the primary gene transcript and rapidly degraded during maturation of messenger RNA. Most genes in the nuclei of eukaryotes contain introns, as do mitochondrial and chloroplast genes. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
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Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lenses: Pieces of glass or other transparent materials used for magnification or increased visual acuity. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number
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3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Manometry: Tests that measure muscle pressure and movements in the GI tract. [NIH] Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc. [NIH] Mastectomy: Surgery to remove the breast (or as much of the breast tissue as possible). [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of
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the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Health Services: Organized services to provide mental health care. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metastatic cancer: Cancer that has spread from the place in which it started to other parts of the body. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary
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arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Mother-Child Relations: Interaction between the mother and the child. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter Studies: Controlled studies which are planned and carried out by several cooperating institutions to assess certain variables and outcomes in specific patient populations, for example, a multicenter study of congenital anomalies in children. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic
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method that allows simultaneous study of two or more dependent variables. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Music Therapy: The use of music as an adjunctive therapy in the treatment of neurological, mental, or behavioral disorders. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Natural Disasters: Sudden calamitous events producing great material damage, loss, and distress. They are the result of natural phenomena such as earthquakes, floods, etc. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatology: A subspecialty of pediatrics concerned with the newborn infant. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU]
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Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropsychology: A branch of psychology which investigates the correlation between experience or behavior and the basic neurophysiological processes. The term neuropsychology stresses the dominant role of the nervous system. It is a more narrowly defined field than physiological psychology or psychophysiology. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nursing Services: A general concept referring to the organization and administration of nursing activities. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Obsessional: Neurosis characterized by the repetitive intrusion into the mind, against volition, of ideas, numinations and phobias, often associated with compulsive actions. [NIH]
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Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. [NIH] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxytocin: A nonapeptide posterior pituitary hormone that causes uterine contractions and stimulates lactation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by
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disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Parent-Child Relations: The interactions between parent and child. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]
Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penile Erection: The state of the penis when the erectile tissue becomes filled with blood and causes the penis to become rigid and elevated. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Perceived risk: Estimate or evaluation of risk as observed through personal experience or personal study, and personal evaluation of consequences. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU]
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Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Pernicious: Tending to a fatal issue. [EU] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins
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that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Preoperative: Preceding an operation. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or
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severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychoanalysis: The separation or resolution of the psyche into its constituent elements. The term has two separate meanings: 1. a procedure devised by Sigmund Freud, for investigating mental processes by means of free association, dream interpretation and interpretation of resistance and transference manifestations; and 2. a theory of psychology developed by Freud from his clinical experience with hysterical patients. (From Campbell, Psychiatric Dictionary, 1996). [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors.
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[EU]
Psychological Techniques: Methods used in the diagnosis and treatment of behavioral, personality, and mental disorders. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychopharmacology: The study of the effects of drugs on mental and behavioral activity. [NIH]
Psychophysiology: The study of the physiological basis of human and animal behavior. [NIH]
Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychosurgery: Treatment of chronic, severe and intractable psychiatric disorders by surgical removal or interruption of certain areas or pathways in the brain, especially in the prefrontal lobes. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Public Sector: The area of a nation's economy that is tax-supported and under government control. [NIH] Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulsation: A throb or rhythmical beat, as of the heart. [EU] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH]
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Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Recovery Room: Hospital unit providing continuous monitoring of the patient following anesthesia. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH]
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Reflective: Capable of throwing back light, images, sound waves : reflecting. [EU] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Relaxation Techniques: The use of muscular relaxation techniques in treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal cell cancer: Cancer that develops in the lining of the renal tubules, which filter the blood and produce urine. [NIH] Renal cell carcinoma: A type of kidney cancer. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retching: Dry vomiting. [NIH]
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Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retrogression: A reversion to some earlier stage of succession consequent on the introduction of an adverse factor, commonly soil degradation. [NIH] Reversion: A return to the original condition, e. g. the reappearance of the normal or wild type in previously mutated cells, tissues, or organisms. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]
Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ritalin: Drug used to treat hyperactive children. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical
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structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]
Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sign Language: A system of hand gestures used for communication by the deaf or by people speaking different languages. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smallpox: A generalized virus infection with a vesicular rash. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels.
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[NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Security: Government sponsored social insurance programs. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Standardize: To compare with or conform to a standard; to establish standards. [EU]
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Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stenosis: Narrowing or stricture of a duct or canal. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH]
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Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thioctic Acid: A vitamin-like antioxidant that acts as a free-radical scavenger. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU]
238
Psychotherapy
Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]
Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH]
Dictionary 239
Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] War: Hostile conflict between organized groups of people. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU]
241
INDEX A Abdomen, 156, 197, 202, 218, 220, 226, 236, 237 Abdominal, 197, 225, 226, 238 Abdominal Pain, 197, 238 Aberrant, 197, 205 Absenteeism, 131, 197 Acetylcholine, 197, 204, 224 Actualization, 116, 197 Adaptation, 6, 26, 52, 60, 116, 145, 197 Adjunctive Therapy, 197, 200, 223 Adjustment, 6, 29, 39, 41, 48, 56, 60, 107, 112, 117, 197 Adolescence, 9, 37, 41, 169, 197, 226 Adolescent Psychiatry, 5, 44, 64, 181, 182, 197 Adrenal Cortex, 197, 207 Adrenergic, 197, 200, 210, 211, 236 Adverse Effect, 13, 15, 31, 197, 234 Affinity, 197, 198, 209, 235 Age of Onset, 37, 198, 238 Agonist, 198, 210, 223, 224 Agoraphobia, 37, 198, 217, 226, 227 Akathisia, 198, 200 Aldehyde Dehydrogenase, 198, 210 Algorithms, 198, 202 Alkaloid, 198, 201, 205, 224 Alleles, 198, 219 Alternative medicine, 22, 153, 198 Ameliorating, 51, 198 Amenorrhea, 198, 199 Amino acid, 198, 199, 205, 212, 214, 229, 233, 234, 236, 238 Amino Acid Sequence, 198, 199, 212 Amnestic, 198, 213 Amphetamines, 199, 205 Anal, 19, 37, 50, 72, 94, 109, 169, 199, 220, 222 Analgesics, 176, 199 Anaphylatoxins, 199, 206 Anatomical, 147, 199, 204, 217, 233 Anesthesia, 40, 199, 211, 231 Anomalies, 199, 222 Anorectal, 173, 199 Anorexia, 23, 65, 75, 84, 154, 156, 199 Anorexia Nervosa, 23, 65, 75, 84, 154, 199 Anthropology, 169, 199 Antibacterial, 199, 235 Antibiotic, 57, 199, 235
Antibodies, 57, 199, 220, 228 Antibody, 198, 199, 200, 205, 217, 221, 235 Antidepressant, 15, 17, 19, 21, 36, 43, 45, 50, 52, 54, 57, 126, 155, 199, 204, 213, 217, 239 Antidiarrheals, 155, 199 Antiemetic, 199, 200, 216 Antiepileptic, 15, 199 Antigen, 198, 199, 200, 206, 216, 217, 221 Antigen-Antibody Complex, 200, 206 Antioxidant, 200, 237 Antipsychotic, 51, 200, 223 Antispasmodics, 155, 200 Anus, 199, 200, 202, 205 Anxiety Disorders, 8, 9, 10, 11, 30, 135, 200, 226 Anxiolytic, 200, 225 Applicability, 40, 114, 200 Aqueous, 200, 201 Art Therapy, 4, 86, 121, 200 Arterial, 200, 216, 229, 237 Arteries, 200, 202, 207, 222 Articular, 200, 225 Atrophy, 43, 200, 223 Atropine, 200, 201 Atypical, 51, 201, 224 Auditory, 134, 201 Autoimmune disease, 201, 222 Autonomic, 197, 200, 201, 224, 227 B Bacteria, 199, 200, 201, 213, 222, 233, 235, 237, 239 Bacterial Physiology, 197, 201 Bactericidal, 201, 212 Bacterium, 201, 205 Basal Ganglia, 200, 201, 204 Base, 29, 97, 141, 156, 201, 208, 219, 237 Behavior Therapy, 201 Behavioral Sciences, 61, 70, 74, 201 Belching, 156, 201 Benign, 201, 214 Bereavement, 59, 148, 201 Bibliotherapy, 64, 201 Bilateral, 36, 42, 201 Bile, 201, 213, 220, 236 Bile duct, 201 Biliary, 156, 201, 209 Biochemical, 198, 201, 219, 225, 234 Biotechnology, 63, 64, 153, 163, 201
Psychotherapy
Bipolar Disorder, 104, 148, 180, 202 Bladder, 168, 202, 206, 208, 217, 222, 229, 238 Bloating, 156, 202 Blood Glucose, 172, 202, 218 Blood Platelets, 202, 234 Blood pressure, 202, 203, 216, 222, 235 Blood vessel, 202, 203, 204, 219, 234, 236, 237, 239 Body Fluids, 202, 210, 235 Body Image, 145, 202, 208 Body Mass Index, 202, 225 Bowel, 35, 85, 145, 154, 155, 173, 199, 202, 209, 218, 236, 238 Bowel Movement, 202, 209, 236 Branch, 193, 202, 213, 224, 226, 230, 235, 236, 237 Breathing Exercises, 172, 202 Bronchitis, 202, 204 Buccal, 202, 220 Bulimia, 20, 21, 23, 53, 57, 84, 152, 154, 202 C Calcium, 202, 205 Cancer Information Service, 39, 202, 204 Carbohydrate, 202, 214 Carcinogenic, 203, 218, 229, 236 Carcinoma, 169, 203 Cardiac, 174, 175, 203, 211, 223, 236 Cardiovascular, 17, 154, 170, 175, 203, 209, 234 Cardiovascular disease, 17, 170, 175, 203 Catecholamine, 203, 210, 227 Causal, 19, 32, 45, 203, 218 Central Nervous System, 197, 199, 203, 205, 214, 215, 222, 234 Central Nervous System Infections, 203, 215 Cerebral, 51, 201, 203, 207, 208, 211, 212, 230 Cerebral Cortex, 203, 212 Cerebrovascular, 203 Cerebrum, 203 Cetirizine, 203, 216 Character, 141, 203, 208 Chemoreceptor, 200, 203 Chemotactic Factors, 203, 206 Chest Pain, 155, 204 Child Behavior, 58, 204 Child Psychiatry, 8, 169, 204 Chin, 204, 221 Cholesterol, 201, 204, 207, 236 Choline, 31, 204
242
Cholinergic, 200, 204, 224 Chorea, 200, 204 Chromosomal, 56, 204 Chromosome, 204, 219, 234 Chronic Obstructive Pulmonary Disease, 65, 204 CIS, 202, 204, 233 Cisplatin, 204, 225 Citalopram, 43, 204 Clinical study, 204, 207 Clinical trial, 4, 10, 11, 12, 13, 14, 33, 38, 42, 59, 125, 127, 163, 204, 207, 210, 222, 229, 231 Cloning, 201, 205 Coca, 205 Cocaine, 18, 31, 32, 34, 140, 205 Codons, 205 Cognition, 51, 53, 205, 223 Cognitive behavior therapy, 15, 16, 54, 205 Cognitive Therapy, 10, 14, 43, 60, 104, 126, 205 Colitis, 205 Colon, 205, 218, 219, 238 Combination Therapy, 66, 205 Comorbidity, 5, 20, 21, 37, 65, 205 Competency, 67, 69, 205 Complement, 52, 199, 205, 206 Complementary and alternative medicine, 81, 92, 206 Complementary medicine, 206 Complete remission, 206, 232 Compliance, 10, 13, 15, 104, 149, 206 Compulsions, 206, 225 Computational Biology, 163, 206 Concomitant, 58, 206 Confounding, 37, 206 Congestion, 200, 206 Congestive heart failure, 25, 176, 206 Connective Tissue, 47, 206, 209, 213, 233 Connective Tissue Cells, 206 Consciousness, 101, 199, 207, 208, 229 Constipation, 35, 173, 181, 200, 207 Constriction, 148, 207, 219 Consultation, 8, 169, 170, 207 Consumption, 7, 12, 207, 232 Contraindications, ii, 207 Control group, 26, 35, 37, 40, 41, 207, 231 Controlled clinical trial, 30, 31, 46, 74, 207, 231 Controlled study, 27, 59, 207 Conventional therapy, 207 Conventional treatment, 22, 82, 207
243
Convulsions, 207, 211, 216 Coordination, 8, 20, 21, 36, 44, 120, 170, 207, 222 Coronary, 15, 203, 207, 221 Coronary heart disease, 15, 203, 207 Coronary Thrombosis, 207, 222 Corpus, 207, 226 Cortical, 207, 234 Cortisol, 48, 207 Cost Savings, 131, 207 Cost-benefit, 34, 207 Cranial, 207, 208, 214, 227 Craniocerebral Trauma, 208, 215 Criterion, 43, 55, 208 Crossing-over, 208, 231 Curative, 40, 95, 152, 208, 237 Cutaneous, 78, 208, 220 Cystitis, 168, 208 Cytotoxic, 208, 225 Cytotoxic chemotherapy, 208, 225 D Data Collection, 34, 49, 208, 213 Decision Making, 38, 46, 208 Degenerative, 31, 208, 220, 222, 225 Delirium, 148, 149, 180, 200, 208 Delivery of Health Care, 208, 215 Delusions, 208, 230 Dementia, 69, 178, 181, 200, 208 Depersonalization, 208, 226, 233 Depressive Disorder, 8, 22, 33, 41, 42, 44, 51, 56, 60, 126, 180, 184, 209, 220 Derealization, 208, 209, 226 Dermatitis, 209, 216 Dermatology, 78, 209 Dermis, 209, 238 Desipramine, 155, 209 Detoxification, 19, 209 Diabetes Mellitus, 18, 209, 214 Diagnostic procedure, 129, 153, 209 Diarrhea, 35, 199, 209 Diastolic, 209, 216 Dicyclomine, 200, 209 Dietetics, 154, 209 Digestion, 201, 202, 209, 210, 218, 220, 236 Digestive system, 128, 209 Direct, iii, 33, 86, 95, 100, 115, 130, 205, 209, 210, 231, 236 Discrete, 32, 57, 209 Disinfectant, 209, 212 Disorientation, 208, 209, 210 Disparity, 7, 209 Distal, 209, 211
Disulfiram, 18, 209 Diurnal, 48, 210 Dizziness, 210, 226 Dopamine, 19, 31, 200, 205, 210, 224 Double-blind, 12, 39, 54, 210 Drinking Behavior, 8, 210 Drive, ii, vi, 39, 77, 210, 219 Drug Interactions, 210 Drug Tolerance, 210, 237 Duct, 210, 233, 236 Duodenum, 201, 210, 213, 236 Dyskinesia, 200, 204, 210 Dyspepsia, 155, 156, 177, 210 Dysphoria, 78, 210 Dysphoric, 209, 210 Dyspnea, 210, 226 Dystonia, 200, 210 Dystrophy, 183, 210 E Eating Disorders, 10, 23, 67, 84, 171, 180, 210 Effector, 197, 205, 210 Ejaculation, 147, 211, 234 Electroacupuncture, 22, 211 Electroconvulsive Therapy, 22, 36, 211 Electrode, 36, 211 Electrolyte, 208, 211, 235 Emetic, 13, 211 Emphysema, 204, 211 Empirical, 11, 26, 31, 46, 56, 97, 101, 130, 211 Endogenous, 210, 211 Endorphins, 211, 224 Endoscopy, 156, 211 Endotoxins, 206, 211 End-stage renal, 146, 211 Enkephalins, 211, 224 Environmental Health, 162, 164, 211 Enzymatic, 198, 202, 206, 211, 216, 233 Enzyme, 19, 198, 210, 211, 229, 239 Epidemic, 18, 140, 211, 235 Epinephrine, 197, 210, 211, 224, 238 Erectile, 147, 168, 169, 170, 171, 172, 212, 226 Erection, 168, 170, 171, 172, 212 ERV, 164, 212 Esophagus, 209, 212, 236 Ethanol, 12, 204, 212 Evacuation, 207, 212 Evoke, 137, 212, 236 Excitation, 199, 203, 212, 224 Exogenous, 211, 212, 238
Psychotherapy
Exon, 35, 212 Expiration, 202, 212, 232 Expiratory, 212 Expiratory Reserve Volume, 212 Extracellular, 206, 212, 235 Extracellular Matrix, 206, 212 Extrapyramidal, 198, 200, 210, 212 Eye Movements, 134, 212 F Facial, 113, 132, 212 Facial Expression, 113, 132, 212 Family Characteristics, 29, 212 Family Planning, 163, 212 Family Relations, 13, 212 Family Therapy, 23, 122, 139, 140, 171, 212 Fat, 16, 207, 213, 219, 222, 225, 233 Fatigue, 170, 213, 215 Feces, 207, 213, 236 Fetus, 213, 227, 228 Fibrosis, 47, 213, 233 Fistula, 213 Fluoxetine, 43, 54, 213 Flushing, 210, 213 Fluvoxamine, 9, 213 Focus Groups, 27, 32, 213 Fold, 50, 213 Free Association, 213, 229 Fungi, 213, 222 G Gallbladder, 197, 201, 209, 213 Gas, 201, 212, 213, 216, 239 Gastrin, 213, 216 Gastroduodenal, 156, 213 Gastrointestinal, 155, 156, 209, 211, 212, 213, 234, 236 Gastrointestinal tract, 212, 213, 234 Gene, 130, 198, 202, 213, 218, 234 General practitioner, 46, 213 Genetic Counseling, 39, 213 Genetics, 34, 214 Genotype, 19, 214 Gestation, 51, 214, 226, 227 Gestures, 214, 234 Gland, 197, 214, 225, 229, 236 Glucose, 16, 202, 209, 214, 216, 218 Glucose Intolerance, 209, 214 Glucose tolerance, 16, 214 Glucose Tolerance Test, 16, 214 Glucuronic Acid, 214, 215 Glutamic Acid, 214, 224 Glycine, 198, 214, 224 Governing Board, 214, 228
244
Grade, 32, 214 Graft, 214, 216 Growth, 10, 36, 60, 107, 113, 118, 131, 133, 136, 197, 199, 214, 227, 238 H Happiness, 55, 214 Headache, 50, 85, 177, 179, 181, 214, 215, 216 Headache Disorders, 50, 215 Health Behavior, 61, 215 Health Care Costs, 131, 215 Health Education, 27, 47, 215 Health Expenditures, 215 Health Services, 14, 26, 28, 33, 44, 52, 58, 59, 208, 215 Health Status, 215 Heart attack, 203, 215 Heart failure, 25, 215 Hemicrania, 215 Hemophilia, 169, 215 Hemorrhage, 208, 215, 236 Hemostasis, 215, 234 Heparin, 169, 215 Hepatic, 208, 214, 215 Hereditary, 38, 215, 222, 223 Heredity, 213, 214, 216 Histamine, 199, 200, 203, 216 Home Care Services, 33, 216 Home Nursing, 216 Homogeneous, 25, 216 Hormonal, 200, 216 Hormone, 173, 207, 211, 213, 216, 218, 221, 225, 233 Hormone Replacement Therapy, 173, 216 Host, 31, 216, 239 Hydrogen, 201, 203, 216, 222 Hydroxyzine, 169, 216 Hypersensitivity, 216, 233 Hypertension, 18, 203, 215, 216 Hypnotherapy, 156, 216 Hypnotic, 40, 216 Hypoglycaemia, 208, 216 Hypotension, 200, 207, 210, 216 Hypothalamic, 7, 216 Hypothalamus, 216 Hypoxia, 208, 217 I Id, 79, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 192, 194, 217 Imipramine, 155, 217 Immune function, 6, 217 Immune response, 199, 201, 217, 236, 239
245
Immune system, 6, 217, 220, 222, 239 Immunity, 217 Immunodeficiency, 140, 148, 149, 171, 217 Immunodeficiency syndrome, 149, 217 Immunogenic, 6, 217 Impairment, 5, 9, 18, 20, 21, 25, 29, 45, 49, 51, 59, 123, 208, 210, 217, 221, 230 Impotence, 84, 135, 147, 168, 170, 171, 212, 217 In vivo, 215, 217 Incest, 105, 135, 217 Incision, 217, 218 Incontinence, 183, 209, 217 Indicative, 141, 217, 226, 239 Induction, 200, 217 Infant Behavior, 204, 217 Infarction, 207, 217, 221 Infection, 149, 168, 169, 203, 208, 217, 220, 233, 234, 236, 238, 239 Inflammation, 47, 85, 156, 202, 205, 208, 209, 213, 218, 228, 229, 233, 238 Inflammatory bowel disease, 145, 154, 218 Ingestion, 214, 218, 228 Initiation, 22, 38, 62, 218 Inotropic, 210, 218 Insight, 4, 31, 33, 49, 218 Insomnia, 182, 218 Insulator, 218, 222 Insulin, 15, 214, 218, 238 Insulin-dependent diabetes mellitus, 218 Intermittent, 218, 220 Interpersonal Relations, 14, 59, 119, 218 Intervention Studies, 41, 218 Intestinal, 154, 214, 218 Intestine, 202, 218, 219 Intoxication, 22, 208, 218, 239 Intracellular, 217, 218, 221, 231, 233 Intracellular Membranes, 218, 221 Intraoperative Complications, 40, 218 Intravenous, 16, 218 Introns, 218 Invasive, 172, 217, 218 Ions, 201, 211, 216, 219, 222 Ischemia, 200, 219 J Joint, 200, 219, 225, 236 K Kb, 162, 219 Kidney Disease, 128, 162, 170, 219 Kidney Failure, 211, 219 L Labile, 205, 219
Lactation, 219, 225 Large Intestine, 209, 218, 219, 231, 234 Latent, 219, 228 Lectin, 219, 221 Lenses, 132, 219, 232 Libido, 147, 219 Library Services, 192, 219 Ligament, 219, 229 Linkage, 29, 34, 169, 219 Linkage Disequilibrium, 34, 219 Lipid, 204, 218, 219, 222 Lithium, 37, 78, 104, 200, 219 Liver, 170, 197, 201, 209, 213, 214, 215, 220 Localized, 217, 220, 227, 233, 238, 239 Longitudinal Studies, 55, 220 Longitudinal study, 17, 29, 220 Long-Term Care, 5, 175, 220 Lupus, 170, 220 Lymphatic, 218, 220 Lymphocyte, 200, 220, 221 Lymphoid, 199, 220 M Macula, 220 Macula Lutea, 220 Macular Degeneration, 41, 220 Malaise, 210, 220 Malnutrition, 200, 220 Mania, 148, 220 Manic, 200, 202, 220, 230 Manic-depressive psychosis, 220, 230 Manifest, 32, 220 Manometry, 156, 220 Marital Status, 55, 220 Mastectomy, 40, 220 Mediate, 6, 8, 50, 210, 220 Mediator, 55, 220, 234 Medical Records, 17, 221 MEDLINE, 163, 221 Membrane, 31, 57, 206, 212, 221, 222, 227, 233 Membrane Proteins, 57, 221 Memory, 70, 90, 103, 135, 199, 208, 221 Menopause, 175, 221, 228 Mental Disorders, 51, 128, 182, 197, 204, 221, 229, 230 Mental Health Services, iv, 4, 18, 26, 32, 33, 38, 44, 52, 58, 61, 117, 164, 174, 177, 183, 184, 221 Mental Processes, 221, 229, 230 Mental Retardation, 76, 182, 221 Mentors, 44, 55, 221 Mesolimbic, 200, 221
Psychotherapy
Meta-Analysis, 68, 221 Metabolite, 31, 216, 221, 224 Metastasis, 221 Metastatic, 48, 69, 145, 221 Metastatic cancer, 69, 221 MI, 27, 195, 221 Microbe, 222, 237 Microbiology, 56, 197, 201, 222 Mobility, 56, 222 Modeling, 6, 10, 14, 23, 41, 50, 60, 61, 120, 222 Modification, 12, 15, 96, 155, 156, 169, 198, 222, 230 Molecular, 34, 57, 163, 165, 201, 206, 215, 222, 231, 237, 238 Molecular Structure, 222, 238 Molecule, 200, 201, 206, 210, 212, 219, 222, 231 Monitor, 8, 33, 222, 224 Monotherapy, 54, 222 Mood Disorders, 14, 52, 82, 222 Mother-Child Relations, 42, 222 Motility, 35, 156, 222, 234 Motion Sickness, 222, 223 Movement Disorders, 200, 222 Mucosa, 220, 222 Mucus, 222, 238 Multicenter Studies, 46, 222 Multicenter study, 22, 222 Multiple sclerosis, 56, 222 Multivariate Analysis, 16, 222 Muscular Dystrophies, 210, 223 Music Therapy, 4, 223 Myelin, 222, 223 Myocardium, 221, 223 N Naloxone, 223 Naltrexone, 12, 13, 22, 34, 39, 223 Narcotic, 223 Natural Disasters, 134, 223 Nausea, 13, 40, 156, 199, 200, 210, 223, 225, 226 NCI, 1, 127, 161, 202, 204, 223 Need, 3, 18, 19, 26, 30, 32, 38, 39, 54, 61, 82, 139, 145, 147, 153, 154, 186, 223, 237, 238 Neonatology, 169, 223 Nephropathy, 219, 223 Nerve, 197, 199, 204, 221, 222, 223, 233, 234, 236, 238 Nervous System, 203, 221, 223, 224, 227, 236, 237 Networks, 139, 223
246
Neural, 209, 223 Neurodegenerative Diseases, 57, 223 Neuroleptic, 198, 200, 223, 225 Neurologic, 15, 147, 224 Neurology, 15, 109, 169, 181, 224 Neuronal, 31, 204, 224 Neurons, 205, 224, 236, 237 Neuropsychology, 169, 224 Neurosis, 224, 227 Neurotransmitter, 12, 197, 198, 210, 214, 216, 224, 236, 237 Nicotine, 27, 224 Nonverbal Communication, 224, 230 Norepinephrine, 197, 209, 210, 224 Nortriptyline, 36, 43, 224 Nuclear, 201, 212, 224 Nuclear Family, 212, 224 Nursing Services, 216, 224 O Observational study, 19, 25, 224 Obsessional, 78, 224 Obsessive-Compulsive Disorder, 25, 213, 225 Obstetrics, 169, 225 Odds Ratio, 225, 232 Office Visits, 56, 225 Ondansetron, 12, 225 Opiate, 140, 223, 225 Opium, 225 Orgasm, 147, 211, 225 Orthostatic, 200, 225 Osteoarthritis, 179, 225 Osteoporosis, 178, 225 Outpatient, 10, 12, 27, 50, 95, 102, 103, 104, 107, 110, 120, 122, 131, 148, 149, 225 Overweight, 20, 21, 57, 78, 155, 184, 225 Ovum, 214, 225 Oxytocin, 7, 225 P Palliative, 179, 225, 237 Pancreas, 197, 209, 218, 225 Pancreatic, 156, 225 Panic, 5, 30, 37, 84, 135, 179, 213, 217, 225, 226 Panic Disorder, 5, 30, 37, 179, 213, 217, 226 Parent-Child Relations, 60, 226 Paresthesias, 226 Parkinsonism, 200, 226 Paroxetine, 72, 226 Paroxysmal, 215, 226 Partial remission, 226, 232 Parturition, 225, 226
247
Patch, 226, 238 Pathogenesis, 145, 226 Pathologic, 207, 216, 226, 239 Pathophysiology, 50, 226 Patient Education, 148, 155, 168, 190, 192, 195, 226 Pediatrics, 44, 175, 223, 226 Pelvic, 169, 226, 229 Pelvis, 197, 226 Penile Erection, 147, 226 Penis, 172, 211, 226 Perceived risk, 39, 226 Perinatal, 13, 52, 226 Peripheral Nervous System, 211, 223, 224, 227, 236 Pernicious, 25, 227 Personality Disorders, 10, 227 Pharmacologic, 40, 51, 53, 57, 199, 227, 237 Pharmacotherapy, 10, 15, 17, 21, 24, 31, 34, 37, 54, 60, 63, 67, 71, 72, 171, 227 Phobia, 9, 12, 30, 227 Phobic Disorders, 227 Phospholipids, 213, 227 Physical Examination, 147, 171, 227 Physical Therapy, 169, 227 Physiologic, 31, 198, 227, 231 Physiology, 172, 227 Pilot study, 7, 11, 22, 56, 227 Placenta, 227, 230 Plants, 198, 201, 204, 205, 214, 219, 224, 227, 237 Plasma, 31, 35, 199, 214, 215, 219, 227, 228, 234 Plasma cells, 199, 228 Pneumonia, 207, 228 Poisoning, 208, 218, 223, 228 Polymorphism, 35, 228 Posterior, 199, 225, 228 Postmenopausal, 35, 225, 228 Postoperative, 40, 175, 228 Post-traumatic, 215, 222, 228 Potentiates, 209, 228 Practicability, 228, 238 Practice Guidelines, 164, 172, 176, 183, 228 Precipitating Factors, 215, 228 Preclinical, 23, 228 Precursor, 204, 210, 211, 224, 228, 238 Predisposition, 12, 228 Prenatal, 32, 90, 228 Preoperative, 40, 228 Presynaptic, 224, 228, 237 Prevalence, 9, 10, 15, 27, 51, 81, 225, 228
Problem Solving, 41, 45, 106, 228 Progression, 6, 48, 228 Progressive, 172, 208, 210, 214, 223, 225, 228, 232 Projection, 138, 224, 229 Promoter, 35, 229 Prone, 38, 229 Prospective study, 16, 220, 229 Prostate, 169, 229 Prostatitis, 85, 169, 229 Protease, 205, 229 Protein S, 202, 229, 233 Proteins, 198, 200, 205, 215, 221, 222, 227, 229, 231, 234 Proteolytic, 206, 229 Protocol, 6, 8, 9, 13, 38, 39, 45, 57, 58, 178, 229 Protozoa, 229 Pruritus, 216, 229 Psychic, 137, 219, 221, 224, 229, 230, 234 Psychoactive, 229, 239 Psychoanalysis, 63, 64, 112, 123, 145, 229 Psychogenic, 145, 229 Psychological Techniques, 136, 230 Psychomotor, 89, 143, 208, 223, 230 Psychopathology, 19, 20, 21, 29, 37, 42, 57, 60, 99, 230 Psychopharmacology, 8, 64, 72, 104, 149, 230 Psychophysiology, 224, 230 Psychosis, 46, 148, 179, 200, 230 Psychosurgery, 230 Psychotropic, 170, 230 Public Health, 5, 14, 27, 39, 59, 148, 149, 164, 230 Public Policy, 163, 230 Public Sector, 26, 230 Puerperium, 29, 225, 230 Pulsation, 137, 230 Pulse, 154, 222, 230 Q Quality of Life, 6, 15, 21, 25, 28, 32, 34, 39, 42, 47, 48, 50, 56, 81, 126, 145, 155, 230 R Race, 29, 50, 230 Radiation, 207, 231 Random Allocation, 231 Randomization, 24, 35, 38, 231 Randomized clinical trial, 14, 18, 19, 33, 35, 39, 40, 45, 48, 231 Randomized Controlled Trials, 9, 26, 65, 231
Psychotherapy
Rape, 134, 231 Reality Testing, 230, 231 Receptor, 12, 197, 200, 203, 210, 216, 225, 231, 234 Receptors, Serotonin, 231, 234 Recombinant, 57, 231 Recombination, 57, 231 Recovery Room, 40, 231 Rectum, 199, 200, 202, 205, 209, 213, 217, 218, 219, 229, 231 Recurrence, 6, 24, 44, 51, 72, 126, 202, 220, 231 Refer, 1, 202, 205, 210, 211, 213, 220, 223, 230, 231, 237 Reflective, 138, 232 Reflex, 183, 212, 232 Refraction, 232, 235 Refractory, 15, 53, 232 Regimen, 44, 104, 211, 227, 232 Regurgitation, 156, 232 Reimbursement Mechanisms, 33, 232 Relapse, 5, 22, 24, 25, 35, 36, 42, 44, 51, 53, 54, 72, 232 Relative risk, 17, 232 Relaxation Techniques, 156, 172, 232 Reliability, 25, 26, 97, 232 Remission, 16, 25, 29, 44, 54, 202, 220, 231, 232 Renal cell cancer, 6, 232 Renal cell carcinoma, 6, 232 Renal failure, 208, 232 Research Design, 8, 11, 16, 30, 38, 50, 232 Respiration, 202, 203, 222, 232 Response rate, 36, 232 Restoration, 227, 232 Retching, 156, 232 Retina, 220, 233 Retinal, 209, 233, 239 Retrogression, 131, 233 Reversion, 233 Rheumatism, 233 Rheumatoid, 57, 179, 233 Rheumatoid arthritis, 179, 233 Ribosome, 233, 238 Rickettsiae, 233 Risk factor, 17, 175, 229, 232, 233 Ritalin, 149, 233 S Salivary, 209, 233 Salivary glands, 209, 233 Schizoid, 233, 239
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Schizophrenia, 23, 33, 35, 50, 53, 70, 73, 74, 181, 183, 211, 233, 239 Schizotypal Personality Disorder, 208, 233, 239 Scleroderma, 47, 233 Sclerosis, 47, 222, 233 Screening, 15, 17, 39, 57, 140, 146, 175, 183, 204, 234 Sedative, 216, 217, 234 Segregation, 231, 234 Seizures, 15, 208, 226, 234 Semen, 211, 229, 234 Senile, 225, 234 Sequencing, 10, 22, 234 Serotonin, 9, 35, 155, 200, 204, 209, 213, 224, 225, 226, 227, 231, 234, 238 Sertraline, 15, 34, 234 Serum, 199, 205, 234 Sex Characteristics, 197, 234 Shock, 57, 234, 238 Side effect, 36, 40, 82, 197, 198, 200, 203, 204, 234, 237 Sign Language, 3, 234 Signs and Symptoms, 232, 234 Small intestine, 210, 216, 218, 234 Smallpox, 57, 234 Smoking Cessation, 27, 234 Smooth muscle, 57, 199, 207, 216, 234, 236 Social Environment, 230, 235 Social Security, 231, 235 Social Support, 25, 36, 50, 51, 59, 235 Sodium, 54, 235 Solvent, 212, 235 Soma, 235 Somatic, 87, 91, 100, 197, 227, 235 Sound wave, 232, 235 Specialist, 186, 235 Species, 211, 230, 235, 239 Specificity, 10, 68, 198, 235 Spectrum, 39, 81, 95, 149, 169, 235 Spinal cord, 182, 203, 204, 223, 227, 232, 235 Sporadic, 3, 223, 235 Stabilization, 19, 235 Stabilizer, 54, 235 Standardize, 8, 235 Stasis, 131, 236 Stenosis, 179, 236 Steroid, 207, 236 Stimulant, 54, 184, 216, 236 Stimulus, 121, 134, 137, 138, 210, 211, 212, 226, 227, 232, 236, 237
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Stomach, 197, 201, 209, 212, 213, 214, 216, 223, 234, 236 Stool, 205, 217, 219, 236 Stricture, 236 Stroke, 43, 111, 128, 162, 203, 236 Subacute, 217, 236 Subarachnoid, 215, 236 Subclinical, 217, 234, 236 Substance P, 221, 236 Support group, 154, 171, 236 Sympathomimetic, 210, 211, 224, 236 Symphysis, 204, 229, 236 Symptomatic, 9, 22, 36, 47, 156, 199, 236 Symptomatic treatment, 199, 236 Symptomatology, 22, 29, 42, 53, 59, 236 Synapse, 197, 209, 228, 236, 237, 238 Synaptic, 224, 237 Synaptic Transmission, 224, 237 Synergistic, 12, 155, 237 Systemic, 47, 139, 202, 208, 210, 211, 217, 233, 237 Systolic, 216, 237 T Tardive, 200, 204, 237 Temporal, 215, 220, 237 Therapeutics, 43, 237 Thioctic Acid, 66, 237 Thorax, 197, 237 Threshold, 15, 36, 216, 237 Thrombosis, 229, 236, 237 Tissue, 149, 200, 201, 203, 206, 210, 211, 212, 214, 217, 219, 220, 221, 223, 224, 226, 232, 233, 234, 235, 236, 237 Tolerance, 16, 214, 237 Tooth Preparation, 197, 237 Topical, 212, 237 Toxic, iv, 201, 217, 224, 237 Toxicity, 15, 31, 210, 237 Toxicology, 62, 164, 237 Toxin, 237 Toxoplasmosis, 149, 238 Transdermal, 170, 238 Transfection, 201, 238 Translation, 58, 198, 238
Translocation, 56, 238 Transmitter, 197, 210, 221, 224, 238 Trauma, 7, 31, 48, 62, 67, 75, 100, 134, 208, 238 Treatment Outcome, 7, 10, 18, 24, 26, 29, 45, 47, 50, 106, 110, 131, 238 Triage, 44, 238 Tricyclic, 155, 204, 209, 217, 238 Trigger zone, 200, 238 Tryptophan, 234, 238 Type 2 diabetes, 15, 238 Tyrosine, 210, 238 U Ulcer, 156, 182, 238 Ulcerative colitis, 145, 218, 238 Ultrasonography, 156, 238 Unconscious, 122, 136, 217, 238 Urethra, 226, 229, 238 Urinary, 156, 169, 183, 208, 209, 217, 238 Urine, 62, 156, 202, 217, 232, 238 Urticaria, 203, 216, 239 Uterine Contraction, 225, 239 V Vaccine, 229, 239 Vascular, 47, 147, 168, 170, 209, 215, 217, 218, 227, 239 Vasodilation, 210, 239 Vasodilator, 210, 216, 239 VE, 31, 114, 134, 239 Vein, 218, 224, 239 Venlafaxine, 36, 239 Vertebrae, 235, 239 Vesicular, 234, 239 Veterinary Medicine, 163, 239 Virulence, 237, 239 Virus, 140, 148, 149, 171, 203, 234, 239 Visual Acuity, 219, 239 Vitro, 215, 217, 239 Volition, 224, 239 W Wakefulness, 208, 239 War, 134, 239 Withdrawal, 22, 44, 208, 239
Psychotherapy
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