RESUMEN
BACKGROUND AND AIMS: Compulsive sexual behaviour disorder (CSBD) is a medical condition that can impair social and occupational functioning and lead to severe distress. To date, treatment effectiveness studies of CSBD are under-developed; typically, treatment for CSBD is based on guidelines for substance or other behavioural addictions. Mindfulness-based relapse prevention (MBRP) is an evidence-based treatment for substance addiction aimed at, among other things, reducing craving and negative affect-i.e. processes that are implicated in the maintenance of problematic sexual behaviours. However, to our knowledge no prior research has been published evaluating mindfulness-based intervention (MBI) in the treatment of CSBD, except two clinical case reports. Therefore, the aim of the current pilot study was to examine whether MBRP can lead to clinical improvement in CSBD. Methods: Participants were 13 adult males with a diagnosis of CSBD. Before and after the eight-week MBRP intervention, participants completed a booklet of questionnaires including measurements of porn viewing, masturbation and emotional distress. Results: As expected, we found that after MBRP participants spent significantly less time engaging in problematic pornography use and exhibited a decrease in anxiety, depression and obsessive-compulsive (OC) symptoms. Discussion and Conclusions: The findings indicate that MBRP could be beneficial for CSBD individuals. Further clinical effectiveness studies with bigger sample sizes, delayed post-training measurements and randomised control trial design are warranted. In conclusion, MBRP leads to a decrease in time spent watching porn and a decrease in emotional distress in CSBD patients.
Asunto(s)
Atención Plena , Adulto , Conducta Compulsiva/prevención & control , Humanos , Masculino , Proyectos Piloto , Prevención Secundaria , Conducta SexualAsunto(s)
Trastorno Autístico/tratamiento farmacológico , Conducta Compulsiva/prevención & control , Naltrexona/uso terapéutico , Antagonistas de Narcóticos/uso terapéutico , Conducta Sexual/efectos de los fármacos , Niño , Humanos , Masculino , Naltrexona/farmacología , Antagonistas de Narcóticos/farmacologíaRESUMEN
Drug addiction is a chronic relapsing disorder of compulsive drug use. Studies of the neurobehavioral factors that promote drug relapse have yet to produce an effective treatment. Here we take a different approach and examine the factors that suppress-rather than promote-relapse. Adapting Pavlovian procedures to suppress operant drug response, we determined the anti-relapse action of environmental cues that signal drug omission (unavailability) in rats. Under laboratory conditions linked to compulsive drug use and heightened relapse risk, drug omission cues suppressed three major modes of relapse-promotion (drug-predictive cues, stress, and drug exposure) for cocaine and alcohol. This relapse-suppression is, in part, driven by omission cue-reactive neurons, which constitute small subsets of glutamatergic and GABAergic cells, in the infralimbic cortex. Future studies of such neural activity-based cellular units (neuronal ensembles/memory engram cells) for relapse-suppression can be used to identify alternate targets for addiction medicine through functional characterization of anti-relapse mechanisms.
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Cocaína/farmacología , Condicionamiento Operante/efectos de los fármacos , Señales (Psicología) , Neuronas/fisiología , Corteza Prefrontal/efectos de los fármacos , Alcoholismo/fisiopatología , Alcoholismo/prevención & control , Animales , Cocaína/administración & dosificación , Conducta Compulsiva/fisiopatología , Conducta Compulsiva/prevención & control , Condicionamiento Operante/fisiología , Inhibidores de Captación de Dopamina/farmacología , Masculino , Corteza Prefrontal/fisiopatología , Ratas Long-Evans , Ratas Sprague-Dawley , Ratas Transgénicas , Recurrencia , Trastornos Relacionados con Sustancias/fisiopatología , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
Compulsive drives for alcohol, where intake persists despite adverse consequences, are substantial obstacles to treating Alcohol Use Disorder (AUD). However, there are limited treatment options and thus considerable interest in identifying new, potent and safe pharmacotherapies. We found that non-canonical N-methyl-d-aspartate receptors (NMDARs), active at hyperpolarized potentials, drive compulsion-like alcohol drinking in rats without affecting regular, alcohol-only intake. Congruent human studies suggest that NMDAR inhibition reduces alcohol drinking in treatment-seekers but not non-treatment-seekers and suppresses craving. These cross-species studies of consumption under conflict indicate that inhibiting non-canonical NMDARs could be of clinical value for AUD. d-serine activates NMDARs overall, but actually inhibits non-canonical NMDARs. Also, d-serine has been widely tested in humans as a moderate NMDAR modulator, but some nephrotoxicity concerns remain, and thus any strategy that reduces d-serine exposure could be of broad utility. Here, co-administration of sodium benzoate (NaBenz), which reduces d-serine breakdown, allowed subthreshold d-serine levels to suppress compulsion-like alcohol drinking without altering normal alcohol-only consumption, providing a novel intervention for AUD and underscoring the importance of non-canonical NMDARs for compulsion-like intake. Low NaBenz doses alone had no average effect on intake. NaBenz/d-serine reduced compulsion-like intake in nearly all animals, while higher d-serine alone decreased compulsion-like intake with less of an effect in lower-drinking subjects. Thus, combining subthreshold NaBenz and d-serine suppressed compulsion-like intake, helping both to alleviate some d-serine concerns, and, importantly, to reduce consequence-resistant consumption across nearly all individuals. Therefore, NaBenz/d-serine likely represents an FDA-approved and immediately-accessible pharmacotherapy to help counteract compulsion-like drives and treat AUD.
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Consumo de Bebidas Alcohólicas/prevención & control , Conducta Compulsiva/prevención & control , Antagonistas de Aminoácidos Excitadores/farmacología , Serina/farmacología , Benzoato de Sodio/farmacología , Animales , Relación Dosis-Respuesta a Droga , Sinergismo Farmacológico , Isomerismo , Masculino , RatasRESUMEN
With the massive growth in Internet technologies, people have become wary of excessive Internet usage, known as compulsive Internet usage or Internet addiction. This study looks into how exercise is related to compulsive Internet usage. Previous research showed varying results regarding the relationship between sports habit and Internet usage; this project clarifies the relationship by investigating mediating variables in terms of interest in different aspects of sports, such as physical education, mastering sport skills, sports participation, and watching sports. Two survey studies were conducted. The participants were 232 male and 107 female Taiwanese undergraduate students in the first survey, totaling 339 students. The second survey had 233 males, 98 female students, and 2 who did not disclose their gender, with a final total of 333. The results reveal that interest in physical education (IPE) mediates sports habit and compulsive Internet usage. As long as the student had a habit of doing sports that increased IPE, this would in turn decrease compulsive Internet use. The importance of igniting students' IPE is discussed.
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Conducta Compulsiva/psicología , Internet , Deportes , Estudiantes/psicología , Adolescente , Conducta Compulsiva/prevención & control , Estudios Transversales , Ejercicio Físico/psicología , Femenino , Humanos , Masculino , Educación y Entrenamiento Físico , Encuestas y Cuestionarios , Taiwán , Adulto JovenRESUMEN
Compulsive, binge eating of highly palatable food constitutes a core feature of some forms of obesity and eating disorders, as well as of the recently proposed disorder of food addiction. Trace amine-associated receptor 1 (TAAR1) is a highly conserved G-protein-coupled receptor bound by endogenous trace amines. TAAR1 agonists have been shown to reduce multiple behavioral effects of drugs of abuse through their actions on the mesocorticolimbic system. In this study, we hypothesized that TAAR1 may have a role in compulsive, binge-like eating; we tested this hypothesis by assessing the effects of a TAAR1 agonist, RO5256390, in multiple excessive feeding-related behaviors induced by limiting access to a highly palatable diet in rats. Our results show that RO5256390 blocked binge-like eating in rats responding 1 h per day for a highly palatable sugary diet. Consistent with a palatability-selective effect, drug treatment selectively reduced the rate and regularity of palatable food responding, but it did not affect either baseline intake or food restriction-induced overeating of the standard chow diet. Furthermore, RO5256390 fully blocked compulsive-like eating when the palatable diet was offered in an aversive compartment of a light/dark conflict box, and blocked the conditioned rewarding properties of palatable food, as well as palatable food-seeking behavior in a second-order schedule of reinforcement. Drug treatment had no effect on either anxiety-like or depressive-like behavior, and it did not affect control performance in any of the tests. Importantly, rats exposed to palatable food showed decreased TAAR1 levels in the medial prefrontal cortex (mPFC), and RO5256390 microinfused into the infralimbic, but not prelimbic, subregion of the mPFC-reduced binge-like eating. Altogether, these results provide evidence for TAAR1 agonism as a novel pharmacological treatment for compulsive, binge eating.
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Trastorno por Atracón/metabolismo , Trastorno por Atracón/prevención & control , Conducta Compulsiva/metabolismo , Conducta Compulsiva/prevención & control , Receptores Acoplados a Proteínas G/agonistas , Receptores Acoplados a Proteínas G/metabolismo , Animales , Trastorno por Atracón/psicología , Conducta Compulsiva/psicología , Condicionamiento Operante/efectos de los fármacos , Condicionamiento Operante/fisiología , Conducta Alimentaria/efectos de los fármacos , Conducta Alimentaria/psicología , Masculino , Corteza Prefrontal/efectos de los fármacos , Corteza Prefrontal/metabolismo , Ratas , Ratas WistarRESUMEN
The aim of this study was to develop a humane alternative to the traditional remote devices that deliver punishers contingent on home-alone dog barking. Specifically, we evaluated the use of remote delivery of food contingent on intervals of not barking during the pet owner's absence. In Experiment 1, 5 dogs with a history of home-alone nuisance barking were recruited. Using an ABAB reversal design, we demonstrated that contingent remote delivery of food decreased home-alone barking for 3 of the dogs. In Experiment 2, we demonstrated that it is possible to thin the differential-reinforcement-of-other-behavior (DRO) schedule gradually, resulting in a potentially more acceptable treatment. Our results benefit the dog training community by providing a humane tool to combat nuisance barking.
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Automatización/métodos , Terapia Conductista/instrumentación , Terapia Conductista/métodos , Conducta Animal/fisiología , Conducta Compulsiva/prevención & control , Refuerzo en Psicología , Animales , Perros/fisiología , Femenino , Humanos , Masculino , Vocalización AnimalRESUMEN
OBJECTIVE: To examine whether previously identified childhood risk factors for bulimia or compulsive eating (BCE) predict self-reported lifetime BCE by age 30 years in a prospective birth cohort. METHOD: Using data from the 1970 British Cohort Study at birth, 5, and 10 years, associations between 22 putative childhood risk factors and self-reported lifetime BCE at 30 years were examined, adjusting for sex and socioeconomic status. RESULTS: Only female sex (odds ratio (OR): 9.2; 95% confidence interval (CI): 1.9-43.7; p = 0.005), low self-esteem (OR:2.9; 95%CI: 1.1-7.5; p = 0.03) and high maternal education (OR:5.4; 95%CI: 2.0-14.8; p = 0.001) were significantly associated with higher risk of BCE, whereas high SES at 10 years was significantly protective (OR:0.2; 95%CI: 0.1-0.8; p = 0.022) of BCE in fully adjusted multivariable logistic regression analysis. DISCUSSION: Our findings do not support a strong role for childhood weight status and eating behaviours in the development of bulimia and compulsive eating pathology, rather suggesting a focus on self esteem may have greater relative importance. Findings in relation to maternal education and SES need further exploration.
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Trastorno por Atracón/etiología , Bulimia Nerviosa/etiología , Fenómenos Fisiológicos Nutricionales Infantiles , Conducta Compulsiva/etiología , Conducta Alimentaria , Sobrepeso/prevención & control , Obesidad Infantil/fisiopatología , Adulto , Trastorno por Atracón/epidemiología , Trastorno por Atracón/prevención & control , Trastorno por Atracón/psicología , Bulimia Nerviosa/epidemiología , Bulimia Nerviosa/prevención & control , Bulimia Nerviosa/psicología , Niño , Estudios de Cohortes , Conducta Compulsiva/epidemiología , Conducta Compulsiva/prevención & control , Conducta Compulsiva/psicología , Escolaridad , Conducta Alimentaria/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Madres/educación , Sobrepeso/epidemiología , Sobrepeso/psicología , Obesidad Infantil/psicología , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Autoimagen , Autoinforme , Factores Sexuales , Reino Unido/epidemiologíaRESUMEN
Association Splitting, a novel cognitive intervention, was tested in patients with alcohol dependence as an add-on intervention in an initial randomized controlled trial. Preliminary support for Association Splitting has been found in patients with obsessive-compulsive disorder, as well as in an online pilot study of patients with alcohol use disorders. The present variant sought to reduce craving by strengthening neutral associations with alcohol-related stimuli, thus, altering cognitive networks. Eighty-four inpatients with verified diagnoses of alcohol dependence, who were currently undergoing inpatient treatment, were randomly assigned to Association Splitting or Exercise Therapy. Craving was measured at baseline, 4-week follow-up, and six months later with the Obsessive-Compulsive Drinking Scale (primary outcome) and the Alcohol Craving Questionnaire. There was no advantage for Association Splitting after three treatment sessions relative to Exercise Therapy. Among Association Splitting participants, 51.9% endorsed a subjective decline in craving and 88.9% indicated that they would use Association Splitting in the future. Despite high acceptance, an additional benefit of Association Splitting beyond standard inpatient treatment was not found. Given that participants were concurrently undergoing inpatient treatment and Association Splitting has previously shown moderate effects, modification of the study design may improve the potential to detect significant effects in future trials.
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Alcoholismo/psicología , Terapia Cognitivo-Conductual/métodos , Conducta Compulsiva/prevención & control , Ansia , Terapia por Ejercicio , Adulto , Consumo de Bebidas Alcohólicas/psicología , Alcoholismo/diagnóstico , Alcoholismo/rehabilitación , Femenino , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Inventario de Personalidad/estadística & datos numéricos , Proyectos Piloto , Escalas de Valoración Psiquiátrica , Resultado del TratamientoRESUMEN
The aim of this study was to evaluate an intervention programme for people with severe mental illness that targets the reduction in compulsory psychiatric admissions. In the current study, we examine the feasibility of retaining patients in this programme and compare outcomes over the first 12 months to those after treatment as usual (TAU). Study participants were recruited in four psychiatric hospitals in the Canton of Zurich, Switzerland. Patients were eligible if they had at least one compulsory admission during the past 24 months. Participants were assigned at random to the intervention or to the TAU group. The intervention programme consists of individualised psycho-education focusing on behaviours prior to illness-related crisis, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. In total, 238 (of 756 approached) inpatients were included in the trial. After 12 months, 80 (67.2%) in the intervention group and 102 (85.7%) in the TAU group were still participating in the trial. Of these, 22.5% in the intervention group (35.3% TAU) had been compulsorily readmitted to psychiatry; results suggest a significantly lower number of compulsory readmissions per patient (0.3 intervention; 0.7 TAU). Dropouts are characterised by younger age and unemployment. This interim analysis suggests beneficial effects of this intervention for targeted psychiatric patients.
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Conducta Compulsiva/prevención & control , Trastornos Mentales/complicaciones , Trastornos Mentales/rehabilitación , Psicoterapia/métodos , Adulto , Conducta Compulsiva/etiología , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Estadísticas no Paramétricas , Suiza , Factores de Tiempo , Resultado del TratamientoRESUMEN
The gold-standard treatment for OCD is exposure and ritual prevention (ERP), yet despite its well-established efficacy, only a small percentage of OCD patients have access to this treatment. Remote treatments (e.g., videoconferencing) are becoming increasingly popular avenues for treatment delivery and show promise in increasing patient access to evidence-based mental health care. The current pilot study utilized an open trial to examine the feasibility and preliminary efficacy of videoconference-mediated, twice weekly, ERP for adults (n=15) with OCD. Results revealed that ERP was associated with significant improvements in OCD symptoms and large within-group effect sizes. Among the 10 individuals who completed a 3-month follow-up assessment, 30% of participants no longer met DSM-IV-TR criteria for OCD and 80% of participants were rated as very much or much improved on the CGI. This study adds to the growing body of literature suggesting that videoconference-based interventions are viable alternatives to face-to-face treatment.
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Conducta Ceremonial , Conducta Compulsiva/prevención & control , Trastorno Obsesivo Compulsivo/terapia , Telemedicina/métodos , Comunicación por Videoconferencia , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Trastorno Obsesivo Compulsivo/psicología , Proyectos Piloto , Resultado del TratamientoRESUMEN
Dieting and the increased availability of highly palatable food are considered major contributing factors to the large incidence of eating disorders and obesity. This study was aimed at investigating the role of the cannabinoid (CB) system in a novel animal model of compulsive eating, based on a rapid palatable diet cycling protocol. Male Wistar rats were fed either continuously a regular chow diet (Chow/Chow, control group) or intermittently a regular chow diet for 2 days and a palatable, high-sucrose diet for 1 day (Chow/Palatable). Chow/Palatable rats showed spontaneous and progressively increasing hypophagia and body weight loss when fed the regular chow diet, and excessive food intake and body weight gain when fed the palatable diet. Diet-cycled rats dramatically escalated the intake of the palatable diet during the first hour of renewed access (7.5-fold compared to controls), and after withdrawal, they showed compulsive eating and heightened risk-taking behavior. The inverse agonist of the CB1 receptor, SR141716 reduced the excessive intake of palatable food with higher potency and the body weight with greater efficacy in Chow/Palatable rats, compared to controls. Moreover, SR141716 reduced compulsive eating and risk-taking behavior in Chow/Palatable rats. Finally, consistent with the behavioral and pharmacological observations, withdrawal from the palatable diet decreased the gene expression of the enzyme fatty acid amide hydrolase in the ventromedial hypothalamus while increasing that of CB1 receptors in the dorsal striatum in Chow/Palatable rats, compared to controls. These findings will help understand the role of the CB system in compulsive eating.
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Antagonistas de Receptores de Cannabinoides/farmacología , Conducta Compulsiva/prevención & control , Conducta Alimentaria/efectos de los fármacos , Piperidinas/farmacología , Pirazoles/farmacología , Análisis de Varianza , Animales , Conducta Animal/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Cuerpo Estriado/metabolismo , Preferencias Alimentarias/efectos de los fármacos , Área Hipotalámica Lateral/metabolismo , Masculino , Núcleo Accumbens/metabolismo , Ratas Wistar , Receptor Cannabinoide CB1/metabolismo , Rimonabant , Asunción de Riesgos , Núcleo Hipotalámico Ventromedial/metabolismoRESUMEN
BACKGROUND: Eveningness and Internet addiction are major concerns in adolescence and young adulthood. We investigated the relationship between morningness-eveningness and compulsive Internet use in young adults and explored the moderating effects of perceived parenting styles and family support on such relationships. METHODS: The participants consisted of 2731 incoming college students (men, 52.4%; mean age, 19.4±3.6years) from a National University in Taiwan. Each participant completed the questionnaires, which included the Morningness-Eveningness Scale (MES), the Yale-Brown Obsessive Compulsive Scale modified for Internet use (YBOCS-IU), the Parental Bonding Instrument for parenting style, the Family Adaptation, Partnership, Growth, Affection, and Resolve questionnaire (APGAR) for perceived family support, and the Adult Self-Report Inventory-4 (ASRI-4) for psychopathology. The morning (n=459), intermediate (n=1878), and evening (n=394) groups were operationally defined by the MES t scores. RESULTS: The results showed that eveningness was associated with greater weekend sleep compensation, increased compulsive Internet use, more anxiety, poorer parenting styles, and less family support; additionally, the most associated variables for increased compulsive Internet use were the tendency of eveningness, male gender, more anxiety symptoms, less maternal affection/care, and a lower level of perceived family support. The negative association between the morning type and compulsive Internet use severity escalated with increased maternal affection/care and decreased with increased perceived family support. The positive association between the evening type and compulsive Internet use severity declined with increased maternal protection. However, the father's parenting style did not influence the relationship between morningness-eveningness and compulsive Internet use severity. CONCLUSIONS: Our findings imply that sleep schedule and the parental and family process should be part of specific measures for prevention and intervention of compulsive Internet use.
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Conducta Adictiva/psicología , Conducta Compulsiva/psicología , Internet , Responsabilidad Parental/psicología , Índice de Severidad de la Enfermedad , Adolescente , Trastornos de Ansiedad/psicología , Conducta Adictiva/prevención & control , Ritmo Circadiano , Conducta Compulsiva/prevención & control , Relaciones Familiares , Padre/psicología , Femenino , Humanos , Masculino , Madres/psicología , Trastorno de Pánico/psicología , Relaciones Padres-Hijo , Inventario de Personalidad , Trastornos Fóbicos/psicología , Factores Sexuales , Adulto JovenRESUMEN
Compulsive behavior is a debilitating clinical feature of many forms of neuropsychiatric disease, including Tourette syndrome, obsessive-compulsive spectrum disorders, eating disorders, and autism. Although several studies link striatal dysfunction to compulsivity, the pathophysiology remains poorly understood. Here, we show that both constitutive and induced genetic deletion of the gene encoding the melanocortin 4 receptor (MC4R), as well as pharmacologic inhibition of MC4R signaling, normalize compulsive grooming and striatal electrophysiologic impairments in synapse-associated protein 90/postsynaptic density protein 95-associated protein 3 (SAPAP3)-null mice, a model of human obsessive-compulsive disorder. Unexpectedly, genetic deletion of SAPAP3 restores normal weight and metabolic features of MC4R-null mice, a model of human obesity. Our findings offer insights into the pathophysiology and treatment of both compulsive behavior and eating disorders.
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Conducta Compulsiva/fisiopatología , Proteínas del Tejido Nervioso/deficiencia , Proteínas del Tejido Nervioso/genética , Obesidad/fisiopatología , Receptor de Melanocortina Tipo 4/deficiencia , Receptor de Melanocortina Tipo 4/genética , Animales , Peso Corporal , Conducta Compulsiva/prevención & control , Cuerpo Estriado/fisiopatología , Modelos Animales de Enfermedad , Femenino , Aseo Animal/fisiología , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Obesidad/prevención & control , Péptidos Cíclicos/farmacología , Receptor de Melanocortina Tipo 4/antagonistas & inhibidores , Transducción de Señal/efectos de los fármacos , Transmisión Sináptica/fisiologíaRESUMEN
BACKGROUND: Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. Currently, the cognitive-behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. METHODS: Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. RESULTS: To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e. symmetry and ordering). CONCLUSIONS: Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed.
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Conducta Ceremonial , Terapia Cognitivo-Conductual , Conducta Compulsiva/prevención & control , Trastorno Obsesivo Compulsivo/psicología , Trastorno Obsesivo Compulsivo/terapia , Conducta Compulsiva/psicología , Humanos , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/diagnóstico , Prevención PrimariaRESUMEN
INTRODUCTION: This study examined the associations between work-related irrational cognitions and workaholism. For this purpose, a 16-item work-related irrational beliefs questionnaire (WIB-Q) was developed. METHODS: Employees (n = 913) completed an online survey that included, besides the irrational cognitions scale, measures of negative affect and workaholism. RESULTS: The results show that four factors could be distinguished, which represent irrational beliefs concerning (1) performance demands, (2) co-workers' approval (3) failure and (4) control. All scales showed good internal consistency. Furthermore, it was found that, after controlling for negative affect, performance demands were associated with workaholism, whereas the remaining types of irrationality were unrelated to workaholism. CONCLUSIONS: In other words, the findings suggest that interventions for workaholism should target irrational self-oriented performance demands and negative emotions. As Rational Emotive Behavior Therapy focuses on identifying and replacing irrational cognitions, it appears a useful intervention technique for the treatment of workaholics.
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Conducta Compulsiva/psicología , Empleo/psicología , Encuestas y Cuestionarios , Adulto , Cognición , Conducta Compulsiva/diagnóstico , Conducta Compulsiva/prevención & control , Emociones , Análisis Factorial , Femenino , Humanos , Control Interno-Externo , Relaciones Interprofesionales , Masculino , Modelos Psicológicos , Países Bajos , Psicoterapia Racional-Emotiva , Reproducibilidad de los Resultados , AutoimagenRESUMEN
The current data suggest that up to 50% of patients with schizophrenia have obsessive-compulsive (OC) symptoms coexisting with psychosis and between 7.8 and 46% of schizophrenia patients also have full-blown obsessive-compulsive disorder (OCD). The aim of this study was to examine the efficacy of the most selective serotonin reuptake inhibitor escitalopram in the management of OCD in schizophrenia patients. The study was an open-label prospective trial of 12 weeks' duration in which escitalopram at a dose of up to 20 mg/day was added to the existing antipsychotic drug regimen in schizophrenia patients with OCD. Fifteen patients (10 men/five women) with the diagnosis of schizophrenia and OCD were recruited for the study (mean age: 39±14, range 21-61 years) and received escitalopram according to the study design. A significant improvement was observed in the total Yale Brown Obsessive-Compulsive Scale (Y-BOCS) scores and in the scores of both the Y-BOCS-Obsession and the Y-BOCS-Compulsion subscale at the end point. In addition, a significant improvement was observed in the total scores of the Positive and Negative Syndrome Scale and particularly in scores of anxiety, tension, depression, and preoccupation items. No adverse effects of escitalopram were reported by patients during the trial. In our prospective 12-week open-label study, escitalopram 20 mg/day was well tolerated and improved OC symptoms in schizophrenia patients. Our preliminary results are encouraging and a double-blind randomized study is required to confirm our results.
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Antipsicóticos/uso terapéutico , Citalopram/uso terapéutico , Trastorno Obsesivo Compulsivo/tratamiento farmacológico , Esquizofrenia/tratamiento farmacológico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Adulto , Antipsicóticos/efectos adversos , Ansiedad/prevención & control , Citalopram/efectos adversos , Conducta Compulsiva/prevención & control , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Quimioterapia Combinada/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Obsesiva/prevención & control , Trastorno Obsesivo Compulsivo/complicaciones , Escalas de Valoración Psiquiátrica , Esquizofrenia/complicaciones , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Adulto JovenAsunto(s)
Alcoholes/administración & dosificación , Conducta Compulsiva/prevención & control , Infección Hospitalaria/prevención & control , Desinfectantes/administración & dosificación , Desinfección/métodos , Desinfección de las Manos/métodos , Conductas Relacionadas con la Salud , Jabones/administración & dosificación , HumanosRESUMEN
OBJECTIVE: Cognitive impairments in individuals with alcohol dependence may interfere with the progress of treatment and contribute to the progression of the disease. This study aimed to determine whether cognitive remediation (CR) therapy applied during treatment for alcohol dependence improves cognitive functioning in alcohol-dependent inpatients. A secondary aim was to evaluate whether the benefits of CR generalize to noncognitive clinically meaningful outcomes at the end of inpatient treatment. METHOD: Forty-one alcohol-dependent patients entering inpatient treatment for alcohol dependence were randomly assigned to receive conventional treatment (n = 21) or an additional 12 sessions of computer-assisted CR focusing on cognitive enhancement in attention/executive function and memory domains (n = 20). Assessments of cognitive abilities in these domains as well as of psychological well-being and alcohol craving were conducted at baseline (at the beginning of inpatient treatment) and after CR (at the end of treatment). RESULTS: Results indicated that, relative to patients completing conventional treatment, those who received supplemental CR showed significant improvement in attention/executive function and memory domains, particularly in attention (alertness, divided attention), working memory, and delayed memory (recall). In addition, patients receiving CR during alcohol-dependence treatment showed significantly greater improvements in psychological well-being (Symptom Checklist-90-Revised) and in the compulsion aspect of craving (Obsessive Compulsive Drinking Scale-German version). CONCLUSIONS: CR during inpatient treatment for alcohol dependence is effective in improving cognitive impairments in alcohol-dependent patients. The benefits generalize to noncognitive outcomes, demonstrating that CR may be an efficacious adjunctive intervention for the treatment of alcohol dependence.