PubMed Health⌕ Search

Biomedical subjects

D D Burns

Publications and source records attributed to D D Burns.

13 recordsLinked to original sources
PubMed2000

Does psychotherapy homework lead to improvements in depression in cognitive-behavioral therapy or does improvement lead to increased homework compliance?

The bidirectional causal relationships between psychotherapy homework (HW) compliance and changes in depression were assessed in 2 groups of depressed outpatients treated with cognitive-behavioral therapy using nonrecursive structural equation modeling techniques. The data were consistent with the hypothesis that HW compliance had a causal effect on changes in depression, and the magnitude of this effect was large. Patients who did the most HW improved much more than patients who did little or no HW. In contrast, depression severity did not appear to influence HW compliance. HW compliance did not appear to be a proxy for any other, unobserved (3rd) variable, such as motivation. Although the causal effect of HW on depression was large, the correlation between HW and depression was small. Some possible explanations, along with suggestions for future studies, are proposed.

Adult↗
PubMed1999

Statistical method to evaluate management strategies to decrease variability in operating room utilization: application of linear statistical modeling and Monte Carlo simulation to operating room management.

BACKGROUND: Operating room (OR) managers seeking to maximize labor productivity in their OR suite may attempt to reduce day-today variability in hours of OR time for which there are staff but for which there are no cases ("underutilized time"). The authors developed a method to analyze data from surgical services information systems to evaluate which management interventions can most effectively decrease variability in underutilized time. METHODS: The method uses seven summary statistics of daily workload in a surgical suite: daily allocated hours of OR time, estimated hours of elective cases, actual hours of elective cases, estimated hours of add-on cases, actual hours of add-on cases, hours of turnover time, and hours of underutilized time. Simultaneous linear statistical equations (a structural equation model) specify the relationship among these variables. Estimated coefficients are used in Monte Carlo simulations. RESULTS: The authors applied the analysis they developed to two OR suites: a tertiary care hospital's suite and an ambulatory surgery center. At both suites, the most effective strategy to decrease variability in underutilized OR time was to choose optimally the day on which to do each elective case so as to best fill the allocated hours. Eliminating all (1) errors in predicting how long elective or add-on cases would last, (2) variability in turnover or delays between cases, or (3) day-to-day variation in hours of add-on cases would have a small effect. CONCLUSIONS: This method can be used for decision support to determine how to decrease variability in underutilized OR time.

Humans↗
PubMed1998

Why are depression and anxiety correlated? A test of the tripartite model.

L. A. Clark and D. Watson's (1991) tripartite model groups the symptoms of depression and anxiety into 3 components: nonspecific symptoms of general distress, which do not distinguish depression and anxiety; physiologic arousal, which is relatively unique to anxiety; and anhedonia (or low positive affect), which is unique to depression. Structural equation modeling was used to test this model with self-report data from 3 different samples: outpatients seeking treatment for mood disorder, anxiety disorder, or both (n = 483) outpatients seeking treatment for substance abuse (n = 453), and college students (n = 516). The tripartite model did not fit any of the sample covariance matrices, because the nonspecific symptoms of depression and anxiety could not be adequately represented by a single General Distress factor. An alternative model, in which the Anhedonia and Nonspecific Depression factors loaded on a second-order Depression factor, while the Somatic Arousal and Nonspecific Anxiety factors loaded on a second-order Anxiety factor, produced an excellent fit in all the groups. The Nonspecific Depression and Nonspecific Anxiety factors were the most valid and specific indicators of depression and anxiety, respectively. Anhedonia and Somatic Arousal were significantly less valid measures of depression and anxiety. The implications of these findings are discussed.

Adolescent↗
PubMed1994

Intimate relationships and depression: is there a causal connection?

The causal pathways that link depression and dissatisfaction in intimate relationships were estimated in 115 patients during the first 12 weeks of treatment with cognitive-behavioral therapy for depression. Depression severity, as measured by the Beck Depression Inventory, was negatively correlated with relationship satisfaction at intake and at 12 weeks. However, structural equation modeling was not consistent with the hypothesis that depression severity has a causal effect on relationship satisfaction levels and suggested that relationship satisfaction may have only a weak reciprocal effect on depression severity. As predicted, married patients were substantially less depressed 12 weeks after the beginning of treatment, when controlling for initial depression severity. Contrary to expectations, marital status predicted improvement even when relationship satisfaction was controlled. Unexpectedly, dysthymia at intake was associated with low relationship satisfaction after 12 weeks, when initial relationship satisfaction was controlled, suggesting that chronic, low-level depression may have a stronger association with interpersonal problems than other forms of depression, such as major depressive episodes. The theoretical and clinical implications of the findings are discussed.

Adolescent↗
PubMed1993

Relationships between symptoms of depression and anxiety and dysfunctional beliefs about achievement and attachment.

Psychiatric outpatients (N = 293) provided data to test the symptom specificity and final common pathway hypotheses about symptoms of depression and anxiety. The symptom specificity hypothesis predicts that the symptoms reported by a depressed or anxious patient depend on the dysfunctional beliefs he or she endorses. In contrast, the final common pathway hypothesis predicts that symptoms are unrelated to the types of beliefs the patient endorses. These hypotheses were tested in the context of theories that emphasize the importance of dysfunctional beliefs about achievement and attachment. Only limited support for the symptom specificity hypothesis was obtained; support was strongest for the link between attachment beliefs and anxiety symptoms. Relationships between symptoms and dysfunctional beliefs did not depend on psychiatric diagnosis.

Achievement↗
PubMed1992

Therapeutic empathy and recovery from depression in cognitive-behavioral therapy: a structural equation model.

This study demonstrated that therapeutic empathy has a moderate-to-large causal effect on recovery from depression in a group of 185 patients treated with cognitive-behavioral therapy (CBT). The authors simultaneously estimated the reciprocal effect of depression severity on therapeutic empathy and found that this effect was quite small. In addition, homework compliance had a separate effect on clinical recovery, over and above the effect of therapeutic empathy. The patients of novice therapists improved significantly less than did the patients of more experienced therapists, when controlling for therapeutic empathy and homework compliance. Ss who terminated therapy prematurely were less likely to complete the self-help assignments between sessions, rated their therapists as significantly less empathic, and improved significantly less. Ss with borderline personality disorder improved significantly less, but they rated their therapists as just as empathic and caring as other patients. The significance of these findings for psychotherapy research, treatment, and clinical training is discussed.

Adolescent↗
PubMed1991

Coping styles, homework compliance, and the effectiveness of cognitive-behavioral therapy.

Factor analysis of the Self-Help Inventory (Burns, Shaw, & Crocker, 1987) in a group of 307 consecutive outpatients seeking cognitive-behavioral therapy (CBT) for affective disorders revealed 3 factors that assessed the frequency with which subjects used active coping strategies when depressed, the perceived helpfulness of these coping strategies, and their willingness to learn new coping strategies. The Frequency and Helpfulness scales did not predict patients' subsequent compliance with self-help assignments or their rate of improvement during the first 12 weeks of treatment. These findings suggest that very resourceful patients are not better candidates for CBT than other patients and that patients' expectations about the value of active coping strategies do not predict the response to CBT. In contrast, the Willingness scale was correlated with the degree of improvement during the first 12 weeks of treatment. The Willingness scale and compliance with self-help assignments made additive and separate contributions to clinical improvement. Further research on motivational factors may be indicated.

Adaptation, Psychological↗
PubMed1989

Medical illness and the acceptance of suffering.

This article challenges the belief that depression and anxiety are the inevitable consequences of medical illness. The authors describe how cognitive behavioral therapy can help individuals accept their disabilities and modify the distorted thinking patterns which may compound their suffering. Three case studies demonstrate the successful application of cognitive techniques to feelings of depression and anxiety in two patients with Stage III ovarian carcinoma and one patient with multiple sclerosis.

Adaptation, Psychological↗
PubMed1976

Localization and possible role of an adenosine triphosphatase in Chlorobium thiosulfatophilum.

1. Evidence is presented that the ATPase activity detected in cell extracts of Chlorobium thiosulfatophilum is bound to the cytoplasmic membrane rather than to the chlorobium vesicles. 2. The activity of this ATPase is inhibited in vitro by various carbodiimides, phloridzin and sodium azide. 3. The apparent Km for ATP is approximately 0.2 mM and the enzyme shows product inhibition by ADP. 4. Photophosphorylation, characterized in vivo, is inhibited by many of the compounds that inhibit the ATPase.

Adenosine Diphosphate↗