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Biomedical subjects

E Léger

Publications and source records attributed to E Léger.

4 recordsLinked to original sources

Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial.

Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.

Adult↗

Correction of inflated responsibility in the treatment of obsessive-compulsive disorder.

This study evaluates the efficacy of a cognitive treatment for obsessive-compulsive disorder (OCD). Four patients with OCD whose major complaints were checking rituals were treated in a multiple baseline across subjects design. Cognitive correction targeted inflated responsibility, without any exposure or response prevention. All subjects reported a clinically significant decrease in interference caused by rituals, a 52-100% reduction in Y-BOCS scores, and a decrease in perceived responsibility. Therapeutic gains were maintained at follow-up (6 and 12 months) for three patients. Results suggest that cognitive therapy targeting inflated responsibility is a promising alternative to exposure-based treatment.

Adult↗

[Influence of sampling techniques on blood sodium, potassium and hemoglobin concentration measured by a blood gas analyser].

A study was carried out to assess the influence of sampling technique on sodium, potassium and haemoglobin blood concentrations measured simultaneously with a bedside blood gas analyser (Ciba Corning 288) and in the central laboratory. Blood samples from forty intensive care unit patients were used to test cight techniques: capillary tubes (Radiometer & Corning), preheparinized syringes (Terumo 2.5 ml, Sherwood 1 and 3 ml, Corning 1 ml) and Radiometer 2 ml) and a conventional syringe (Plastimed) which was rinsed with heparin just before use. Each result was compared with that obtained by the laboratory. For haemoglobin concentrations, the results were underestimated by the bedside analyser with Terumo, Corning, Radiometer and Plastimed syringes. The differences between results varied with the haemoglobin concentration, and precision was low: 38 to 55% of results showed a difference of more than 1 g.dl-1, and 13 to 25% a difference of more than 2 g.dl-1. The results obtained with the capillary tubes and the preheparinized syringes (Sherwood) showed differences independent of the value, as well as higher precision: 13 to 20% of values differed more than 1 g.dl-1, and 0 to 3% more than 2 g.dl-1. The capillary tubes moderately overestimated the haemoglobin concentration (+0.02 to +0.65 g.dl-1) while Sherwood's syringes underestimated it (-0.48 to -0.94 g.dl-1). For the sodium and potassium concentrations, the eight methods gave results similar to those obtained by the laboratory. It is concluded that these modules for bedside biological analysis, when used in optimal conditions, rapidly provide reliable results for some parameters.

Blood Gas Analysis↗

[Anxiety and physical limitation: a complex relation].

Psychological problems affecting physically handicapped individuals are understudied. However, some studies suggest a higher risk of developing an elevated level of anxiety among these individuals. A previous study reported that people with multiple sclerosis show more anxiety than patients suffering from another type of physical limitations. These results raise questions about the specificity of the link between anxiety and some medical conditions. The aim of the present study is to increase our understanding of manifestations of anxiety associated with degenerative illnesses. Three groups of patients with different physical limitations were compared on their level of anxiety and on various cognitive process. Groups were composed as: 1) 20 patients suffering from multiple sclerosis, 2) 18 patients diagnosed with another degenerative illness (either arthritis, muscular dystrophy or ataxia), and 3) 20 participants presenting a non-degenerative handicap. The 3 groups were not significantly different on age, sex and duration of the physical limitations. Symptoms of anxiety were measured with 3 questionnaires:1) the Hospital Anxiety and Depression Scale, 2) the Penn State Worry Questionnaire, used to assess the tendency to worry, and 3) the Worry Domains Questionnaire, assessing diversity and intensivity of worry themes. In turn, cognitive processes were evaluated with 4 questionnaires: 1) the Acceptance of Disability scale, used to assess the person's level of acceptance regarding a disability, 2) the Interpretation of Disturbing Thoughts questionnaire, an idiographical measure about the interpretation of thoughts associated with a physical handicap, 3) the Intolerance of Uncertainty scale, presenting beliefs about uncertainty and its consequences, and 4) the Cognitive Avoidance questionnaire, to evaluate the tendency of avoiding disturbing thoughts and images. Participants completed all questionnaires alone and the experimenter was available to answer any questions. MANOVAs were used to compare the 3 groups on the studied variables. Statistical analysis revealed no significant differences among groups for symptoms of anxiety and depression, tendency to worry and worry themes. Similarly, no significant differences were obtained on cognitive processes. The multiple sclerosis group and the other degenerative illness group were combined and compared to the non-degenerative handicap group. MANOVAs conducted on symptoms and cognitive processes did not yield any significant differences. Results of the present study seem to indicate that the type of physical limitations is not an indicator of the presence of specific anxiety symptoms or cognitive processes. On an exploratory basis, all participants were compared according to their level of acceptance of disability. Results indicated that a lower level of acceptance was significantly associated with more anxious and depressive symptoms, excessive worries, and a greater intolerance of uncertainty. It seems that acceptance of disability plays a key role in maintaining psychological distress among people with a physical handicap. The influence of intolerance of uncertainty on acceptance of disability needs to be further explored.

Adult↗