Biomedical subjects
Publications and source records attributed to G A Hibbert.
To evaluate the frequency of eating disorder features among women receiving treatment for an alcohol problem, 52 female attenders at an alcohol clinic were assessed using a standardized research clinical interview, and the findings compared with data on a general population sample. The results suggest that eating disorder features are overrepresented among women who present for treatment for an alcohol problem.
Patients who experienced panic attacks, with or without avoidance, were treated for two weeks with either training in controlled breathing or a placebo treatment. Subsequently, both groups received a limited period of conventional anxiety treatments, most commonly in vivo exposure. Patients were subdivided into 'hyperventilators' and 'non-hyperventilators' on the basis of the conventional provocation test. Observer ratings of anxiety showed a greater improvement for the group that received breathing training, but there was no evidence that 'hyperventilators' benefited more from respiratory training than 'non-hyperventilators'. Self-report measures of anxiety, avoidance, and depression/dysphoria showed no difference between treatments. These findings suggest that training in controlled breathing is not of specific benefit for those identified as 'hyperventilators' by the provocation test, but that it may have a non-specific effect in the treatment of patients with panic attacks.
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The covariation over time of depressive symptoms was studied by repeated ratings of the symptoms of individual depressed in-patients. Both within-patient factor analysis of symptom scores and correlation of symptom change scores to total change scores suggested that, while the symptoms of reduced interest and pleasure covaried closely with ratings of observed and reported low mood, the more 'biological' symptoms of sleep and appetite disturbance showed little covariation. The implications for the study of depression are discussed.
Cognitive therapy for depression is a psychological treatment designed to train patients to identify and correct the negative depressive thinking which, it has been hypothesised, contributes to the maintenance of depression. General practice patients meeting Research Diagnostic Criteria for primary major depressive disorder were randomly allocated either to continue with the treatment they would normally receive (which in the majority of cases included antidepressant medication) or to receive, in addition, sessions of cognitive therapy. At completion of treatment, patients receiving cognitive therapy were significantly less depressed than the comparison group, both on blind ratings of symptom severity made by psychiatric assessors and on a self-report measure of severity of depression. At three-month follow-up cognitive therapy patients no longer differed from patients receiving treatment-as-usual, but this was mainly as a result of continuing improvement in the comparison group.
Twenty-five out-patients with generalised anxiety or panic disorders were interviewed. A characteristic ideational component was identified, centering on the theme of personal danger and, in particular, on physical harm. A range of features of the ideational content is described. In the 12 months preceding onset 88 per cent of the patients had experienced significant stresses. For 50 per cent the onset of panic attacks was precipitated by somatic symptoms other than those of anxiety. The relationship between ideational content, stress and somatic symptoms is discussed.
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