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Biomedical subjects

P Salkovskis

Publications and source records attributed to P Salkovskis.

10 recordsLinked to original sources

Prevalence and service implications of health anxiety in genitourinary medicine clinics.

A comparison of the prevalence of health anxiety in genitourinary medicine (GUM) clinics in two UK centres was carried out using a new rating scale, the Health Anxiety Inventory (HAI). The relationship of health anxiety to demographic and clinical variables, and its impact on service contacts, was also examined in one of these centres. 694 patients were assessed and significant health anxiety was identified in 8-11%. HAI scores were stable over time and high levels persisted in the absence of treatment. Attenders with sexually transmitted infections had significantly lower levels of health anxiety than those with other conditions. Contacts with clinic doctors and health advisors in the nine months before and after assessment were significantly greater in those with high health anxiety, with doctor appointments 37% higher in the high HAI group (P = 0.005). Health anxiety is a source of considerable morbidity in GUM clinics deserving further study.

Adult↗

Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research.

The purpose of this paper is to consider the possible origins of an inflated sense of responsibility which occupies an important place in the cognitive theory of obsessive compulsive disorder (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154. Salkovskis, P. M. (1985). Obsessional-compulsive Problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23 (5), 571-583). Clinical experience and consideration of current cognitive conceptualisations of obsessions and obsessive compulsive disorder suggest a number of possibilities, each of which is described after a brief introduction to the concept itself. While there are reasons to believe that some general patterns can be identified, the origins of obsessional problems are best understood in terms of complex interactions specific to each individual.

Cognitive Behavioral Therapy↗

Cognitive therapy for premenstrual syndrome: a controlled trial.

The aim of this study was to evaluate the effectiveness of cognitive therapy (CT) as a psychological treatment for premenstrual syndrome (PMS), by comparison with a waitlist control group. Women meeting selection criteria for PMS were randomly allocated to one of two treatment groups: (i) an immediate treatment group, who received 12 weekly sessions of individual CT; or (ii) a waiting list group who recorded symptoms of PMS for a length of time equivalent to the duration of an individual treatment in the immediate treatment group. General practitioners and gynecologists referred women who were complaining of distressing and disabling emotional and physical symptoms in the second half of the menstrual cycle, as verified by 2 months of prospective diary recording. Assessments of the women's psychological and social functioning were made on entry to the study, 2 months later, and at the end of the treatment period. This design allows evaluation of the efficacy of CT relative to any spontaneous remission that may have occurred as a consequence of the passage of time, the keeping of menstrual diaries, interview, and self-rated assessments. Results indicated that CT was significantly more effective than assignment to the waitlist group. Diary measures and self-report questionnaires indicated an almost complete remission of psychological and somatic symptoms and of impairment of functioning. It is concluded that CT for PMS is associated with substantial improvements that cannot be attributed to the passage of time or the completion of the diary and other assessments.

Adult↗

Biochemical and behavioural effects of acute tryptophan depletion in abstinent bulimic subjects: a pilot study.

We studied the effect of acute tryptophan (TRP) depletion in a group of eight abstinent bulimic (BN) subjects and in 12 healthy female controls. Despite being free of episodes of binge-eating and vomiting for a prolonged period, the abstinent BN subjects still appeared to practice dietary restrain as judged by their food intake in a test meal. In addition, their plasma TRP concentrations were significantly lower than those of the controls. Administration of a TRP-free amino acid load (52 g) significantly lowered plasma total and free TRP. However, compared to a balanced amino acid load, this procedure did not have significant effects on mood, appetite or food intake in either the abstinent BN subjects or the healthy controls.

Adult↗

Induced mood, phobic responding and the return of fear.

The link between depression and phobic responding is poorly understood. Forty-eight spider phobics were exposed to videotaped spider sequences whilst in relatively depressed or relatively elated moods, then presented the same stimuli whilst in a neutral mood. Results indicated that depressed mood increased initial responding, and was associated with greater return of fear during the second (non-mood) sequence. The return of fear was not attributable solely to differential habituation rates during the first sequence, suggesting that the differences observed may have been due to cognitive effects.

Adolescent↗

Cognitive treatment for panic disorder.

Several kinds of evidence indicate that there are important psychological causes of panic disorder as well as the biological causes that have been demonstrated by others. These psychological causes are fears that physical symptoms of anxiety will be followed by an immediate medical emergency: for example, that palpitations will be followed by a heart attack. Evidence is presented to show (a) that such fears are more frequent among panic disorder patients than other anxious patients; (b) that activating the fears can produce panic; and (c) that reducing the fears can attenuate the effects of procedures that produce panic. For panic disorder, cognitive therapy, which reduces these specific fears, gives results comparable to those of imipramine and alprazolam. If further research confirms that these therapeutic effects of cognitive therapy are sustained well beyond the end of treatment, cognitive therapy could be the treatment of choice for panic disorder.

Alprazolam↗

Community psychiatric nursing intervention in an accident and emergency department: a clinical pilot study.

In a pilot study, 99 patients referred from a general hospital accident and emergency department were seen by a community psychiatric nurse (CPN) using a time series design. They were categorized into those patients having a previous psychiatric history and those with none. The level of service use for the 6 months immediately prior to CPN intervention, 6 months following referral, and 6 months of follow-up indicated a very high level of psychiatric and general medical service use by this group. Referral to the CPN was associated with substantial reduction in the demands on other services made by the group with previous psychiatric history. The group with no previous history showed a decrease in total service usage at follow-up.

Adolescent↗