Biomedical subjects

T P Oei

Publications and source records attributed to T P Oei.

At least 19 recordsLinked to original sources

PubMed2001

Cognitive and biochemical processes in depressed adult outpatients: a test of the circular process model.

The circular process model is a psychobiological model of depression, in which it is postulated that catecholamines and negative cognitions interact to influence depression. Since its publication, there have been no empirical tests to support or refute the model. This study tested the model in 92 depressed adult outpatients with non-bipolar non-psychotic depression. There were no significant bivariate correlations among the biochemical and cognitive measures. However, the interactive model was supported by results of two out of three hierarchical regression analyses, in which the biochemical-by-cognitive interactive terms significantly predicted depression after the main effects of each variable were accounted for. These findings show sufficient evidence in support of the Circular Process Model to warrant further testing over the treatment period.

Adolescent↗

PubMed1999

Pre-existing antidepressant medication and the outcome of group cognitive-behavioural therapy.

OBJECTIVE: This study aimed to investigate the impact of pre-existing medication on the outcome of group cognitive-behavioural therapy (CBT) in the treatment of patients with depression. METHOD: Of the 71 patients diagnosed with major depression who participated in group CBT, 25 were on medication (CBT-M) and 46 were unmedicated (CBT). The patients received 12 sessions of group CBT over a 3-month period. The dependent measures used were the Beck Depression Inventory, Zung Self-Rating Depression Scale, Automatic Thoughts Questionnaire, Hopelessness Scale, Dysfunctional Attitude Scale, Daily Activity Rating Scale and Daily Mood Rating Scale. RESULTS: Both the CBT and CBT-M groups showed statistically significant improvement in depression scores and cognitive process measures. However, the rate of improvement for both groups on these measures did not differ. CONCLUSION: The study indicated that pre-existing antidepressant medication did not enhance or detract from the positive treatment outcome of depressed patients receiving a group CBT treatment.

Adult↗

PubMed1999

Cognitive changes following recovery from depression in a group cognitive-behaviour therapy program.

OBJECTIVE: We report on the changes in cognitions as a result of cognitive-behaviour therapy (CBT), in 35 recovered and 32 non-recovered mood disordered patients who had undergone a 12-week group CBT program for depression. METHOD: An end-of-therapy cut-off score of 10 on the BDI was used to define recovered and non-recovered patients. ANOVA analyses were conducted to explore possible main effects of recovery status and time on various clinical measures, including cognitions and activity levels. RESULTS: Mean mood and activity self-rating measures were significantly higher for the recovered as compared to the non-recovered patients over the course of the program. Similarly, scores on the Automatic Thoughts Questionnaire (ATQ) for recovered patients were within the non-clinical range, in contrast to their non-recovered counterparts. In addition, recovered patients improved significantly in their Hopelessness scores, and there was a change in the expected direction in their Dysfunctional Attitudes Scale scores, although this was not significant. CONCLUSION: These results are consistent with the proposition of cognitive theory (i.e. the remediation of negative cognition plays a significant role in recovery from depression during CBT).

Adult↗

PubMed1999

Predictors of career commitment and employment level of tertiary-educated Indonesian women.

This study investigated the relationships among education, liberal sex-role values, gender-role orientation (masculinity/femininity), career commitment, and employment level for a sample of 302 married Indonesian women. All participants were tertiary educated and currently employed either as teachers in tertiary institutions or as managers in government or private enterprise. Multiple regression analysis revealed that liberal sex-role values and masculinity were significant predictors of career commitment, whereas education was the only variable to significantly predict employment level. Results are compared with previous research on predictors of career commitment and employment level in both Asian and Western cultures. Directions for further research are discussed.

Asia↗

PubMed1999

Development of a Satisfaction with Therapy and Therapist Scale.

OBJECTIVE: While much work has gone into developing measures of specific factors in psychotherapy for depression, measures for non-specific factors have been lacking. This paper aims to develop a scale for a non-specific factor called 'Satisfaction with Therapy and Therapist Scale'. METHOD: Sixty-seven patients with major depression completed the questionnaires during the fourth session of cognitive therapy. The patients went through an assessment clinical interview using a SCID. They also completed the ATQ, BDI and DAS questionnaires during the fourth session. RESULTS: Principal component factor analysis with varimax rotation showed that the scale possesses two factors, 'Satisfaction with Therapy' and 'Client Evaluation of Therapist', accounting for 64.7% of the total variance. The alpha Cronbach for the two factors is 0.91 and 0.80 with the total scale alpha at 0.90. The scale also possesses good concurrent and discriminant validity. CONCLUSION: The Satisfaction with Therapy and Therapist Scale is an adequate measure for measuring a non-specific factor in psychotherapy.

Adult↗

PubMed1999

Is there evidence to show that fetal alcohol syndrome can be prevented?

Fetal Alcohol Syndrome (FAS) is currently the major cause of mental retardation in the Western world. Since FAS is not a natural phenomenon and is created by mixing alcohol and pregnancy, the solution to decreasing the incidence of all alcohol-related birth defects is therefore entirely preventable. To date, little is known about the effectiveness of prevention programs in reducing the incidence of FAS. Therefore, it is the intention of this article to review the effectiveness of prevention programs in lowering the incidence of FAS. The present review revealed that prevention programs, to date, have been successful in raising awareness of FAS levels across the groups examined. However, this awareness has not been translated into behavioral changes in "high risk" drinkers as consumption levels in this group have decreased only marginally, indicating prevention programs have had minimal or no impact in lowering the incidence of FAS. Urgent steps must now be taken to fully test prevention programs, and find new strategies involving both sexes, to reduce and ultimately eliminate the incidence of FAS.

Ethics↗

PubMed1998

Biological and psychological processes in recovery from depression during cognitive therapy.

This study investigated the relationship between biological and psychological processes in the recovery phase of depression during treatment with cognitive therapy. In particular, we tested the hypothesis that biological and psychological processes are independent; the hypothesis that they are related in a linear or sequential process; and the hypothesis that there is a circular relationship between them. 35 depressed patients completed a 12 week program of cognitive therapy. Changes in measures of negative thinking and amine dysfunction over the course of therapy were compared for those who improved and those who did not. There was a significant relationship between improvement in symptoms and change for ATQ scores, DAS scores, and epinephrine levels. There was significant change in metanephrine levels during therapy which was not related to improvement. The changes were not consistent across indices. Although the results did not provide definite support for any of the four models of the relationship between biological and psychological variables during recovery from depression, the finding that there was some change in some of the indices of amine dysfunction during cognitive therapy indicates that the interface between biological and psychological processes in depression should continue to be studied.

Adaptation, Psychological↗

PubMed1998

Catastrophic cognitions in panic disorder with and without agoraphobia.

The cognitive models of panic disorder with (PDA) or without (PD) agoraphobia are now widely recognised. These models propose that patients misinterpret external or internal cues in a catastrophic manner and as a result of these catastrophic cognitions the symptoms are maintained. There is now a large body of empirical evidence for this proposal and the aim of this paper is to systematically review the literature to evaluate whether the empirical evidence supports the contribution of catastrophic cognitions to PD and PDA. Empirical studies using different methodologies, such as interview, questionnaire, self-monitoring, and in vivo techniques are reviewed. The results indicate there is substantial empirical evidence in support of the central role of catastrophic cognition in cognitive models. Different methodologies provided convergent support for the importance of catastrophic cognitions in the maintenance of panic disorder and agoraphobia. Limitations in the interpretation of the existing research are highlighted and future research directions are proposed.

Agoraphobia↗

PubMed1998

Depression after traumatic brain injury: conceptualization and treatment considerations.

The understanding and treatment of depression that develops following traumatic brain injury (TBI) is still unclear and likely to be the result of a complex variety of interacting factors. Past researchers have developed ways to classify important variables related to patients' depression into broad domains such as: Pre-injury assets and liabilities, the nature and severity of brain injury; and reaction to difficulties. However, a better conceptualization of the problem is required in order to guide the assessment and treatment considerations for depressed patients with TBI. This review provides this conceptualization by postulating six theoretical relationships between depression and TBI. The degree of empirical support provided in the literature for these links is indicated. Research findings suggested that an individual with TBI is the most susceptible to depression when any of the following conditions exist: a pre-existing psychiatric disturbance is exacerbated; the injury sustained involved the left anterior region of the brain; and when her individual has poor insight into her deficits, attempts to resume her pre-injury roles and experiences significant failure. For each relationship, a likely outcome is predicted if the recommended treatment plan is not conducted. The present conceptualization and treatment considerations will be of substantial benefit to clinicians working in the area.

Brain Injuries↗

PubMed1998

The differential role of alcohol expectancies and drinking refusal self-efficacy in problem and nonproblem drinkers.

OBJECTIVE: The present study aimed to examine the discriminatory ability of alcohol expectancies and drinking refusal self-efficacy and to identify the differential role of these constructs in social and problem drinkers. METHOD: Drinkers (N = 276) were self-selected from general (n = 185) and clinical (n = 91) populations to complete a 40-minute questionnaire that asked about alcohol expectancies, drinking refusal self-efficacy, consumption, degree of dependence and demographics. RESULTS: The results showed that in social drinkers both the expectancy and self-efficacy constructs were reliably able to discriminate between types of drinker. Expectancy was related to consumption in social drinkers, but did not appear to account for a significant proportion of the variance in problem drinkers. CONCLUSIONS: The findings are discussed in terms of a two-process model of drinking behavior that suggests that expectancies operate differently in social and problem drinkers.

Adult↗

PubMed1998

A comparison of estimates of the prevalence of heavy drinkers in local regions of Queensland.

OBJECTIVE: This study developed and compared separate estimates of the number of heavy drinkers (the in-need population for alcohol treatment interventions) across eight local regions in Queensland. METHOD: Estimates were based on: (i) a self-report population survey of alcohol consumption; and (ii) an application of the Ledermann log-normal distribution of consumption model to liquor sale figures. RESULTS: Estimates based on the 1989-1990 National Health Survey (NHS) data indicated that 10.98% (n = 83,880) of adult male drinkers and 1.25% (n = 6581) of adult female drinkers in Queensland (total = 90,461) were on average drinking the equivalent of six or more standard drinks a day in the week prior to the survey (4.74% of Queensland adult drinkers, n = 90,461). Estimates based on the Ledermann model indicated that 12.18% of adult Queensland drinkers (n = 232,283) were drinking six or more standard drinks a day. Estimates based on the Ledermann model were 157% larger than estimates based on NHS data (i.e. a difference of 141,821 heavy drinkers), with large variations in the two estimates across local regions. CONCLUSION: The NHS data appears to underestimate the population of heavy drinkers, whereas the Ledermann model overestimates it. In this situation, it seems preferable to use the more conservative self-report survey estimates.

Adolescent↗

PubMed1997

Comparison of specific and nonspecific factors in a group cognitive therapy for depression.

Research into the efficacy of psychotherapy has often reported equivalence in treatment outcome when comparing different therapies. These findings have been interpreted as evidence for what are variously termed placebo, common or nonspecific processes. We suggested that this issue is best examined in comparison of specific and nonspecific processes in the action of a specified therapy and disorder. No comparisons of this nature have yet been reported in relation to cognitive therapy for depression. This study compared specific processes (automatic thoughts and dysfunctional attitudes) and major common processes (satisfaction with therapy and client evaluation of therapist) in the action of a group cognitive therapy for depression. Sixty patients suffering from major depression received a 12 week course of group cognitive therapy. Results from hierarchical regression suggested that the specific processes of cognitive therapy were more associated with reduction in depression than common processes which contributed to the prediction of reduction in depression via specific processes.

Adolescent↗

PubMed1997

Does concurrent drug intake affect the long-term outcome of group cognitive behaviour therapy in panic disorder with or without agoraphobia?

The present study investigated the impact of pre-existing pharmacotherapy regimes on the long-term outcome of brief intensive group cognitive-behavioural therapy (BIGCBT) in the treatment of panic disorder with or without agoraphobia in 106 patients (74 females). Forty patients were allocated to BIGCBT without medication, 40 to BIGCBT plus anti-anxiety medication, 10 to BIGCBT plus anti-depressant medication and 16 to BIGCBT plus combined anti-anxiety and anti-depressant medications. The mean follow-up period was 3.2 yr and ranged from 1.1 to 6.2 yr. The results demonstrated that patients who received BIGCBT concurrent with pre-existing medication regimes did not differ significantly (P > 0.001) from each other or from patients who underwent BIGCBT without medication on any of the dependent measures either at pre-treatment assessment or long-term follow-up. However, BIGCBT (with or without pharmacotherapy) was associated with significant (P < 0.001) long-term improvements in frequency of panic attacks, avoidance behaviour and questionnaire measures of anxiety, depression and agoraphobia. Furthermore, the large majority (80%) of patients in the BIGCBT without medication group remained medication-free at long-term follow-up. Of those patients who underwent BIGCBT concurrent with pre-existing pharmacotherapy, a large percentage (44%) reported no longer taking medication for their condition at long-term follow-up. Overall, it is concluded that pre-existing medication regimes (anti-anxiety, anti-depressant or combinations of these) do not significantly enhance or detract from the long-term outcome of a BIGCBT program used in the treatment of panic disorder and agoraphobia.

Adolescent↗

PubMed1997

Factors associated with dropout in a group cognitive behaviour therapy for mood disorders.

The high prevalence of premature attrition from psychotherapy is a phenomenon which has been well recognized in the psychological literature. The pressing concern that a number of clients may not be benefiting from treatment because they are dropping out has led to a plethora of research in the area of individual psychotherapy. No studies, however, have attempted to investigate the characteristics of dropout in group cognitive behaviour therapy for depression. To address this gap in research, the present study examined the factors associated with dropout in a group cognitive behaviour therapy for depression, using 131 Ss who went through the group therapy for 12 weeks. The results showed that sociodemographic measures (e.g. age) and measures of depressive symptoms (e.g. depression scores) did not discriminate dropouts from completers. An investigation of patterns of mood changes in the course of the therapy also failed to find significant differences between the dropouts and completers. However, weekly therapist rating of client participation revealed that dropouts participated significantly less than completers during the therapy sessions. The results are discussed in light of the findings of current literature and future research in premature attrition.

Adolescent↗

PubMed1997

Is alcohol a cofactor of HIV and AIDS? Evidence from immunological and behavioral studies.

The authors aim to critically examine empirical research on the effects of alcohol on HIV and AIDS from the immunological and behavioral fields. In vitro immunological studies demonstrate that social drinking increases the susceptibility of human cells to HIV infection. Animal studies show that acute and chronic alcohol ingestion increases rate of progression from retrovirus to clinical illness. In humans with HIV, no experimental evidence shows that alcohol is a cofactor of AIDS. Findings from behavioral studies show that a link between social drinking and risk of HIV is weak. No experimental evidence demonstrates that chronic drinking influences rate and course of disease progression to AIDS in humans who are HIV+. It is premature to promote the role of alcohol as a cofactor in HIV and AIDS.

AIDS-Related Opportunistic Infections↗

PubMed1997

Management of co-morbid anxiety and alcohol disorders: parallel treatment of disorders.

Co-morbid alcohol-related disorders and anxiety disorders have been found to occur in alcohol treatment populations, anxiety treatment populations and the general community. People suffering from co-occurring alcohol-related and anxiety disorders are more prone to relapse to alcohol abuse, and more likely to re-enter the treatment system for either disorder than sufferers of either disorder without a co-morbid disorder. To review the current state of the management of this disorder, evidence of the prevalence of this co-morbid condition in clinical and community populations is examined, then the theoretical mechanisms that might explain this connection are reviewed. A comparison of the few treatment studies of co-morbid alcohol and anxiety disorders shows a limited number of pharmacological treatment trials and no psychotherapy outcome trials. This review shows that it is no longer sustainable to conceptualize co-morbidity of alcohol and anxiety disorders as a unitary concept, i.e. lumping alcohol-related and anxiety disorders as one global condition, but as separate distinct combinations of particular anxiety disorders, e.g. alcohol dependence and panic disorder, alcohol dependence and generalize anxiety disorder. The recommended treatment approach, supported by the evidence, is to offer separate and parallel therapy for the alcohol-related and anxiety disorder, until empirical evidence from treatment outcome studies suggest otherwise. There is an urgent need to conduct treatment outcome research for the subtypes of co-morbid alcohol and anxiety disorders.

Journal Article↗

PubMed1995

Correlates of premenstrual dysphoria in help-seeking women.

Comparisons were made between the premenstrual changes reported by nontreatment-seekers (NTS) (n = 32) and those of treatment-seekers (TS) (n = 52). The Premenstrual Assessment Form Luteal Phase and Follicular Phase versions were completed and the Beck Depression Inventory, the Automatic Thoughts Questionnaire and the State-Trait Anxiety Inventory were completed at both the luteal and follicular phases. Prospective daily ratings were made for two treatment cycles on the Daily Ratings Form and TS were screened for a mood-disorder history. Using the commonly cited 30% decrease in dysphoric levels from the pre- to postmenstrual phases as the criterion of prospective confirmation, women with prospectively confirmed dysphoria (PMD +) were not significantly more symptomatic than those without prospective dysphoric confirmation (PMD -). However, TS were more symptomatic than NTS on measures of depression, anxiety and frequency of negative automatic thoughts but not on mood behaviour and physical changes reflected in the PAF scales. No demographic differences were found between TS and NTS. Results did not support the issue of requiring 'confirmation' of self-reports within a help-seeking group or the use of the 30% criterion in particular. Findings further suggest that the 95-item PAF may be inadequate in differentiating TS from others.

Adult↗

PubMed1995

The efficacy of cognitive behaviour therapy in treating premenstrual dysphoric changes.

This study assesses the efficacy of cognitive behaviour therapy (CBT) in treating premenstrual dysphoric changes. The CBT condition (n = 24) aimed to modify dysfunctional thinking as a means of impacting on negative premenstrual symptoms and changes. The components of CBT were cognitive restructuring and assertion training. A comparison condition called 'information-focused therapy' (IFT) (n = 9) aimed to present information only and did not address belief restructuring. The components were relaxation training, nutritional and vitamin guidelines, dietary and lifestyle recommendations, aspects of child management training and assertion training. Results indicated that the amelioration of anxiety, depression, negative thoughts and physical changes can be effectively addressed by either CBT or IFT. The extent to which a women's belief system is critical in the experience of premenstrual distress requires further empirical investigation.

Adult↗