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Biomedical subjects

W Edward Craighead

Publications and source records attributed to W Edward Craighead.

5 recordsLinked to original sources

Using patient characteristics and attitudinal data to identify depression treatment preference groups: a latent-class model.

A latent-class model is used to identify and characterize groups of patients who share similar attitudes towards treating depression. The results predict the probability of preference-group membership on the basis of observable characteristics and answers to attitudinal questions. Understanding the types of preference groups that exist and a patient's probability of membership in each of the groups can help clinicians tailor the treatment to the patient and may increase patient adherence. One hundred four depressed patients completed a survey on attitudes towards treatment of Major Depressive Disorder. Analysis shows that treatment preferences vary among depressed patients. Three classes are identified that differ in their sensitivity to treatment costs and side effects. One class cares primarily about treatment effectiveness; side effects and the cost of treatment have little impact on this class's treatment decisions. Another class is highly sensitive to cost and side effects. A third class is somewhat sensitive to cost and side effects. Younger and male patients are more likely to be sensitive to treatment costs and side effects.

Adolescent↗

Appetitive responses to sexual stimuli are attenuated in individuals with low levels of sexual desire.

Despite the high prevalence of sexual desire disorders, little is known about their biological underpinnings in humans. Animal studies suggest that dopamine is involved in appetitive sexual behavior; thus, one aim of this study was to elucidate that relationship in humans. This study used measurement of the acoustic startle response (ASR) and prepulse inhibition of the startle response (PPI) as psychophysiological indicators of changes in motivational states to assess the potential relation between sexual desire and appetitive motivation in humans. Responses to sexually provocative stimuli consisting of single nude men and single nude women in a sample of 153 participants (77 men, 76 women) were assessed. The results indicated that ASR was attenuated after exposure to appetitive stimuli (i.e., sexually provocative pictures of attractive individuals) to a greater extent among participants with higher levels of sexual desire, as measured by the Sexual Desire Inventory-2 (Spector, I. P., Carey, M. P., & Steinberg, L. (1996). Journal of Sex & Marital Therapy, 22, 175-190). In addition, PPI was inversely associated with subjective ratings across stimuli such that greater subjective levels of desire were correlated with lower levels of PPI. In general, these results suggest that individuals with lower levels of sexual desire may have a diminished physiological response to appetitive sexual stimuli.

Acoustic Stimulation↗

Family-focused treatment for adolescents with bipolar disorder.

BACKGROUND: Research has begun to elucidate the optimal pharmacological treatments for pediatric-onset bipolar patients, but few studies have examined the role of psychosocial interventions as adjuncts to pharmacotherapy in maintenance treatment. This article describes an adjunctive family-focused psychoeducational treatment for bipolar adolescents (FFT-A). The adult version of FFT has been shown to be effective in forestalling relapses in two randomized clinical trials involving bipolar adults. METHODS: FFT-A is administered to adolescents who have had an exacerbation of manic, depressed, or mixed symptoms within the last 3 months. It is given in 21 outpatient sessions of psychoeducation, communication enhancement training, and problem solving skills training. We describe modifications to the adult FFT model to address the developmental issues and unique clinical presentations of pediatric-onset patients. RESULTS: An open treatment trial involving 20 bipolar adolescents (11 boys, 9 girls; mean age 14.8+/-1.6) found that the combination of FFT-A and mood stabilizing medications was associated with improvements in depression symptoms, mania symptoms, and behavior problems over 1 year. LIMITATIONS: These early results are based on a small-scale open trial. CONCLUSIONS: Results from an ongoing randomized controlled trial will clarify whether combining FFT-A with pharmacotherapy improves the 2-year course of adolescent bipolar disorder. If the results are positive, then a structured manual-based psychosocial approach will be available for clinicians who treat adolescent bipolar patients in the community.

Adolescent↗

Cognitive-behavioral intervention for depressed, substance-abusing adolescents: development and pilot testing.

OBJECTIVES: To develop a cognitive-behavioral treatment for depressed, substance-abusing adolescents, determine its feasibility, and test its association with symptomatic improvement. METHOD: Based on the efficacy of cognitive-behavioral interventions for either adolescent depression or substance abuse, an integrated group and family therapy intervention was developed for adolescents with both problems. The developers treated a group of six adolescents and families, and then trained experienced therapists to deliver the treatment to a second group of seven. Adolescents were 14 to 18 years of age. Measures of depression and substance abuse were collected before, during, and after treatment. RESULTS: High retention in treatment and attendance at sessions supported feasibility. Parent interviews demonstrated significant improvement in adolescent substance abuse, and adolescent measures demonstrated significant improvement in both domains. CONCLUSIONS: Integrated outpatient cognitive-behavioral intervention is feasible and associated with improvement for depressed, substance-abusing adolescents. Controlled efficacy studies are needed. Additional treatment modalities will be required for a proportion of these adolescents.

Adolescent↗

Exercise therapy for depression in middle-aged and older adults: predictors of early dropout and treatment failure.

Psychosocial factors predicting treatment dropout or failure to benefit from treatment were identified in a randomized trial of exercise therapy and pharmacotherapy for major depression. One hundred fifty-six men and women over age 50 diagnosed with major depressive disorder were assigned to a 16-week program of aerobic exercise, medication (sertraline), or a combination of exercise and medication. Thirty-two patients (21%) failed to complete the program and were considered treatment "dropouts." At the end of 16 weeks, 83 patients (53%) were in remission; the remaining patients not in remission were considered treatment "failures." Baseline levels of self-reported anxiety and lift satisfaction were the best predictors of both patient dropout and treatment success or failure across all treatment conditions.

Aged↗