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PubMedDate not supplied

Clinical effectiveness of cognitive behavior therapy in the management of TMD.

PURPOSE: This study aimed to investigate whether cognitive behavior therapy (CBT) was effective as a standard intervention for temporomandibular disorders (TMD). MATERIALS AND METHODS: The subjects were 134 TMD outpatients with no history of treatment for TMD. They had pain persisting for 1 month or more and/or limited jaw movement. All patients underwent CBT. Symptom fluctuation was evaluated by a self-administered questionnaire. RESULTS: Symptoms had disappeared and improved in 112 patients within 2 months. CONCLUSION: It was suggested that most TMD symptoms can be relieved only by CBT in less than 2 months without further intervention.

Adult↗
PubMed1996

Changes in taste responsiveness in patients with anorexia nervosa during behavior therapy.

We evaluated the changes in taste responsiveness of anorexia nervosa (AN) patients during behavior therapy. Taste responsiveness of AN patients was lower at admission when compared to controls but it improved significantly over the course of treatment (p < 0.01). Taste responsiveness improved prior to increase in body weight. No significant correlation was noted between weight gain and improvement in taste responsiveness. The period required to reach a food intake of 1600 Kcal/day and the duration of hospitalization were highly correlated (r = 0.72, p < 0.05). Those who reached 1600 Kcal/day earlier showed more rapid improvements in taste responsiveness. These results suggest that decreased taste responsiveness in AN patients can rapidly improve and such early improvement may result in better progression of treatment.

Adolescent↗
PubMed2006

Tailoring cognitive-behavioral therapy for chronic pain: a case example.

Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment for chronic pain. However, many patients who might benefit from this treatment either refuse treatment, fail to adhere to treatment recommendations, or drop out prematurely. Adherence to and engagement in CBT for chronic pain might be improved by tailoring a limited number of its components to individual preferences. Motivational interviewing, in which the therapist facilitates the patient's motivation for changing behavior, might also promote CBT engagement and adherence. We describe components of a tailored CBT treatment for chronic pain in the context of ongoing research and illustrate the process of tailoring CBT with a case study.

Accidents, Traffic↗
PubMed1975

Short-term analytically oriented psychotherapy versus behavior therapy.

Ninety-four outpatients with anxiety neurosis or personality disorder were randomly assigned for four months to a waiting list, behavior therapy, or psychoanalytically oriented therapy. The target symptoms of all three groups improved significantly, but the two treated groups improved equally well and significantly more than those on the waiting list. There were no significant differences among the groups in work or social adjustment; however, the patients who received behavior therapy had a significant overall improvement at four months. One year and two years after the initial assessment, all groups were found to be equally and significantly improved.

Adult↗
PubMed1976

Concurrent psychotherapy and behavior therapy. Treatment of psychoneurotic outpatients.

The feasibility and effects of treating psychoneurotic outpatients with concomitant but separate treatment programs of psychoanalytically oriented psychotherapy and behavior therapy was investigated in three cases, utilizing detailed clinical observations and questionnaire responses. The two treatment regimens appeared to have synergistic effects, and anticipated difficulties, such as a split therapeutic alliance, symptom substitution, or preciptious withdrawal from psychotherapy after symptom removal, did not occur. Although there was no evidence of symptom substitution after the behavioral removal of the "target symptom," both clinical observations and questionnaire responses indicated that successful behavior therapy had many unanticipated effects on the patient's nontarget behaviors and cognitions.

Adult↗
PubMed1991

[Behavior therapy interventions in hyperkinetic disorders in preschool children].

A behavior therapy program for increasing the intensity and duration of play activities in preschool children with hyperkinetic disorders is described. Participation by parents allows the program to be broadened to include training in parent-child interaction. Case studies with three children demonstrated the efficacy of some aspects of the program.

Attention↗
PubMed1992

Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder.

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a "regular" classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.

Achievement↗
PubMed2001

The efficacy of cognitive-behavioral therapy on the core symptoms of bulimia nervosa.

Cognitive behavioral therapy (CBT) is widely regarded as the treatment of choice for bulimia nervosa (BN), with previous reviews of the CBT outcome literature claiming an approximate 40%-50% recovery rate. Most of these reviews have focused on reductions of binge eating and purging; however, the cognitive model of BN that underlies the CBT approach identifies three additional symptoms as central to the disorder: restrictive eating, concerns with shape and weight, and self-esteem. The purpose of this review was to determine the effect of CBT on the five core symptoms of BN, particularly those neglected in previous reviews. This review found that while most studies provided outcome data on binge eating, purgative behavior, and concern with shape and weight, fewer studies provided data on restraint and self-esteem. While generally favorable, evidence for the efficacy of CBT on the core symptoms of BN was mixed, depending on the outcome measures used. Shortcomings in the literature are identified and suggestions to correct these shortcomings are provided.

Bulimia↗
PubMed1982

Fear of flight: behavior therapy versus a systems approach.

Systematic desensitization is re-examined as a treatment for flight fear from the perspective of family-systems theory. The problem of the person who avoids flight is considered first from the viewpoint of behavior therapy, and behavioral treatment is briefly described. This problem is next described in terms of the patients's to society, family, and the therapist. From this perspective, the flight-avoidant person is seen to be an "identified patient"-someone defined as ill by the system in which he or she is enmeshed. The problem is then redefined, not as flight fear, but as the pressure to fly, and implications for treatment are discussed.

Attitude of Health Personnel↗
PubMed2001

The factor structure of the working alliance inventory in cognitive-behavioral therapy.

Studies of the therapeutic alliance in cognitive-behavioral therapy (CBT) have varied in their results, necessitating a deeper understanding of this construct. Through an exploratory factor analysis of the alliance in CBT, as measured by the Working Alliance Inventory (shortened, observer-rated version), the authors found a two-factor structure of alliance that challenges the commonly accepted one general factor of alliance. The results suggest that the relationship between therapist and client (Relationship) may be largely independent of the client's agreement with and confidence in the therapist and CBT (Agreement/ Confidence), necessitating independent measures of these two factors, not one measure of a general alliance factor.

Adult↗
PubMed2000

The effects of treatment compliance on outcome in cognitive-behavioral therapy for panic disorder: quality versus quantity.

Cognitive-behavioral therapy (CBT) is skill based and assumes active patient participation in regard to treatment-related assignments. The effects of patient compliance in CBT outcome studies are equivocal, however, and 1 gap in the literature concerns the need to account for the quality versus the quantity of assigned work. In this study, both quality and quantity of home-based practice were assessed to better evaluate the effects of treatment compliance in patients with panic disorder (N = 48) who participated in a 12-session CBT protocol. Patient estimates of compliance were not significantly associated with most outcome measures. On the other hand, therapist ratings of compliance significantly predicted positive changes on most outcome measures. Moreover, therapist and independent rater estimates of the quality of the participant's work, relative to the quantity of the work, were relatively better predictors of outcome.

Adult↗
PubMed2002

Common changes in cerebral blood flow in patients with social phobia treated with citalopram or cognitive-behavioral therapy.

BACKGROUND: Neurofunctional changes underlying effective antianxiety treatments are incompletely characterized. This study explored the effects of citalopram and cognitive-behavioral therapy on regional cerebral blood flow (rCBF) in social phobia. METHODS: By means of positron emission tomography with oxygen 15-labeled water, rCBF was assessed in 18 previously untreated patients with social phobia during an anxiogenic public speaking task. Patients were matched for sex, age, and phobia severity, based on social anxiety questionnaire data, and randomized to citalopram medication, cognitive-behavioral group therapy, or a waiting-list control group. Scans were repeated after 9 weeks of treatment or waiting time. Outcome was assessed by subjective and psychophysiological state anxiety measures and self-report questionnaires. Questions were readministered after 1 year. RESULTS: Symptoms improved significantly and roughly equally with citalopram and cognitive-behavioral therapy, whereas the waiting-list group remained unchanged. Four patients in each treated group and 1 waiting-list patient were classified as responders. Within both treated groups, and in responders regardless of treatment approach, improvement was accompanied by a decreased rCBF-response to public speaking bilaterally in the amygdala, hippocampus, and the periamygdaloid, rhinal, and parahippocampal cortices. Between-group comparisons confirmed that rCBF in these regions decreased significantly more in treated groups than control subjects, and in responders than nonresponders, particularly in the right hemisphere. The degree of amygdalar-limbic attenuation was associated with clinical improvement a year later. CONCLUSIONS: Common sites of action for citalopram and cognitive-behavioral treatment of social anxiety were observed in the amygdala, hippocampus, and neighboring cortical areas, ie, brain regions subserving bodily defense reactions to threat.

Adult↗
PubMed1993

Sexual function in depressed men. Assessment by self-report, behavioral, and nocturnal penile tumescence measures before and after treatment with cognitive behavior therapy.

Clinicians have long associated depression with alterations in sexual function, predominantly loss of sexual interest. In a longitudinal study measuring self-report, behavioral, and nocturnal penile tumescence variables before and after treatment with cognitive behavior therapy in an unmedicated sample of 40 outpatient depressed men, we found, contrary to expectation, that sexual activity per se was not reduced during the depressed state. Rather, loss of sexual interest appeared to be related to the cognitive set of depression, ie, loss of sexual satisfaction that then improved with remission from depression. Depressed men were heterogeneous, however, with respect to sexual behavior, eg, an anxious and more chronically depressed subgroup of men who did not have remissions with cognitive behavior therapy reported increased sexual interest and sexual activity. Also, contrary to expectation, nocturnal penile tumescence abnormalities in depressed men did not reverse when measured in early remission, nor did nocturnal penile tumescence measures correlate significantly with behavioral measures of sexual function. Nocturnal penile tumescence alterations in depression may thus be similar to other persistent electroencephalographic sleep abnormalities seen in depressed patients in remission, in being more trait-like than statelike.

Adult↗
PubMed1981

Behavior therapy in a gait-training program for a child with myelomeningocele. A case report.

A behavior therapy program consisting of positive reinforcement contingent upon walking with braces and crutches was conducted with a four and one-half-year-old child with myelomeningocele. Behavioral physical therapy was begun first in the clinic setting and then in the home. Follow-up clinic assessments document maintenance of functionally independent ambulation over a seven-month period. The results support the efficacy of using behavioral techniques in a physical therapy program for a child with myelomeningocele. The need for further research and development of physical therapy programs using behavioral techniques is briefly discussed.

Behavior Therapy↗
PubMed2006

Cognitive behavior therapy for fear of flying: sustainability of treatment gains after September 11.

This study examines the long-term efficacy of cognitive-behavioral therapy (CBT) for fear of flying (FOF) after a catastrophic fear-relevant event, the September 11, 2001, terrorist attacks. Participants (N = 115) were randomly assigned to and completed treatment for FOF using 8 sessions of either virtual reality exposure therapy (VRE) or standard exposure therapy (SE) prior to September 11, 2001. Individuals were reassessed in June, 2002, an average of 2.3 years after treatment, with a response rate of 48% (n = 55). Analyses were run on the original data and, using multiple imputation procedures, on imputed data for the full sample. Individuals maintained or improved upon gains made in treatment as measured by standardized FOF questionnaires and by number of flights taken. There were no differences between VRE and SE. Thus, results suggest that individuals previously treated for FOF with cognitive-behavioral therapy can maintain treatment gains in the face of a catastrophic fear-relevant event, even years after treatment is completed.

Adult↗
PubMed2002

Relapse predictors of patients with bulimia nervosa who achieved abstinence through cognitive behavioral therapy.

BACKGROUND: Little information exists on relapse in patients with bulimia nervosa who responded with complete abstinence from binge eating and purging to cognitive behavioral therapy. Identification of relapse predictors may be useful to design effective early intervention strategies for relapse of susceptible patients with bulimia nervosa. METHODS: This multisite study examined relapse in 48 patients with bulimia nervosa who had responded to cognitive behavioral therapy with complete abstinence from binge eating and purging. Structured interviews and questionnaires were used to assess patients before and after treatment and at 4 months after treatment. RESULTS: Four months after treatment, 44% of the patients had relapsed. Those who relapsed had a higher level of preoccupation and ritualization of eating and less motivation for change, and had maintained abstinence for a shorter time during the treatment period. CONCLUSIONS: The predictors of relapse found in this study can be readily determined by clinicians. The effectiveness of early additional treatment interventions needs to be determined with well-designed studies of large samples.

Adolescent↗
PubMed1999

Cognitive-behavioral therapy for noncardiac chest pain: a randomized trial.

PURPOSE: Patients with nonischemic chest pain frequently experience recurrent symptoms, have persistent functional and occupational disability, and are high utilizers of health-care resources. Our aim was to evaluate the efficacy of a cognitive-behavioral treatment for patients with noncardiac chest pain. PATIENTS AND METHODS: Subjects were recruited from patients with at least weekly episodes of noncardiac chest pain, as diagnosed by a cardiologist. The main outcome measures were frequency and intensity of chest pain at 6 and 12 months. RESULTS: Seventy-two patients were enrolled in the study; 37 were assigned to cognitive-behavior therapy and 35 to usual care. Sixty-five patients completed the study. Intervention patients improved significantly with regard to frequency and intensity of chest pain: 15 (48%) of the 31 patients in the treatment group were pain free at 12-month follow-up compared with 4 (13%) of the 33 patients in the control group (P = 0.002). CONCLUSIONS: Cognitive-behavioral therapy for noncardiac chest pain patients was effective compared with usual care.

Adult↗