Are Therapy Dogs Like Xanax? Does Animal-Assisted Therapy Impact Processes Relevant to Cognitive Behavioral Psychotherapy?

Despite an increase in the popularity of animal-assisted therapy, little is known about the impact of animals on processes relevant to effective psychotherapy. This study tested the impact of having a dog present on process variables relevant to cognitive behavioral therapy, including emotional arousal, the content of trauma narratives, and cognitive change. We employed an expressive writing paradigm as an analog of exposure therapy, a common evidence-based treatment for anxiety and trauma disorders. Participants were randomly assigned to either a trauma or control writing condition, with or without a dog present. Writing about a trauma resulted in significantly more acute anxious arousal than control writing, but participants in the trauma/dog condition showed less distress than those in the trauma/no dog condition. Despite the palliative effect of the dog on acute anxious arousal, process variables in the two trauma conditions were no different. Both trauma groups wrote comparable essays (rated on negative emotionality, cognitive insight, and severity of trauma). At follow-up, only the participants in the trauma condition with a dog showed significant decreases in depressive symptoms. The results suggest that dogs can lower acute distress without compromising emotional processing or therapeutic mechanisms, and may actually improve long-term outcome for some individuals.     

Using dreams in cognitive behavioral psychotherapy: Theory, method, and examples.

Dream analysis can be a fruitful complementary technique in cognitive–behavioral therapy, providing it is based on a theoretical conception of dreaming and an interpretation method that are both compatible with the principles and methodology of CBT. The present paper first presents some aspects of a cognitive conception of dreaming explaining the occurrence and specificities of dream representations by their production processes. The next section describes an interpretation method that gives the patients the opportunity to find some sources and meanings of their dreams. Finally examples are given of the different ways in which the result of a dream interpretation contributed to therapy. Thanks to their condensed and often exaggerated treatment of a theme, dreams often facilitate becoming aware of cognitive distortions and schemas and help to proceed to cognitive restructuring. They also give to the therapists an opportunity to underline the patient’s resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problematic Internet use: an overview

There is wide agreement that the Internet can serve as a tool that enhances well-being. It is more difficult, however, to find consensus around the issue of problematic Internet use. That may be in part because scientific investigation has lagged far behind technological advances and media attention. The diagnostic schemas that have been proposed since 1996, and the screening tools that have been developed, stress similarities with substance use, impulse control disorders, and obsessive-compulsive disorder. Prevalence figures vary as a function of the diagnostic definition used, the age group studied, and whether the surveys were conducted online. Studies suggest high comorbidity rates with mood disorders and, among younger individuals, attention-deficit/hyperactivity disorder. Treatment should address any comorbid conditions present, as those may be causing, or exacerbating, problematic Internet use. Interventions that may specifically target problematic Internet use include cognitive behavioral therapy and selective serotonin reuptake inhibitors, but detailed guidelines must await further studies. For a medium that has so radically changed how we conduct our lives, the Internet’s effects on our psychology remain understudied. More research is needed into the pathophysiology, epidemiology, natural course, and treatment of problematic Internet use. In addition, the more subtle psychological changes, such as disinhibition, that seem to characterize people’s online behavior also deserve attention, even if they cannot be seen as necessarily pathological.     

Internet‐delivered psychological treatments: from innovation to implementation

Internet interventions, and in particular Internet‐delivered cognitive behaviour therapy (ICBT), have existed for at least 20 years. Here we review the treatment approach and the evidence base, arguing that ICBT can be viewed as a vehicle for innovation. ICBT has been developed and tested for several psychiatric and somatic conditions, and direct comparative studies suggest that therapist‐guided ICBT is more effective than a waiting list for anxiety disorders and depression, and tends to be as effective as face‐to‐face CBT. Studies on the possible harmful effects of ICBT are also reviewed: a significant minority of people do experience negative effects, although rates of deterioration appear similar to those reported for face‐to‐face treatments and lower than for control conditions. We further review studies on change mechanisms and conclude that few, if any, consistent moderators and mediators of change have been identified. A recent trend to focus on knowledge acquisition is considered, and a discussion on the possibilities and hurdles of implementing ICBT is presented. The latter includes findings suggesting that attitudes toward ICBT may not be as positive as when using modern information technology as an adjunct to face‐to‐face therapy (i.e., blended treatment). Finally, we discuss future directions, including the role played by technology and machine learning, blended treatment, adaptation of treatment for minorities and non‐Western settings, other therapeutic approaches than ICBT (including Internet‐delivered psychodynamic and interpersonal psychotherapy as well as acceptance and commitment therapy), emerging regulations, and the importance of reporting failed trials.     

The efficacy of smartphone‐based mental health interventions for depressive symptoms: a meta‐analysis of randomized controlled trials

The rapid advances and adoption of smartphone technology presents a novel opportunity for delivering mental health interventions on a population scale. Despite multi‐sector investment along with wide‐scale advertising and availability to the general population, the evidence supporting the use of smartphone apps in the treatment of depression has not been empirically evaluated. Thus, we conducted the first meta‐analysis of smartphone apps for depressive symptoms. An electronic database search in May 2017 identified 18 eligible randomized controlled trials of 22 smartphone apps, with outcome data from 3,414 participants. Depressive symptoms were reduced significantly more from smartphone apps than control conditions (g=0.38, 95% CI: 0.24‐0.52, p<0.001), with no evidence of publication bias. Smartphone interventions had a moderate positive effect in comparison to inactive controls (g=0.56, 95% CI: 0.38‐0.74), but only a small effect in comparison to active control conditions (g=0.22, 95% CI: 0.10‐0.33). Effects from smartphone‐only interventions were greater than from interventions which incorporated other human/computerized aspects along the smartphone component, although the difference was not statistically significant. The studies of cognitive training apps had a significantly smaller effect size on depression outcomes (p=0.004) than those of apps focusing on mental health. The use of mood monitoring softwares, or interventions based on cognitive behavioral therapy, or apps incorporating aspects of mindfulness training, did not affect significantly study effect sizes. Overall, these results indicate that smartphone devices are a promising self‐management tool for depression. Future research should aim to distil which aspects of these technologies produce beneficial effects, and for which populations.     

多巴胺信号系统在衰老引起的行为和认知能力退化中的作用

衰老是生物体随时间推移各项生理功能逐渐发生改变的自然现象。动物的衰老伴随着行为和认知能力的降低,因此研究动物行为和认知功能退化的分子神经机制对于提高老年群体的生活质量具有重要意义。近年来,随着正电子发射断层扫描技术和功能性核磁共振脑成像技术在神经生物学上的广泛运用,越来越多证据表明多巴胺系统功能在衰老过程中显著降低,并且这是人类和动物行为和认知功能退化的重要原因。本文将概述自然衰老过程中多巴胺信号系统功能变化及机制和其在动物行为和认知退化中的作用等方面研究进展。     

Long life evolves in large-brained bird lineages*

The brain is an energetically costly organ that consumes a disproportionate amount of resources. Species with larger brains relative to their body size have slower life histories, with reduced output per reproductive event and delayed development times that can be offset by increasing behavioral flexibility. The “cognitive buffer” hypothesis maintains that large brain size decreases extrinsic mortality due to greater behavioral flexibility, leading to a longer lifespan. Alternatively, slow life histories, and long lifespan can be a pre-adaptation for the evolution of larger brains. Here, we use phylogenetic path analysis to contrast different evolutionary scenarios and disentangle direct and indirect relationships between brain size, body size, life history, and longevity across 339 altricial and precocial bird species. Our results support both a direct causal link between brain size and lifespan, and an indirect effect via other life history traits. These results indicate that large brain size engenders longer life, as proposed by the “cognitive buffer” hypothesis.     

The pursuit of euthymia

Psychiatrists often consider the positive characteristics displayed by a patient in their clinical judgment, yet current assessment and treatment strategies are shifted on the side of psychological dysfunction. Euthymia is a transdiagnostic construct referring to the presence of positive affects and psychological well‐being, i.e., balance and integration of psychic forces (flexibility), a unifying outlook on life which guides actions and feelings for shaping future accordingly (consistency), and resistance to stress (resilience and tolerance to anxiety or frustration). There is increasing evidence that the evaluation of euthymia and its components has major clinical implications. Specific instruments (clinical interviews and questionnaires) may be included in a clinimetric assessment strategy encompassing macro‐analysis and staging. The pursuit of euthymia cannot be conceived as a therapeutic intervention for specific mental disorders, but as a transdiagnostic strategy to be incorporated in an individualized therapeutic plan. A number of psychotherapeutic techniques aiming to enhance positive affects and psychological well‐being (such as well‐being therapy, mindfulness‐based cognitive therapy, and acceptance and commitment therapy) have been developed and validated in randomized controlled clinical trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continuing growth and development, the belief that life is purposeful and meaningful, satisfaction with one's relations with others, the capacity to manage effectively one's life, and a sense of self‐determination.     

Cognitive Experience and Its Effect on Age-Dependent Cognitive Decline in Beagle Dogs

Test-sophisticated beagle dogs show marked age sensitivity in a size discrimination learning task, with old and senior dogs performing significantly more poorly than young dogs. By contrast, age differences in learning were not seen in dogs naïve with respect to neuropsychological test experience. These results indicate that old animals benefit less from prior cognitive experience than young animals, which is an example of an age-dependent loss in plasticity. This finding also suggests that behaviorally experienced animals are a more useful model of human cognitive aging than behaviorally naïve animals. We also looked at the effect of a program of behavioral enrichment in aged dogs. One year of enrichment did not lead to significant differences, but after 2 years the behaviorally enriched group performed significantly better than the control group. The effect after 2 years indicates that a prolonged program of cognitive enrichment can serve as an effective intervention in aged dogs. These findings demonstrate that cognitive abilities in aged animals can be modified by providing behavioral experience, indicating that cognitive abilities remain moderately plastic, even in very old animals.     

Action of estrogens in the aging brain: Dementia and cognitive aging

Background

Menopause is associated with sharp declines in concentrations of circulating estrogens. This change in hormone milieu has the potential to affect brain functions relevant to dementia and cognitive aging.

Scope of review

Focused review of published results of randomized clinical trials of estrogen-containing hormone therapy for Alzheimer's disease treatment and dementia prevention, observational research on cognition across the menopause transition, and observational research on the association of hormone therapy and Alzheimer's disease risk.

Major conclusions

Clinical trial evidence supports conclusions that estrogen therapy does not improve dementia symptoms in women with Alzheimer's disease and that estrogen-containing hormone therapy initiated after about age 65 years increases dementia risk. Hormone therapy begun in this older postmenopausal group does not ameliorate cognitive aging. Cognitive outcomes of midlife hormone exposures are less well studied. There is no strong indication of short-term cognitive benefit of hormone use after natural menopause, but clinical trial data are sparse. Little research addresses midlife estrogen use after surgical menopause; limited clinical trial data imply short-term benefit of prompt initiation at the time of oophorectomy. Whether exogenous estrogen exposures in the early postmenopause affect Alzheimer risk or cognitive aging much later in life is unanswered by available data. Observational results raise the possibility of long-term cognitive benefit, but bias is a concern in interpreting these findings.

General significance

Estrogen-containing hormone therapy should not be initiated after age 65 to prevent dementia or remediate cognitive aging. Further research is needed to understand short-term and long-term cognitive effects of estrogen exposures closer to the age of menopause.     

Focus: Addiction: Relapse Prevention and the Five Rules of Recovery

There are four main ideas in relapse prevention. First, relapse is a gradual process with distinct stages. The goal of treatment is to help individuals recognize the early stages, in which the chances of success are greatest. Second, recovery is a process of personal growth with developmental milestones. Each stage of recovery has its own risks of relapse. Third, the main tools of relapse prevention are cognitive therapy and mind-body relaxation, which are used to develop healthy coping skills. Fourth, most relapses can be explained in terms of a few basic rules. Educating clients in these rules can help them focus on what is important: 1) change your life (recovery involves creating a new life where it is easier to not use); 2) be completely honest; 3) ask for help; 4) practice self-care; and 5) don’t bend the rules.     

Reducing Dysfunctional Beliefs about Sleep Does Not Significantly Improve Insomnia in Cognitive Behavioral Therapy

The present study examined to examine whether improvement of insomnia is mediated by a reduction in sleep-related dysfunctional beliefs through cognitive behavioral therapy for insomnia. In total, 64 patients with chronic insomnia received cognitive behavioral therapy for insomnia consisting of 6 biweekly individual treatment sessions of 50 minutes in length. Participants were asked to complete the Athens Insomnia Scale and the Dysfunctional Beliefs and Attitudes about Sleep scale both at the baseline and at the end of treatment. The results showed that although cognitive behavioral therapy for insomnia greatly reduced individuals’ scores on both scales, the decrease in dysfunctional beliefs and attitudes about sleep with treatment did not seem to mediate improvement in insomnia. The findings suggest that sleep-related dysfunctional beliefs endorsed by patients with chronic insomnia may be attenuated by cognitive behavioral therapy for insomnia, but changes in such beliefs are not likely to play a crucial role in reducing the severity of insomnia.     

Bentuhua: Culturing Psychotherapy in Postsocialist China

The breathless pace of market reform in China has brought about profound ruptures in socioeconomic structures and increased mental distress in the population. In this context, more middle-class urbanites are turning to nascent psychological counseling to grapple with their problems. This article examines how Chinese psychotherapists attempt to “culture” or indigenize (bentuhua) three imported psychotherapy models in order to fit their clients’ expectations, desires, and sensibilities: the Satir family therapy, cognitive behavioral therapy, and sandplay therapy. It addresses three interrelated questions: What is the role of culture in adopting, translating, and recasting psychotherapy in contemporary China? How is cultural difference understood and mobilized by therapists in the therapeutic encounter? What kind of distinct therapeutic relationship is emerging in postsocialist China? Data presented here are drawn from my semistructured interviews and extensive participant observation at various counseling offices and psychotherapy workshops in the city of Kunming. My ethnographic account suggests that it is through constant dialog, translation, and re-articulation between multiple regimes of knowledge, cultural values, and social practices that a new form of talk therapy with “Chinese characteristics” is emerging. Finally, I reflect upon what this dialogic process of transformation means for psychotherapy as a form of globally circulating knowledge/practice.     

Role of age and neuroinflammation in the mechanism of cognitive deficits in sickle cell disease

This study aims to determine whether sickle cell mice could recapitulate features of cognitive and neurobehavioral impairment observed in sickle cell patients and whether neuroinflammation could be a potential therapeutic target as in other non-sickle cell disease-related cognitive dysfunction. Cognitive (learning and memory) and behavioral (anxiety) deficits in 13- and later 6-month-old male Townes humanized sickle cell (SS) and matched control (AA) mice were evaluated using novel object recognition (NOR) and fear conditioning tests. Immunohistochemistry was performed to quantify peripheral immune cell (CD45⁺) and activated microglia (Iba1⁺) as markers of neuroinflammation in the dentate and peri-dentate gyrus areas. We evaluated cell fate by measuring 5''-bromodeoxyuridine and doublecortin fluorescence and phenotyped proliferating cells using either glial fibrillary acid protein (GFAP⁺), neuronal nuclei (NeuN⁺), CD45⁺, and Iba1⁺. In addition, Golgi-Cox staining was used to assess markers of neuroplasticity (dendritic spine density and morphology and density of dendrite arbors) on cortical and hippocampal pyramidal neurons. Compared to matched AA controls, 13-month-old SS mice showed significant evidence of cognitive and behavioral deficit on NOR and fear conditioning tests. Also, SS mice had significantly higher density of CD45⁺ and activated microglia cells (i.e. more evidence of neuroinflammation) in the dentate and peri-dentate gyrus area. Additionally, SS mice had significantly lower dendritic spine density, but a higher proportion of immature dendritic spines. Treatment of 13-month-old SS mice with minocycline resulted in improvement of cognitive and behavioral deficit compared to matched vehicle-treated SS mice. Also, treated SS mice had significantly fewer CD45⁺ and activated microglia cells (i.e. less evidence of neuroinflammation) in the dentate and peri-dentate gyrus, as well as a significant improvement in markers of neuroplasticity.Impact statementThis study provides crucial information that could be helpful in the development of new or repurposing of existing therapies for the treatment of cognitive deficit in individuals with sickle cell disease (SCD). Its impact is in demonstrating for the first time that neuroinflammation and along with abnormal neuroplasticity are among the underlying mechanism of cognitive and behavioral deficits in SCD and that drugs such as minocycline which targets these pathophysiological mechanisms could be repurposed for the treatment of this life altering complication of SCD.     

Mindspan: lessons from rat models of neurocognitive aging

Research on the biology of aging seeks to enhance understanding of basic mechanisms and thus support improvements in outcomes throughout the lifespan, including longevity itself, susceptibility to disease, and life-long adaptive capacities. The focus of this review is the use of rats as an animal model of cognitive change during aging, and specifically lessons learned from aging rats in behavioral studies of cognitive processes mediated by specialized neural circuitry. An advantage of this approach is the ability to compare brain aging across species where functional homology exists for specific neural systems; in this article we focus on behavioral assessments that target the functions of the medial temporal lobe and prefrontal cortex. We also take a critical look at studies using calorie restriction (CR) as a well-defined experimental approach to manipulating biological aging. We conclude that the effects of CR on cognitive aging in rats are less well established than commonly assumed, with much less supportive evidence relative to its benefits on longevity and susceptibility to disease, and that more research in this area is necessary.     

认知行为干预对晚期癌症疼痛患者影响的临床研究

目的:探讨在临床晚期癌性疼痛患者中,应用认知行为干预的方法,减轻癌痛、改善患者生活质量的可行性。方法:搜集2010年1月至2012年11月间,于哈尔滨医科大学附属第三医院肿瘤内科收治的晚期癌症患者238例,包括晚期的肺癌64例、乳腺癌36例、胃癌33例、肝癌29例、食管癌21例、大肠癌19例、胰腺癌14例、甲状腺癌13例、鼻咽癌6例、骨肉瘤3例,其中发生癌性疼痛的患者214例,肺癌58例、乳腺癌34例、胃癌31例、肝癌28例、食管癌18例、大肠癌17例、胰腺癌13例、甲状腺癌9例、鼻咽癌3例、骨肉瘤1例。对晚期癌症伴发癌痛的患者利用行认知行为干预治疗进行治疗干预,30d为治疗周期,治疗后对晚期癌症患者的生活质量(KPS评分)、癌痛的缓解率的影响。结果:在晚期癌症伴癌痛的患者中,利用认知行为干预后,癌痛总的缓解率为55.6%,其中部分缓解(1~3级)所占比例为49.5%,完全缓解(4级)所占比例为6.1%;在不同级别的疼痛(轻~重)中,程度较轻的疼痛缓解率较高(93.2%),程度为中等的疼痛缓解率为67.3%,而重度疼痛缓解率较低(16.7%);在KPS评分中,238例患者治疗后评分提高率占67.2%;在生活质量评分改善的患者占69.4%。结论:在晚期癌症伴癌痛的患者中,利用认知行为干预的疗法可以对疼痛程度在轻~中度的癌痛有较好的控制作用,并且对患者的生活质量有提高作用。     

小分子RNA与肿瘤治疗

肿瘤是各种原因导致多基因突变累积和相互作用形成的基因网络调控的结果,通过干预致瘤因子可能达到治疗肿瘤或改变肿瘤特性的目的。小分子RNA因可调控基因表达而被作为基因治疗的有效武器。本文结合我们课题组在小分子RNA方面的研究成果,对外源性的siRNA和内源性的miRNA在肿瘤治疗、治疗前景,以及siRNA和miRNA的联系与区别等方面作一综述。     

What Is the Subjective Cost of Cognitive Effort? Load,Trait, and Aging Effects Revealed by Economic Preference

It has long been assumed that people treat cognitive effort as costly, but also that such effort costs may vary greatly across individuals. Individual differences in subjective effort could present a major and pervasive confound in behavioral and neuroscience assessments, by conflating cognitive ability with cognitive motivation. Self-report cognitive effort scales have been developed, but objective measures are lacking. In this study, we use the behavioral economic approach of revealed preferences to quantify subjective effort. Specifically, we adapted a well-established discounting paradigm to measure the extent to which cognitive effort causes participants to discount monetary rewards. The resulting metrics are sensitive to both within-individual factors, including objective load and reward amount, and between-individual factors, including age and trait cognitive engagement. We further validate cognitive effort discounting by benchmarking it against well-established measures of delay discounting. The results highlight the promise and utility of behavioral economic tools for assessing trait and state influences on cognitive motivation.     

Complementary remedy of aged-related learning and memory deficits via exogenous choline acetyltransferase

The present study aimed to examine whether the aged mice with naturally occurring cognitive deficits in learning and memory would benefit from supplementation of choline acetyltransferase (ChAT), the biosynthetic enzyme for neurotransmitter acetylcholine. Delivered by protein transduction domain (PTD), ChAT could pass through the blood-brain barrier, enter the neurons, interact with heat shock protein 70kDa, and retain enzyme activity. In behavior tests, PTD-ChAT given to the aged and memory-deficient mice almost completely reversed the behavioral changes, such as impairment of memory retention in the step-through test (an index of long-term memory) and prolonged swimming time in water maze test (an index of spatial recognition memory). The results suggest a novel and potential therapeutic use of PTD-ChAT in the age-related cognitive deficits.