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The current study aims to ascertain the trajectories of psychotherapy clients' symptom change and identify client factors that predict treatment outcome.
We conducted a latent growth mixture model (LGMM) to identify the change trajectories of 44 clients' depression scores during psychotherapy. Client characteristics were then explored to determine whether any were associated with change trajectories. We examined whether the number of physician visits and/or client self-concealment scores predict 63 clients' improvement after controlling for initial symptom severity.
Two trajectories of clients' symptom change were identified nonimprovers (52.3%) and improvers (47.7%). Nonimprovers had higher levels of self-concealment and baseline depression than improvers. The number of physician visits was associated with higher depression scores at baseline and greater clinical improvement during psychotherapy.
Clients showed distinct trajectories of symptom change in psychotherapy. Early identification of clients at risk for treatment failure may increase the probability of therapeutic success.
Clients showed distinct trajectories of symptom change in psychotherapy. Early identification of clients at risk for treatment failure may increase the probability of therapeutic success.To explore the relationship between perceived cognitive problems and cognitive performance in three different samples, taking into account the possible influence of depression, catastrophizing, pain intensity, or medication. Seventy individuals with fibromyalgia, 74 with non-malignant chronic pain and 40 pain-free controls, completed measures of verbal episodic memory, sustained attention, response inhibition, depression, catastrophizing, and pain intensity. Fibromyalgia and chronic pain patients performed worse than controls in verbal memory and sustained attention, but these differences disappeared when depressed participants were excluded from the analyses. Memory complaints were related with depression in all pain patients. However, in the case of fibromyalgia, memory complaints were also related by pain intensity and inversely related by short-term episodic memory. This case-control study shows the importance of jointly assessing cognitive performance and memory complaints and of controlling for variables such as depression, catastrophizing, pain intensity and medication in the studied samples. Accordingly, this study highlights the differences in memory complaints, between the patients with fibromyalgia and the patients with other chronic pain conditions. Finally, it has highlighted the important role played by depression in cognitive performance and memory complaints considering the Neurocognitive Model of Attention to pain.We primarily quantified exposure patterns, transmission characteristics, and the clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among household contacts of individuals with severe coronavirus disease-2019 (COVID-19). We conducted a retrospective cohort study of 20 index patients hospitalized with severe COVID-19 and 79 of their household contacts. We determined the transmission frequency, range of manifestations of SARS-CoV-2 infection, and factors associated with infection in household settings. Of the 79 household contacts, 53 (67%) developed SARS-CoV-2 infection (49 [62%] symptomatic, 4 [5%] asymptomatic). Eight patients (10%) developed severe COVID-19, and one died of COVID-19 pneumonia (case-fatality rate 1.9%). The probability of SARS-CoV-2 infection was similar in children and adults (55% vs. 72%, p = .14), with children being less likely to develop the symptomatic disease (46% vs. 68%, p = .06). Handwashing ≥ 5 times/day was associated with reduced infection risk (52.8% vs. Vanzacaftor chemical structure 76.9%, p = .04). SARS-CoV-2 has a high frequency of transmission among household contacts. Nonhospitalized individuals with SARS-CoV-2 infection should be quarantined in patient care facilities rather than at home to minimize spread, if possible, and frequent handwashing should be practiced to prevent transmission.
This study investigated the preferences of dentists in Australia in providing professional implant maintenance and implant-specific oral hygiene instructions (OHI).
General dentists were surveyed online about their preferences in peri-implant diagnostics, maintenance provision, armamentarium used, and implant OHI techniques and frequency.
Most of the 303 respondents (96%) provided maintenance services; 87.6% reviewed implants regularly while 10.7% only performed diagnostics after detecting clinical signs/symptoms. Supragingival prosthesis cleaning was performed by 77.9% of respondents, 35.0% performed subgingival debridement, 41.9% treated peri-implant mucositis and 18.2% treated peri-implantitis. About 15% did not treat nor refer peri-implant disease, including significantly more non-implant providers and dentists without implant training. Maintenance armamentarium commonly included floss (76.3%), prophylaxis (73.9%), plastic curettes (43.3%) and stainless-steel ultrasonics (38.0%). Brushing (86.5%), flossing (73.9%) and interdental brush use (68.3%) were most commonly recommended. Implant OHI was repeated routinely by 57.4% of dentists who provided it. Dentists with greater implant training and experience were more likely to perform reviews and complex maintenance procedures.
Peri-implant diagnostics performed, treatments provided and armamentarium varied among dentists. Implant providers and those with higher levels of training had more preventative approaches to implant OHI. Possible shortcomings in disease management and OHI reinforcement were identified.
Peri-implant diagnostics performed, treatments provided and armamentarium varied among dentists. Implant providers and those with higher levels of training had more preventative approaches to implant OHI. Possible shortcomings in disease management and OHI reinforcement were identified.This article presents a clinical illustration of group schema therapy (GST) for cluster-C personality disorders (CL-C PDs) to provide therapists an example on how one can perform GST for CL-C PDs and break through persistent avoidance and control mechanisms. A summary of evidence supporting the effectiveness of GST for CL-C PD's is given followed by an overview of basic principles of schema therapy and GST. A case presentation next illustrates the application of GST principles and interventions in the GST CL-C protocol, which improve clients understanding of emotional core needs and development of adaptive ways of getting needs better met, instead of avoiding life. Implications of the case for future applications of GST for CL-C PDs are discussed.