CT reduces cerebral atrophy in Chronic Fatigue Syndrome

Researchers from Raboud University Nijmegen investigated whether Cognitive Therapy (CT) affected the cerebral atrophy of patients suffering from Chronic Fatigue Syndrome (CFS).

The study appeared in BRAIN: A Journal of Neurology.

The study included twenty-two CFS patients and twenty-two control subjects, all of whom underwent a two-step program of CBT. The initial focus of treatment is a “rehabilitative approach of a graded increase in physical activity,” while the second part emphasizes a “psychological approach that addresses thoughts and beliefs about CFS which may impair recovery.”

Upon completion of the CBT treatment, the CFS patients experienced significant improvement in their physical status as well as their cognitive performance. Furthermore, the CFS patients, who had initially shown significantly lower grey matter volume than the control subjects, showed a significant increase in grey matter volume through the work of CBT.

The results of this study, which included the partially reversed cerebral atrophy after effective CBT, are an “example of macroscopic cortical plasticity in the adult human brain, demonstrating a surprisingly dynamic relation between behavioural state and cerebral anatomy. Furthermore, (their) results reveal a possible neurobiological substrate of psychotherapeutic treatment.”

Study authors: F. P. de Lange, A. Koers, J. S. Kalkman, et al.

For children and adolescents, psychological harm of traumatic events reduced by CBT

In a review in the American Journal of Preventive Medicine, it was noted that children and adolescents who experience psychological harm caused by traumatic events are often treated by practitioners who are not aware of, and do not employ, treatments that are “based on the best available evidence.”

Meta-analyses were conducted on interventions that included cognitive behavioral therapy (CBT) in individual and group settings, play therapy, psychodynamic therapy, and others.

The traumas themselves covered a wide range and included sexual abuse, domestic violence, serious illness, and natural disasters. The CBT methods included exposure techniques, modification of inaccurate cognitions, reframing counterproductive cognitions regarding the trauma, and others.

Based on their analyses, the review authors concluded there was “strong evidence … that individual and group CBT can decrease psychological harm among symptomatic children and adolescents exposed to trauma.”

Review authors: H. R. Wethington, R. A. Hahn, D. S. Fuqua-Whitley, et al.

UK national guidelines emphasize CBT for children and adolescents

A recent article in Current Opinion in Psychiatry summarized the UK National Institute for Health and Clinical Excellence (NICE) clinical guidelines and reviews of cognitive behavioral therapy (CBT) for children and adolescents with mental health problems.

NICE is the UK’s independent organization responsible for providing national guidance on the “promotion of good health and the prevention and treatment of ill health.”

For the treatment of depression in children and young people, NICE guidelines recommended “that pharmacological approaches should not be the first-line approach to the treatment of depression in this age group.” It recommended instead “the initial use of psychosocial interventions, including CBT, for all severities of depression.”

Meta-analyses of randomized controlled trials suggested the importance of CBT for children and adolescents with generalized anxiety disorder, depression, obsessive compulsive disorder, and posttraumatic stress disorder. More limited evidence suggested CBT’s benefit in attention deficit hyperactivity disorder and others conditions.

The authors noted that CBT for these populations “should be extended by further primary and secondary research.”

Review authors: A. Munoz-Solomando, T. Kendall, C. J. Whittington

Award to Aaron T. Beck, M.D., for contributions to public understanding of psychology

At the American Psychological Association’s 2008 annual convention in Boston, Aaron T. Beck, M.D., received a presidential award for distinguished lifetime contributions to the public understanding of psychology.

Philadelphia College of Osteopathic Medicine: Honorary degree for Aaron T. Beck, M.D.

At the 2008 commencement of the Philadelphia College of Osteopathic Medicine, an honorary degree was conferred upon Aaron T. Beck, M.D., for his contributions to psychiatry and mental health.

Japan: Social Anxiety Disorder shows positive response to group CBT

A study in BMC Psychiatry reported that the use of cognitive behavioral therapy (CBT) for Social Anxiety Disorder (SAD) was well established in Europe and North America but little was known about its effectiveness in non-Western cultures.

A pilot study of group CBT for SAD was conducted in Japan (groups of 3 or 4; average number of sessions per group was 15). The CBT methods included psychoeducation regarding anxiety, experiments to reduce safety behaviors, cognitive restructuring for dysfunctional assumptions, and others. Where needed, co-administration of antidepressants and benzodiazepines was allowed.

The researchers found a significant reduction in symptoms pre- to post-treatment, and concluded that group CBT “can bring about a similar degree of symptom reduction among Japanese patients with SAD as among Western patients.”

Study authors: J. Chen, Y. Nakano, T. Ietzugu, S. Ogawa, et al.

Erectile Dysfunction benefits from Internet-based CBT

A study in the International Journal of Impotence Research reported that men with erectile dysfunction (ED) benefited from Internet-based cognitive behavioral therapy (CBT). An important aspect of this approach was that it removed much of the anxiety and embarrassment associated with face-to-face discussions of sexual problems. The CBT protocol included the men and their partners, and focused on psychological and relationship factors related to ED.

Designed as a 10-week program, couples participated in communication exercises, sensate focus activities, and email contact with therapists when needed. Improvements in ED were significantly greater among men who completed the program compared to those who received no treatment, and these findings were consistent with face-to-face psychological treatments. Additionally, the positive treatment effects remained stable during the 3-month follow-up period.

Study authors: M. P. McCabe, E. Price, L. Piterman, D. Lording

Potter author, J. K. Rowling, helped by CBT

In a recent article in the Newark Star Ledger, J. K. Rowling, author of Harry Potter, discussed how cognitive behavioral therapy helped her to overcome a serious depression she experienced in her mid-twenties while she was a struggling writer and single mother.

Centers for Disease Control panel recommends CBT for Depression in older adults

A recent review in Preventing Chronic Disease reported that about 5% to 15% of community-dwelling older adults (60+ y.o.) suffer from depression, which results in functional impairment and is possibly associated with increased mortality rates through suicide and complications of cardiac disease. As such, it is increasingly recognized as a significant public health problem in that population.

To address this problem, a panel was convened by the National Center for Chronic Disease Prevention and Health Promotion, one of eight centers within the Centers for Disease Control and Prevention. After systematically reviewing 97 studies, “the researcher-practitioner expert panel strongly recommended interventions based on the depression care management (DCM) model and recommended cognitive behavioral therapy (CBT) as treatment for depression in older adults.”

The report discussed strategies to implement its recommendations. It noted that many CBT practitioners work in specialty mental health settings and are not in contact with primary care or community-based programs for older adults. A further obstacle is that many older adults are reluctant to go to mental health specialists.

The panel concluded that partnerships among researchers, health care providers, and policy makers will be necessary to overcome the obstacles to the treatment of depression in older adults.

Study authors: M. Snowden, L. Steinman, J. Frederick

Adolescents with Chronic Fatigue Syndrome experience enduring benefits of CBT

A new study in Pediatrics reported that adolescents with Chronic Fatigue Syndrome (CFS) who received 10 sessions (over 5 months) of cognitive behavioral therapy (CBT) continued to experience positive effects at 2-year follow-up. Researchers measured fatigue, functional impairment, school attendance, and work attendance (where applicable). At follow-up, participants continued to experience the same improvement in fatigue as they had at the end of treatment. Their physical functioning, school attendance, and work attendance actually improved during the follow-up period. The authors recommended that this treatment become available to more adolescent patients with CFS.

Study authors: H. Knoop, M. Stulemeijer, L. W. A. M. de Jong, T. J. W. Fiselier, G. Bleijenberg