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An Anthroposophic Medical Treatment in the Land of Salt and Gold 盐与金之地的人智疗法
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-22 DOI: 10.1007/s11920-024-01499-z
Meron Barak, Eran Ben-Arye

In this narrative, a general practitioner and psychotherapist trained in anthroposophic medicine presents the narrative and treatment of a 60-year-old woman who experienced the horrors of the “Dark Sabbath” attack in southern Israel on October 7, 2023. The patient’s story is narrated by the physician, who shares his multi-disciplinary and multi-modal anthroposophic medicine approach to address the patient’s acute stress disorder–related symptoms and concerns.

在本故事中,一位接受过人类医学培训的全科医生和心理治疗师讲述了一位 60 岁女性的故事和治疗过程,她经历了 2023 年 10 月 7 日以色列南部 "黑暗安息日 "恐怖袭击事件。医生讲述了患者的故事,并分享了他采用多学科、多模式的人类医学方法来解决患者的急性应激障碍相关症状和问题。
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引用次数: 0
Emergency Preparedness Drills for Active and Mass Shootings in Schools 学校主动和大规模枪击事件应急准备演习
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-19 DOI: 10.1007/s11920-024-01502-7
Jaclyn Schildkraut, Emily A. Greene-Colozzi, Amanda B. Nickerson

Purpose of Review

There is widespread use of emergency preparedness drills in public K-12 schools across the US, but considerable variability exists in the types of protocols used and how these practices are conducted. This review examines research into both “lockdown drills” and “active shooter drills” as it relates to their impact on participants across different outcomes and evaluations of their procedural integrity.

Recent Findings

A number of studies on lockdown drills yielded largely consistent findings about their impacts, whereas findings related to the effects of active shooter drills are less uniform. The research also demonstrated that lockdown drills, though not active shooter drills, can help participants build skill mastery to be able to successfully deploy the procedure.

Summary

Differences in how drills impact participants and whether they cultivate skill mastery are largely attributable to the type of drill being conducted. This review suggests that employing clearly defined drill procedures incorporating best practices, coupled with instructional training, can help schools prepare for emergencies without creating trauma for participants.

综述目的美国公立 K-12 学校广泛使用应急准备演习,但所使用的协议类型和演习方式存在很大差异。本综述考察了有关 "封锁演习 "和 "主动枪手演习 "的研究,因为这两种演习对参与者产生了不同的影响,并对其程序的完整性进行了评估。最近的研究结果一些有关封锁演习的研究对其影响得出了基本一致的结论,而有关主动枪手演习影响的结论则不太一致。研究还表明,封锁演习(尽管不是主动枪击演习)可以帮助参与者掌握技能,从而能够成功地部署程序。总结演习对参与者的影响以及是否培养了技能掌握能力方面的差异在很大程度上取决于演习的类型。本综述表明,采用定义明确的演习程序并结合最佳实践,再加上指导培训,可以帮助学校在不给参与者造成心理创伤的情况下为紧急情况做好准备。
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引用次数: 0
Multimorbidity and the Etiology of Schizophrenia 多病共存与精神分裂症病因学
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-16 DOI: 10.1007/s11920-024-01500-9
A. Szoke, B. Pignon, O. Godin, A. Ferchiou, R. Tamouza, M. Leboyer, F. Schürhoff

Purpose of Review

A global study of multimorbidity in schizophrenia, especially of the association with physical conditions, might offer much needed etiological insights.

Recent Findings

Our review suggests that life-style factors and medication related to schizophrenia are only part of the explanation of the increase in risk for cardiovascular, metabolic, pulmonary disorders, and some cancers. Positive associations with autoimmune disorders (with the exception of rheumatoid arthritis) and epilepsy are promising avenues of research but to date have not been fully exploited. The same holds for the negative comorbidity seen for rheumatoid arthritis and some cancers (e.g., prostate).

Summary

As a whole, our review suggests that most of the explored conditions have a different prevalence in schizophrenia than in the general population. Several hypotheses emerged from this review such as the role of immune and genetic factors, of sex hormones, and of more general variability factors.

最新研究结果我们的研究表明,与精神分裂症有关的生活方式因素和药物治疗只是导致心血管疾病、代谢性疾病、肺部疾病和某些癌症风险增加的部分原因。与自身免疫性疾病(类风湿性关节炎除外)和癫痫的正相关性是很有希望的研究方向,但迄今为止尚未得到充分利用。总之,我们的综述表明,所探讨的大多数疾病在精神分裂症患者中的发病率与普通人群不同。本综述提出了一些假设,如免疫和遗传因素、性激素以及更普遍的可变因素的作用。
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引用次数: 0
Metaverse in Mental Health: The Beginning of a Long History 心理健康中的元宇宙:漫长历史的开端
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-11 DOI: 10.1007/s11920-024-01501-8
Antonio Cerasa, Andrea Gaggioli, Giovanni Pioggia, Giuseppe Riva

Purpose of Review

We review the first pilot studies applying metaverse-related technologies in psychiatric patients and discuss the rationale for using this complex federation of technologies to treat mental diseases. Concerning previous virtual-reality applications in medical care, metaverse technologies provide the unique opportunity to define, control, and shape virtual scenarios shared by multi-users to exploit the “synchronized brains” potential exacerbated by social interactions.

Recent Findings

The application of an avatar-based sexual therapy program conducted on a metaverse platform has been demonstrated to be more effective concerning traditional sexual coaching for treating female orgasm disorders. Again, a metaverse-based social skills training program has been tested on children with autism spectrum disorders, demonstrating a significant impact on social interaction abilities.

Summary

Metaverse-related technologies could enable us to develop new reliable approaches for treating diseases where behavioral symptoms can be addressed using socio-attentive tasks and social-interaction strategies.

综述目的我们回顾了第一批在精神病患者中应用元宇宙相关技术的试点研究,并讨论了使用这种复杂的联合技术治疗精神疾病的理由。关于以往虚拟现实技术在医疗领域的应用,元宇宙技术提供了一个独特的机会来定义、控制和塑造多用户共享的虚拟场景,从而利用社交互动所带来的 "同步大脑 "潜能。最近的研究结果在元宇宙平台上应用基于虚拟化身的性治疗项目,与传统的性指导相比,对治疗女性性高潮障碍更为有效。同样,在自闭症谱系障碍儿童身上测试了基于元宇宙的社交技能培训计划,结果表明该计划对社交互动能力有显著影响。总结元宇宙相关技术可以帮助我们开发出治疗疾病的新方法,利用社会注意力任务和社交互动策略来解决行为症状。
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引用次数: 0
Acute, Chronic, and Everyday Physical Pain in Borderline Personality Disorder 边缘型人格障碍患者的急性、慢性和日常躯体疼痛
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-10 DOI: 10.1007/s11920-024-01498-0
Melissa Nance, Khrystyna Stetsiv, Ian A. McNamara, Ryan W. Carpenter, Johanna Hepp

Purpose of Review

Physical pain is an underrecognized area of dysregulation among those with borderline personality disorder (BPD). Disturbances are observed within the experience of acute, chronic, and everyday physical pain experiences for people with BPD. We aimed to synthesize research findings on multiple areas of dysregulation in BPD in order to highlight potential mechanisms underlying the association between BPD and physical pain dysregulation.

Recent Findings

Potential biological mechanisms include altered neural responses to painful stimuli within cognitive-affective regions of the brain, as well as potentially low basal levels of endogenous opioids. Emotion dysregulation broadly mediates dysregulation of physical pain. Certain psychological experiences may attenuate acute physical pain, such as dissociation, whereas others, such as negative affect, may exacerbate it. Social challenges between patients with BPD and healthcare providers may hinder appropriate treatment of chronic pain.

Summary

Dysregulated physical pain is common in BPD and important in shaping health outcomes including elevated BPD symptoms, chronic pain conditions, and risk for problematic substance use.

综述目的在边缘型人格障碍(BPD)患者中,身体疼痛是一个未得到充分认识的调节障碍领域。我们观察到,边缘型人格障碍患者在急性、慢性和日常身体疼痛体验方面存在障碍。我们旨在综合有关 BPD 多个调节障碍领域的研究成果,以突出 BPD 与身体疼痛调节障碍之间关联的潜在机制。潜在的生物学机制包括大脑认知-情感区域对疼痛刺激的神经反应发生改变,以及内源性阿片类物质的基础水平可能较低。情绪失调广泛介导身体疼痛的失调。某些心理体验可能会减轻急性躯体疼痛,如解离,而其他心理体验,如负面情绪,则可能会加剧疼痛。BPD 患者与医疗服务提供者之间的社交障碍可能会阻碍对慢性疼痛的适当治疗。摘要身体疼痛失调在 BPD 患者中很常见,并且在影响健康结果方面起着重要作用,包括 BPD 症状升高、慢性疼痛状况和问题药物使用风险。
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引用次数: 0
Recent Advances in the Treatment of Treatment-Resistant Depression: A Narrative Review of Literature Published from 2018 to 2023. 治疗难治性抑郁症的最新进展:2018年至2023年发表的文献综述》。
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-22 DOI: 10.1007/s11920-024-01494-4
John L Havlik, Syed Wahid, Kayla M Teopiz, Roger S McIntyre, John H Krystal, Taeho Greg Rhee

Purpose of review: We review recent advances in the treatment of treatment-resistant depression (TRD), a disorder with very limited treatment options until recently. We examine advances in psychotherapeutic, psychopharmacologic, and interventional psychiatry approaches to treatment of TRD. We also highlight various definitions of TRD in recent scientific literature.

Recent findings: Recent evidence suggests some forms of psychotherapy can be effective as adjunctive treatments for TRD, but not as monotherapies alone. Little recent evidence supports the use of adjunctive non-antidepressant pharmacotherapies such as buprenorphine and antipsychotics for the treatment of TRD; side effects and increased medication discontinuation rates may outweigh the benefits of these adjunctive pharmacotherapies. Finally, a wealth of recent evidence supports the use of interventional approaches such as electroconvulsive therapy, ketamine/esketamine, and transcranial magnetic stimulation for TRD. Recent advances in our understanding of how to treat TRD have largely expanded our knowledge of best practices in, and efficacy of, interventional psychiatric approaches. Recent research has used a variety of TRD definitions for study inclusion criteria; research on TRD should adhere to inclusion criteria based on internationally defined guidelines for more meaningfully generalizable results.

综述的目的:我们回顾了治疗耐药抑郁症(TRD)的最新进展,直到最近,这种疾病的治疗方案还非常有限。我们研究了治疗 TRD 的心理治疗、精神药物治疗和介入性精神病学方法的进展。我们还强调了近期科学文献中对 TRD 的各种定义:最近的证据表明,某些形式的心理治疗可以作为TRD的辅助治疗手段,但不能单独作为单一疗法。近期几乎没有证据支持使用丁丙诺啡和抗精神病药物等非抗抑郁药物辅助治疗TRD;副作用和停药率的增加可能会超过这些辅助药物治疗的益处。最后,最近有大量证据支持使用电休克疗法、氯胺酮/开塞露和经颅磁刺激等干预方法治疗 TRD。最近,我们对如何治疗 TRD 有了更深入的了解,这在很大程度上扩展了我们对精神科介入治疗方法的最佳实践和疗效的认识。最近的研究在纳入研究标准时使用了多种 TRD 定义;有关 TRD 的研究应遵守基于国际定义指南的纳入标准,以获得更有意义的可推广结果。
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引用次数: 0
Attachment Theory and Sexual Offending: Making the Connection. 依恋理论与性犯罪:建立联系。
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-06 DOI: 10.1007/s11920-024-01488-2
Melissa D Grady, Jamie Yoder

Purpose of review: The purpose of this review is to discuss how attachment theory can be applied to explain sexual violence. Specifically, it discusses how the development of certain risk factors contributes to these behaviors and how attachment-based models can be used to address this issue through prevention and therapeutic interventions.

Recent findings: Recent research demonstrates that individuals who commit sexual offenses have higher rates of insecure attachment styles and that these styles are associated with a number of criminogenic risk factors associated with sexual offending. Such risk factors include cognitive processing difficulties, affect dysregulation, and challenges in interpersonal relationships, among others. Fortunately, treatment interventions have been shown to foster more secure attachment styles and reduce these risk factors. Attachment theory is a viable theory to both understand and intervene with those who have committed sexual violence to reduce the risk factors associated with sexual violence.

综述目的:本综述旨在讨论如何运用依恋理论来解释性暴力。具体来说,它讨论了某些风险因素的发展是如何导致这些行为的,以及基于依恋的模型是如何通过预防和治疗干预来解决这一问题的:最近的研究表明,实施性犯罪的人具有较高比例的不安全依恋风格,而且这些风格与许多与性犯罪相关的犯罪风险因素有关。这些风险因素包括认知处理困难、情感失调和人际关系挑战等。幸运的是,治疗干预已被证明可以培养更安全的依恋风格并减少这些风险因素。依恋理论是一种可行的理论,可用于理解和干预性暴力犯罪者,以减少与性暴力相关的风险因素。
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引用次数: 0
Dynamic Protective Factors Relevant to Sexual Offending. 与性犯罪相关的动态保护因素。
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-24 DOI: 10.1007/s11920-024-01493-5
David Thornton, Gwenda M Willis, Sharon Kelley

Purpose of review: Focusing on protective factors rather than risk factors potentially better aligns assessment with strengths-based treatment. We examine research into the assessment of protective factors to see whether it can play this role relative to sexual offending.

Recent findings: Structured asses sment of protective factors is well developed relative to violent offending but only recently studied relative to sexual offending. Nevertheless, multiple measures of protective factors have now been trialed with men who have committed sexual offenses and shown to predict reduced recidivism. Although research into individual scales is limited, overlapping content between scales suggests that protective factors aligning with constructs of Resilience, Adaptive Sexuality, and Prosocial Connection and Reward are all relevant to sexual offending. Protective factors relevant to sexual offending are sufficiently well identified that they can usefully be used for treatment need assessment, treatment planning during therapy, and case management. They can also make some contribution to risk assessment. The Structured Assessment of PROtective Factors against Sexual Offending (SAPROF-SO) is currently the most comprehensive measure of protective factors relevant to sexual offending.

审查目的:关注保护因素而非风险因素可能会使评估与基于优势的治疗更好地结合起来。我们对保护性因素评估的研究进行了梳理,看看它是否能在性犯罪中发挥这一作用:对保护性因素的结构化评估在暴力犯罪方面已经得到了很好的发展,但在性犯罪方面的研究才刚刚起步。尽管如此,现在已经对实施过性犯罪的男性进行了多种保护性因素测量试验,结果表明,这些保护性因素可以预测累犯率的降低。尽管对单个量表的研究有限,但量表之间的重叠内容表明,与复原力、适应性、亲社会联系和奖励等建构相一致的保护性因素都与性犯罪有关。与性犯罪相关的保护性因素已被充分确定,可以有效地用于治疗需求评估、治疗期间的治疗规划和个案管理。它们还可以为风险评估做出一些贡献。针对性犯罪的保护性因素结构化评估(SAPROF-SO)是目前对与性犯罪有关的保护性因素进行的最全面的测量。
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引用次数: 0
The Impact of Maternal Interpersonal Violent Trauma and Related Psychopathology on Child Outcomes and Intergenerational Transmission. 母亲的人际暴力创伤和相关精神病理学对儿童结果和代际传递的影响。
IF 6.7 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-01 DOI: 10.1007/s11920-024-01491-7
Shannen Graf, Daniel S Schechter

Purpose of review: This review aims to outline some consequences that maternal history of trauma with and without related psychopathology, such as posttraumatic stress symptoms (PTSS), can have on their children's development and functioning. It then addresses mechanisms through which intergenerational transmission of interpersonal violence (IPV) and related psychopathology may occur.

Recent findings: Findings include the effects of maternal IPV experience and related psychopathology on child social-emotional and biologically-based outcomes. This includes increased developmental disturbances and child psychopathology, as well as physiological factors. Secondly, the review focuses on psychobiological mechanisms by which maternal experience of IPV and related psychopathology likely trigger intergenerational effects. Maternal IPV and related psychopathology can have a negative impact on several areas of their child's life including development, interactive behavior, psychopathology, and physiology. This transmission may partially be due to fetal and perinatal processes, genetic and epigenetic effects, and interactions with their parents.

综述的目的:本综述旨在概述母亲的创伤史以及相关的精神病理学,如创伤后应激症状(PTSS),可能对其子女的发展和功能产生的一些影响。本研究还探讨了人际暴力(IPV)和相关精神病理学的代际传播机制:研究结果包括母亲的 IPV 经历和相关精神病理学对儿童社会情感和生物学结果的影响。这包括发育障碍和儿童心理病理学以及生理因素的增加。其次,本综述将重点放在孕产妇的 IPV 经历和相关心理病理学可能引发代际效应的心理生物学机制上。母亲的 IPV 及相关精神病理学会对其子女生活的多个方面产生负面影响,包括发育、互动行为、精神病理学和生理学。这种传递的部分原因可能是胎儿和围产期过程、遗传和表观遗传效应以及与父母的互动。
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引用次数: 0
Web-Based Initiatives to Prevent Sexual Offense Perpetration: A Systematic Review. 预防性犯罪的网络倡议:系统回顾。
IF 5.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-01 Epub Date: 2024-03-21 DOI: 10.1007/s11920-024-01489-1
Jana Hillert, Lina Sophie Haubrock, Arne Dekker, Peer Briken

Purpose of review: Web-based programs to prevent sexual offense perpetration could provide an opportunity that avoids many of the barriers associated with in-person treatment. The aim of this systematic review is to give an overview of the literature on web-based initiatives aimed at sexual offense perpetration prevention published during the last 10 years (2013-2023) and to report data on the efficacy as well as issues of the discussed initiatives.

Recent findings: We included 18 empirical studies discussing web-based perpetration prevention initiatives, of which six are randomized controlled trials. Among the articles, four cover programs focusing on prevention of sexual reoffending and 14 discuss programs aimed at preventing initial sexual offenses. Evaluations and observations of web-based initiatives aimed at preventing sexual offense perpetration show overall promising results and are well-appreciated. However, evaluation studies are scarce and more randomized controlled trials replicating this effect are warranted.

审查目的:预防性犯罪的网络计划可以提供一个机会,避免许多与面对面治疗相关的障碍。本系统性综述旨在概述过去 10 年(2013-2023 年)内发表的有关旨在预防性犯罪的网络计划的文献,并报告有关所讨论计划的有效性和问题的数据:我们收录了 18 篇讨论基于网络的犯罪预防措施的实证研究,其中 6 篇是随机对照试验。在这些文章中,有 4 篇涉及以预防性犯罪再犯为重点的项目,14 篇讨论了旨在预防初次性犯罪的项目。对旨在预防性犯罪的网络计划进行的评估和观察显示,总体结果很有希望,并得到了广泛好评。然而,评估研究很少,需要更多的随机对照试验来复制这种效果。
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引用次数: 0
期刊
Current Psychiatry Reports
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