Postepy psychiatrii neurologii最新文献

Purpose: The purpose of this paper is to present to a community of behavior specialists, an overview of the subdiscipline of Organizational Behavior Management (OBM) in three aspects. First, OBM is a sub-branch of the larger field of Applied Behavior Analysis. It also has two other aspects: it can complement the traditional set of skills useful to behavior analysts or be one of the alternative careers for them.

Views: Behavior specialists predominantly, and especially in Poland, teach populations with special needs. Whether this is in special education, social assistance or select areas of health care, with young children with autism or adults with intellectual disability, this is where most behavior analysts work. At the same time, they often need to skillfully cooperate in teams, sometimes manage them or instruct people other than those with whom they are usually in contact, such as new team members, parents, and other specialists. OBM can be seen as a supplementary background that answers these needs. It is also a possible alternative career path, with a distinct client base and flagship journal, as well as specific procedures in behavior analysis, experts in the field and specialisms.

Conclusions: Different client populations, variations in instruction techniques and knowledge of response generalization all point to that conclusion that traditional behavior analysts might be largely at a disadvantage in the area covered by OBM: that of a management and team leading and training typically developing clients. Behavior analysts require a background in OBM, otherwise they might "reinvent the OBM wheel" or - which is worse - apply their experiences one-to-one with special populations and bring with them harmful assumptions.

Purpose: Description of the behavioural therapy of a patient after a subarachnoid haemorrhage from a ruptured aneurysm of the anterior communicating artery with an intracerebral haemorrhage, after aneurysm embolisation and left craniotomy, and after an ischemic cerebral stroke.

Case description: The author presents behavioural therapy techniques used in patient rehabilitation in all areas requiring improvement in the daily functioning of a disabled person. The course of selected therapeutic interventions is analysed and the effects of the interventions are assessed. The presented case is an example of successful behavioural therapeutic intervention that led to changes compared to the initial functional state of the organism. Thanks to the use of behavioural techniques, independent multi- profile patient functioning was achieved. Given the limited availability of health services, the focus on the therapy on evidence-based teaching makes them intrinsic to the patient's success.

Comment: The presented phases of therapy fully reflect the effective modification of behaviour patterns in a person after a subarachnoid haemorrhage from a ruptured aneurysm in the anterior communicating artery with an intracerebral haemorrhage, after aneurysm embolisation and left craniotomy, and after an ischemic cerebral stroke. The outcome of the applied behaviour approach seems to be significant enough to encourage the further development of the therapy for stroke patients regardless of the type of neurological disorders, functional difficulties, and age.

Purpose: The main purpose of the article is to present basic theoretical assumptions on Schema Therapy and its hypothetical application among adolescents suffering with anorexia nervosa.

Views: Anorexia nervosa is a very deadly mental disease, more frequently suffered by females than males, with the mean age of onset at approximately 14-15. Studies underline the relatively poor effectiveness of currently applied treatment methods and the need for new approaches that could be recommended for adolescent patients suffering with this disease. The results of studies conducted to date lead to the conclusion that Schema Therapy is a promising approach for this group. It is a transdiagnostic method of work that compiles elements known in other therapeutic approaches, aiming at an increase in the individual's awareness of their feelings and emotional needs, applied both in adolescent and adult groups of patients. Since the symptoms of eating disorders observed in adolescents are strongly connected with family systems it seems reasonable to use treatment techniques that rigorously address the unmet needs and rejected emotions of the individual.

Conclusions: Based on the data published so far it might be hypothesized that the techniques characteristic for Schema Therapy (e.g. imagery rescripting, chairwork, limited reparenting) could be eligible for use with adolescent patients with anorexia nervosa.They address unmet needs, rejected emotions, and early maladaptive schemas that are very frequent in patients with AN. Since the analysis presented provides only hypotheses and the discussion of theoretical aspects, empirical research in this area is needed.

Introduction: This study compared the effectiveness of different types of reinforcement (positive, negative, and a combination of both) in a self-management intervention program designed to increase water intake and walking.

Methods: Four university students participated in a self-management program to increase water intake and walking. Multiple baseline design across behaviors that included baseline (A) condition, positive reinforcement (B) condition, negative reinforcement (C) condition, and combination of both (B + C), was introduced. The participants received $2 every day they met the criteria during the positive reinforcement condition and no consequence if they failed to meet the criteria. In the negative reinforcement condition, $2 was subtracted for each day that the participant did not meet the criteria from the total amount of money available to the participant during that phase of the study. During the condition with positive and negative reinforcement, the participants received $2 every day they met the criteria. However, $2 was subtracted from the total for every day they did not meet the criteria.

Results: There was a clear increase from baseline to the first intervention phase across all the behaviors and participants, and the increase was maintained throughout the study. There were no differences in the effectiveness of different types of reinforcement applied in self-management intervention programs.

Conclusions: The study did show that implementing a relatively low-cost reinforcement contingency increased both exercise and water drinking. The results suggest that there are no consistent differences in the effectiveness of positive or negative reinforcement contingencies in self-management intervention.

Purpose: To illustrate the processes of development within the behavioral theory and the corresponding expansion of the areas in which it is applied, especially the advancement (conceptual developments) of the functional analysis of language inspired by Relational Frame Theory (RFT) research.

Views: Classical and operant conditioning are well-established behavioral learning processes, discovered and described at the beginning of the twentieth century. They provide the tools for analyzing, establishing and modifying the functions of stimuli and responses of the organisms through manipulation of the environment. Although B. F. Skinner provided grounds for the functional analysis of complex behaviors such as language, it was not until the beginning of the twenty-first century that RFT was introduced. From this moment behavior analysts could use behavioral principles to explain how stimulus functions may change without direct learning. The practical application of the growing knowledge about Arbitrarily Applicable Relational Responding (AARR), a basic generalized operant described within RFT, allows us to analyze, explain and change behaviors that had hitherto been beyond the scope of behavioral therapy. The continued growth and development of behavior theory and practice holds the promise for an expansion of its application to new areas and populations in need. One such development is the functional analysis of verbal behavior e.g., relational frames, ROE (relating-orienting-evoking).

Conclusions: It seems useful to add advancements proposed by RFT to the behavioral toolbox with which we could effectively describe, explain and change behavior with precision, scope and depth.

Purpose: Lurasidon is a relatively new, second-generation antipsychotic drug with an interesting receptor profile. It is considered to be safe and has a low risk of side effects. It is a substance with a multi-receptor mechanism of action: it mainly blocks dopaminergic D2 and serotonergic 5-HT2A receptors. According to the Summary of Product Characteristics, the adverse reaction of neutropenia was too rare to enable the estimation of its frequency.

Case description: A case of 39-year-old patient is presented in the article, diagnosed with paranoid schizophrenia, who developed neutropenia as a result of treatment with lurasidone. After the discontinuation of lurasidone and recommended supplementation, the blood test results gradually improved and finally reached the normal range.

Comment: This case report shows the need for regular monitoring of blood cell parameters in patients treated with second-generation antipsychotics, as there is a risk of neutrocytopenia or even agranulocitosis.

Purpose: Treatment of patients with relapsing-remitting multiple sclerosis (RRMS) in Poland begins with first-line therapy; however, the treatment often fails. The aim of this study was to investigate the course of first-line treatment in patients who, despite experiencing an active course of the disease, did not receive more efficacious treatment due to the existing criteria in the drug program.

Methods: The study included 139 patients from 45 treatment centers. Medical data concerning the course of treatment were collected with the use of specific forms.

Results: The most frequently used drugs were β-interferons, and treatment was initiated with these drugs in most cases; however, administration of dimethyl fumarate was also common. The median treatment duration was 30.9 months, with the longest treatment duration observed for β-interferons. The most common reason for therapy switching or termination was treatment failure.

Conclusions: First-line therapy in the studied population was based mainly on β-interferons and dimethyl fumarate. For most medications, the discontinuation of therapy or drug switching were very common and the main reason was total or partial treatment failure. These observations suggest the need for earlier implementation of more effective treatment, based on drugs with high efficacy, in the study population.

Purpose: The aim of this study was to evaluate whether the prevalence of celiac among attention-deficit/hyperactivity disorder (ADHD) patients is higher than among the normal population.

Methods: The present study was a prospective one investigating ADHD children referred to the Neurology Clinic and Pediatric Ward at Amir Al-Momenin Hospital of Zabol (Sistan and Baluchestan, Iran) in 2019 after their parents' signing of a consent form. All patients underwent Biocard™ Celiac and serology tests. Data were analyzed with SPSS version 21 software.

Results: Of all 76 ADHD children undergoing a serum IgA antibodies concentration test, 58 (76%) were male and 18 (23.7%) were female. The mean age of the children was 6.9 ± 2.4, ranging from 2 years to 12 years. The diagnosis of IgA immunodeficiency was rejected for all children based on total serum IgA antibody results. The overall mean anti-tissue transglutaminase (TTG) level was 6.8 ± 5.3 U/ml, ranging from 0.2 to 37 U/ml. There was no significant difference regarding TTG levels between boys and girls (5.1 vs. 6.0) U/ml. Based on the anti-TTG level results, no celiac case was found among the ADHD patients.

Conclusions: There is as yet no evidence suggesting a link between celiac disease and ADHD. Thus, routine celiac disease screening when evaluating for ADHD (and is not recommended). However, the possibility of untreated celiac disease predisposing an individual to ADHD-like behaviors should be considered. Hence, physicians are recommended to evaluate a broad range of physical symptoms, in addition to typical neuropsychiatric symptoms, when evaluating ADHD patients.