Depression represents a major source of disability among individuals who have suffered a traumatic brain injury (TBI), with estimates of prevalence in this population ranging over 50%. In comparison with other sequelae of TBI, depression is often poorly conceptualized and treated among acute care and rehabilitation professionals. One reason for this is the lack of clear etiological models for the development of depression following TBI. This paper argues that post-TBI depression actually represents a heterogeneous category, with multiple etiologic pathways and clinical implications. The literature in this area is reviewed, with an emphasis on an appreciation of the diversity within this clinical population. Conclusions focus on suggestions for differential diagnosis and treatment options.
Many nonpharmacologic (behavioral) techniques are being proposed for the therapy of essential hypertension. The research in this area is reviewed and divided roughly into two categories: the biofeedback and relaxation methodologies. While feedback can be used to lower pressures during laboratory training sessions, studies designed to alter basal blood pressure levels with biofeedback have not yet been reported. The absence of evidence for such changes through biofeedback limits the usefulness of this technique in hypertension control. The various relaxation methods, such as yoga, transcendental meditation, progressive muscle relaxation, and others have shown more promise. With varying degrees of experimental vigor, many of these techniques have been associated with long-lasting changes in blood pressure. The strengths and weaknesses of the various authors' research designs, data and conclusions are discussed, and suggestions for further experimentation are offered.
The symptoms of child sexual abuse and posttraumatic stress disorder (PTSD) affect a child's self-efficacy. A child's self-efficacy beliefs impact the course and treatment of PTSD, because perceived self-efficacy plays a mediating role in children's ability to cope with trauma. Self-efficacy research indicates that emotional competence can be learned and may provide treatment for PTSD that provides symptom reduction as well as a means of substituting problem-solving coping skills for emotion-focused coping skills.
The present study explored the Early Maladaptive Schemas (EMS) of individuals who engage in self-mutilation. One hundred five participants (34 males and 71 females) from a community site and from two clinical sites participated in the study. Four EMS differentiated self-mutilators from nonmutilators: Mistrust/Abuse, Emotional Deprivation, Social Isolation/ Alienation, and Insufficient Self-Control/Self-Discipline. The following schemas were also found to differentiate repetitive self-mutilators from nonmutilators and from self-mutilators who had engaged in only one episode of self-mutilation: Emotional Deprivation, Social Isolation/Alienation, Defectiveness/Shame, and Insufficient Self-Control/Self-Discipline. Finally, the Social Isolation/Alienation schema was found to be endorsed more strongly as the number of self-mutilative episodes increased. The results are largely in accord with the theoretical suppositions of schema theory. The clinical implications of these findings are discussed in the context of schema therapy.
This study examined the relationship between drug preference, drug use, drug availability, and personality among individuals (n = 100) in treatment for substance abuse in an effort to replicate the results of an earlier study (Feldman, Kumar, Angelini, Pekala, & Porter, 2007) designed to test prediction derived from Eysenck's (1957, 1967) theories. Drug preference was measured by the method of paired-comparison and personality was measured with the Zuckerman-Kuhlman Personality Questionnaire-50 CC. Contrary to expectations, high compared with low scorers on Sociability and Impulsive-Sensation Seeking preferred depressants. Surprisingly, low compared with high scorers on neuroticism did not differ in preference for alcohol. As in the previous study, drug preference, use, and availability were highly correlated, although ease of availability was slightly more predictive of drug use than drug preference. Clinical and theoretical implications are discussed.
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