Clinical Case Studies最新文献_第3页

Opening Treatment Windows for Treatment-Resistant Schizophrenia: Improving Emotion Regulation Strategies Using the Unified Protocol in a Case Study in Spain 打开治疗难治性精神分裂症的治疗窗口：使用统一方案改善情绪调节策略——以西班牙为例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-21 DOI: 10.1177/15346501231190912

E. Grasa, I. Corripio, Ó. Peris-Baquero, A. Roldán, Judit Selma, J. Osma

{"title":"Opening Treatment Windows for Treatment-Resistant Schizophrenia: Improving Emotion Regulation Strategies Using the Unified Protocol in a Case Study in Spain","authors":"E. Grasa, I. Corripio, Ó. Peris-Baquero, A. Roldán, Judit Selma, J. Osma","doi":"10.1177/15346501231190912","DOIUrl":"https://doi.org/10.1177/15346501231190912","url":null,"abstract":"Approximately 30%-50% of people with schizophrenia worldwide have treatment-resistant schizophrenia (TRS). Currently available standard psychopharmacological and psychological treatments have proven insufficient to achieve full recovery in these patients. Alternative psychological interventions focused on improving emotion regulation, such as the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), could potentially improve treatment outcomes in this difficult to treat population. The aim of the present case study is to demonstrate how the UP can be adapted for the treatment of TRS. We decided to use UP to treat this particular patient due to the presence of intense unpleasant emotions, aversive reactions, and emotional avoidance strategies. After completing the full treatment protocol, the patient showed significant decreases in scores on the Difficulties in Emotion Regulation Scale (DERS), including total and emotional rejection, life interference, and emotional lack of control. A significant reduction was also observed in anxiety (OASIS) and depressive symptoms (ODSIS). The intervention had a positive impact on auditory hallucinations, with decreased severity, less intense anxiety, and less interference in life. The treatment led to greater control over voices and the patient reported feeling more confident in her relationship with those voices. These results provide preliminary support for the use of UP for the treatment of TRS.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42437152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disentangling the Consequences of Systemic Racism and Clinical Paranoia to Promote Effectiveness of a Cognitive-Behavioral Intervention for Persecutory Delusions in Minoritized Individuals: A Case-Example 解开系统性种族主义和临床偏执的后果以提高认知行为干预对未成年个体顽固性妄想的有效性：一个案例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-19 DOI: 10.1177/15346501231190920

A. Moussa-Tooks, Julia M. Sheffield, D. Freeman, Aaron P. Brinen

{"title":"Disentangling the Consequences of Systemic Racism and Clinical Paranoia to Promote Effectiveness of a Cognitive-Behavioral Intervention for Persecutory Delusions in Minoritized Individuals: A Case-Example","authors":"A. Moussa-Tooks, Julia M. Sheffield, D. Freeman, Aaron P. Brinen","doi":"10.1177/15346501231190920","DOIUrl":"https://doi.org/10.1177/15346501231190920","url":null,"abstract":"While everyone experiences threats, some threats are culturally specific and not universally recognized or addressed by providers. A prominent example is threat-based worry and hypervigilance in Black Americans and other minoritized individuals, which is higher due to systemic racism and increases risk for psychopathology like clinically significant paranoia. To date, there have been no adaptations of cognitive-behavioral therapies for Black Americans with psychosis, despite the long-standing history of systemic racism in the United States, and its increasingly recognized contribution to psychotic experiences. Accordingly, we present the first step towards developing an adapted cognitive-behavioral intervention for Black and minoritized Americans with psychosis. This adaptation of an empirically supported worry-based treatment for persecutory delusions was accomplished by comprehensive conceptualization and integration of how systemic racism and minoritization drive the prevalence and perception of threats. This contrasts with conceptualizing racism-related hypervigilance and cognitions as worry or ignoring these critical experiences altogether, which is invalidating and neglects optimal identification and intervention on behavioral targets. Using a validating and normalizing approach, the individual was able to identify how frequent threats related to systemic racism resulted in increased worry, vigilance, and distress. By identifying and intervening on the perception of threat and associated worry, the individual engaged in more helpful responses to the threat, which in turn increased participation in more meaningful activities and reduced worry and clinical paranoia. This case illustrates how accurate conceptualization clarifies behavioral targets and increases patient engagement, which together enhance the effectiveness of the intervention for minoritized individuals.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44130016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dialectical Behaviour Therapy Enhanced Habit Reversal Training: A Clinical Case of Childhood-Onset Trichotillomania in an Adult With Impulsive Personality Features 辩证行为疗法强化习惯逆转训练:儿童期冲动型成人拔毛癖临床一例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-13 DOI: 10.1177/15346501231189552

Sheeba Shamsudeen, Prasad Kannekanti

{"title":"Dialectical Behaviour Therapy Enhanced Habit Reversal Training: A Clinical Case of Childhood-Onset Trichotillomania in an Adult With Impulsive Personality Features","authors":"Sheeba Shamsudeen, Prasad Kannekanti","doi":"10.1177/15346501231189552","DOIUrl":"https://doi.org/10.1177/15346501231189552","url":null,"abstract":"Research has recognised the psychosocial impairments linked to Trichotillomania (TTM) and established a relationship between problematic hair-pulling and affective regulation. Significant relationships between pulling triggers, their severity, and emotional dysregulation have also been predicted. The current case focused on the efficacy of combined DBT (Dialectical Behaviour Therapy) and HRT (Habit Reversal Training) in a client with TTM and Impulsive Personality features. The client received 11 weekly sessions of DBT-enhanced HRT, which took 3 months to complete. Following the end of this acute treatment phase, four maintenance sessions (two sessions per month) were delivered. The maintenance of treatment benefits was assessed using self-report measures and therapist observations at four time points: at pre-treatment, after the acute treatment phase (at the end of 3 months), and then at a 3-month and a 6-month follow-up. The intervention results suggested a substantial reduction in hair-pulling, hair regrowth in affected parts of the scalp, and self-reported improvements in mood. The study also shows preliminary evidence of DBT-enhanced HRT’s efficacy in a client with TTM and Impulsive Personality features, suggesting the importance of addressing personality structures and distressing emotional regulation that cause functional impairment during TTM treatment.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42712663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Differential Reinforcement Without Extinction and Stimulus Fading to Teach Tolerance of a Sleep Study 无消差强化与刺激消退对睡眠耐受性的影响

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-06-15 DOI: 10.1177/15346501231184269

Sarah E. Martinez, Seth G. Walker, Amanda N. Zangrillo, Alicia N. Graham

{"title":"Differential Reinforcement Without Extinction and Stimulus Fading to Teach Tolerance of a Sleep Study","authors":"Sarah E. Martinez, Seth G. Walker, Amanda N. Zangrillo, Alicia N. Graham","doi":"10.1177/15346501231184269","DOIUrl":"https://doi.org/10.1177/15346501231184269","url":null,"abstract":"There are a growing number of publications supporting behavior-analytic strategies to increase compliance with medical procedures. However, little research has been conducted on the application of applied behavior analysis to teach compliance with and completion of the setup required for an overnight sleep study (polysomnography). The client in this report presented with autism, cerebral palsy, epilepsy, strokes, and severe destructive behavior (i.e., aggression, property destruction, self-injury). These conditions combined with a poor sleep/wake schedule and gasping during the night necessitated a sleep study. The caregiver referred their child to behavioral outpatient services due to medical noncompliance and severe destructive interfering behaviors with similar procedures (e.g., failed electroencephalogram [EEG]). We evaluated the effects of differential reinforcement without extinction and stimulus fading on compliance and reduction of destructive behavior with a 25-step sleep study procedure. Our approach successfully taught tolerance of the procedure and reduced destructive behavior. The client completed the scheduled sleep study and received a diagnosis of mild obstructive sleep apnea.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47766025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism 叙事暴露疗法治疗有色人种变性青少年选择性缄默症的创伤后应激

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-06-09 DOI: 10.1177/15346501231181921

Mark Albert Casas, B. Conn

{"title":"Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism","authors":"Mark Albert Casas, B. Conn","doi":"10.1177/15346501231181921","DOIUrl":"https://doi.org/10.1177/15346501231181921","url":null,"abstract":"Rates of post-traumatic stress (PTS) are greater among transgender and non-binary (TGNB) youth compared to their cisgender peers. This disparity has been linked to increased experiences of trauma among TGNB youth, including greater exposure to child abuse, discrimination, hate crimes, and familial and peer bullying and rejection. Few studies to date have examined the use of trauma-focused interventions with TGNB youth. Narrative Exposure Therapy (NET) has been identified as a potentially impactful treatment for PTS for communities who experience oppression and human rights violations given its social justice-oriented “testimonial” approach and focus on meaning-making around traumatic experiences. While narrative-based approaches are often considered “best practice” for trauma interventions, youth may present with comorbid conditions that present barriers or often preclude them from receiving trauma treatment, such as selective mutism (SM). In this case series, we describe the use of NET for treating PTS symptoms in two transgender youth with comorbid SM, as well as adaptations to support their engagement and progress in treatment. Treatment progress was observed in reduction of PTS symptoms, increase in self-reported resilience and positive well-being, and full remission of SM, with treatment gains observed 6-months post-discharge. From these cases, we identified that (1) NET is a brief treatment that can address PTS and SM symptoms among TGNB youth; (2) NET is able to be adapted to enhance engagement in a narrative-based, trauma-focused therapy for youth with PTS and SM; and (3) NET can also increase self-perceived resilience and a sense of positive well-being for TGNB youth.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41558352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Integrated Behavioral-Neuropsychiatric Treatment Plan Reduces Severe Challenging Behavior in an Adolescent With Neurobehavioral Complications of Neonatal Brain Injury 综合行为-神经精神治疗计划减少新生儿脑损伤神经行为并发症青少年的严重挑战行为

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-06-02 DOI: 10.1177/15346501231179248

Serra R. Langone, Kristen Dever, Joseph N. Ricciardi, Donald L. Sherak

{"title":"An Integrated Behavioral-Neuropsychiatric Treatment Plan Reduces Severe Challenging Behavior in an Adolescent With Neurobehavioral Complications of Neonatal Brain Injury","authors":"Serra R. Langone, Kristen Dever, Joseph N. Ricciardi, Donald L. Sherak","doi":"10.1177/15346501231179248","DOIUrl":"https://doi.org/10.1177/15346501231179248","url":null,"abstract":"We present the case of a 15-year-old adolescent boy with a neurobehavioral disorder who experienced a brain injury during the first month of life. The forms of challenging behaviors were severe and included aggression, property destruction, volitional incontinence, and suicidal statements, and had resulted in two psychiatric hospitalizations and multiple emergency evaluations prior to intervention. The intervention was preceded by a functional behavior assessment suggesting that a differential reinforcement intervention could be designed to minimize reinforcement of challenging behaviors while maximizing reinforcement of adaptive, positive behaviors. The intervention was introduced following the baseline phase and there was an immediate decrease in the rate of challenging behaviors and in the utilization of emergency psychiatric services. Improvements continued for 6 weeks, after which a medication was added to promote sleep onset (to decrease sleep onset latency) along with behavioral guidelines, which led to further improvements for an additional 12 weeks. A follow-up phase of 3 months showed sustained results. The study illustrates the value of an integrated approach utilizing applied behavior analysis and sequenced neuropsychiatry, and a neurobehavioral formulation where components of the participant’s brain injury history are integrated with an operant formulation as circumstances that explain the problem behavior while effectively suggesting strategies for behavioral treatment. Because the intervention was implemented by support staff in a group home, it illustrates the ability of support staff to work therapeutically with severe behavior presentations using structured behavioral interventions.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47650537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modifying Cognitive-Behavioral Therapy for Fear of Sleeping Alone in a Child With Autism Spectrum Disorder 自闭症谱系障碍儿童害怕独自睡觉的修正认知行为疗法

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-05-26 DOI: 10.1177/15346501231179428

Esther Raminfar, Hilary B. Vidair, Emma Bernstein

引用次数: 0

Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in a Case of Ultra-High Risk for Psychosis With Emotional Comorbidity 应用统一的情绪障碍跨诊断治疗方案治疗伴有情绪合并症的超高风险精神病1例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-05-26 DOI: 10.1177/15346501231179250

T. Peláez, Raquel López-Carrillero, Judit Subirana-Mirete, S. Ochoa, J. Osma

{"title":"Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in a Case of Ultra-High Risk for Psychosis With Emotional Comorbidity","authors":"T. Peláez, Raquel López-Carrillero, Judit Subirana-Mirete, S. Ochoa, J. Osma","doi":"10.1177/15346501231179250","DOIUrl":"https://doi.org/10.1177/15346501231179250","url":null,"abstract":"This case study aims to describe the application of the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders in the case of a 30-year-old patient with a diagnosis of Ultra-high Risk for Psychosis (UHR) and comorbid anxiety and depression. UP is a psychological intervention that uses cognitive-behavioral techniques whose objective is to reduce emotional dysregulation, which is one of the transdiagnostic mechanisms of emotional disorders. UP has demonstrated its efficacy in samples of patients with emotional disorders. Frank was a 30-year-old man diagnosed with UHR and other emotional disorders (major depressive disorder, bulimia nervosa, generalized anxiety disorder, and social anxiety disorder) who underwent the UP intervention in 15 group and online sessions, lasting 2 hours each, over the course of 4 months. At the 6-month follow-up evaluation, Frank presented significant improvement in all emotional and functioning variables: anxious and depressive symptoms, negative and positive affect, neuroticism and extraversion, emotional dysregulation, maladjustment, and quality of life. There was also a reduction in subthreshold psychotic symptoms. Frank no longer met the criteria for any emotional disorder. We also found an improvement trend, although not significant, in other variables such as insight and cognitive biases measured with specific questionnaires for psychosis. Frank attended all treatment and follow-up sessions and rated the program very positively. UP may be a clinically useful treatment for young people with comorbid UHR and emotional disorders in the early stages of mental health illnesses that could improve clinical and functional outcomes.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42232131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combined ACT-Based Contingency Contracting Intervention for Aggressive Behavior and Psychologically Flexibility in an Adolescent With Comorbid Autism, Bipolar Disorder, and Schizophrenia 基于ACT的联合应急契约干预对患有自闭症、双相情感障碍和精神分裂症的青少年攻击行为和心理灵活性的影响

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-05-03 DOI: 10.1177/15346501231171867

Raymond Burke, Elana Sickman, Jordan Belisle, Steve Taylor, Dana Paliliunas

{"title":"Combined ACT-Based Contingency Contracting Intervention for Aggressive Behavior and Psychologically Flexibility in an Adolescent With Comorbid Autism, Bipolar Disorder, and Schizophrenia","authors":"Raymond Burke, Elana Sickman, Jordan Belisle, Steve Taylor, Dana Paliliunas","doi":"10.1177/15346501231171867","DOIUrl":"https://doi.org/10.1177/15346501231171867","url":null,"abstract":"Comorbid diagnoses including autism spectrum disorder, bipolar disorder, schizophrenia, and intellectual disability can present a variety of personal barriers and challenges to interventions that promote safety and autonomy. The current case study provides an overview of a 10-week intervention that included elements of Acceptance and Commitment Therapy and contingency contracting to target psychological flexibility and aggressive behavior in a 17-year-old presenting with these comorbid diagnoses. The treatment was fully individualized to include the client’s interests in Star Wars and focused on supporting the client’s self-identified valued outcomes associated with independent living. Prior to intervention, baseline data showed high levels of aggressive behavior in both frequency and duration, and low levels of psychological flexibility and adaptive behaviors were reported. Following implementation of the combined intervention, aggressive behavior reduced significantly below baseline levels, psychological flexibility improved, and the client engaged in a greater frequency of adaptive behaviors relative to baseline. Positive outcomes were also maintained 1-month and 1-year following the intervention. Implications of this case for clinicians and staff are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43328836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Intervention Program for Families of Adults on the Autism Spectrum: A Case Study 自闭症谱系成人家庭干预计划的个案研究

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-04-17 DOI: 10.1177/15346501231170149

Daina M. Tagavi, Gary A. Stobbe, K. Bearss

引用次数: 0