Cognitive Behavioral Therapy ; Child

OBJECTIVE: To explore the efficacy of the cognitive behavior therapy (CBT) for the treatment of chronic subjective tinnitus. METHOD: One hundred and fifty-seven patients were randomly divided into two groups. Sixty-eight patients of the control group were treated by masking therapy; and the other 89 patients of the experimental group were treated by CBT therapy. The score of tinnitus handicap inventory (THI) was utilized to analyze the treatment efficacy in the two groups respectively. RESULT: The effective rate assessed by of THI score in the experimental group was not significantly higher than the control group 2 months after treatment (P > 0.05), but was significantly higher than the control group 6 months and 12 months after treatment (P < 0.05 respectively). CONCLUSION The CBT therapy contributed to achieve rapid adaptation of tinnitus feeling, which shows great value of further clinical application.
Cognitive Behavioral Therapy ; Humans ; Tinnitus ; psychology ; therapy ; Treatment Outcome

Background and Objective: Mindfulness-based interventions (MBI), a novel treatment, and cognitive behavioral therapy (CBT), the standard treatment, are both effective in treating anxiety in adolescents. This study determined the effectiveness of mindfulness-based interventions versus cognitive behavioral therapy in reducing symptoms of anxiety among adolescents experiencing social anxiety through a systematic review and meta-analysis. Methods: A systematic approach was used to identify eligible studies. Electronic databases, reference lists of relevant articles, and gray literature were searched. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and subgroups. Heterogeneity was measured using visual assessment, the I2 statistic, and chi-square test. Results: Randomized controlled trials comparing MBI to CBT for adolescents diagnosed with social anxiety or social phobia disorder were analyzed, with non-randomized studies being excluded. Structured searches in electronic databases, reference lists, and gray literature were conducted by four independent reviewers who initially identified potential articles through title and abstract screening. After a comprehensive review of full-text articles and a consensus-building process, the selection of included articles was finalized. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and to examine subgroups, with heterogeneity being assessed through visual evaluation, the I² statistic, and chi-square tests. Total number of participants was 255; 101 were male and 158 were women. Mean age was 27.5 years old, and diagnosed with Social Anxiety Disorder, Social Phobia, or DSM-IV-Defined-Anxiety-Disorder. They were divided into two groups: 125 participated in 8- to 12-week MBI sessions lasting 2 hours each, while 130 underwent 2-hour CBT sessions spanning 8, 12, or 14 weeks. There is moderate quality of evidence reporting non-significant difference on MBI vs CBT's effectiveness in alleviating symptoms of social anxiety [mean (95% CI) = -0.04 (-0.58, 0.51)]. Conclusion Study found that there were no significant differences between Mindfulness-Based Interventions and Cognitive Behavioral Therapy in reducing social anxiety in adolescents. Mindfulness interventions have advantages in terms of cost-effectiveness for reducing symptoms of anxiety. Future research should include larger sample sizes and longer follow-up periods to further assess long-term effects of these interventions.
Adolescent ; Mindfulness ; Anxiety ; Cognitive Behavioral Therapy ; Occupational Therapy

Objective: As part of the thrust towards Universal Health Care, the Philippines has enhanced health insurance coverage for rehabilitation with recent introductions of benefits for disabilities in children, prostheses, and orthoses. The project aimed to develop a functionality-based framework to guide comprehensive benefits for rehabilitation services for adult Filipinos. Methods: Scoping review was conducted to identify common rehabilitation conditions, frameworks for clinical assessment, and essential services for rehabilitation. Key informant interviews and focus group discussions were conducted with targeted rehabilitation service providers and experts to validate the information collected. A unified pathway of care and essential services for the provision of rehabilitation medicine services was developed through triangulation. The study was conducted from October 2018 to September 2019, with activities done in Metro Manila. Results: The results summarized treatment pathways for four major disease categories: neurologic, musculoskeletal, chronic pain, and activities of daily living/ cardiopulmonary. Impairments were identified reflecting the principles from the International Classification of Function. Disabilities were categorized based on function: mobility, self-care, cognitive-behavioral, and communication. A unified care pathway was developed to harmonize rehabilitation assessment, management, and care. A framework to simplify financial coverage was likewise provided. The extent of management (e.g., duration of therapy) depends on the severity of the disability classified as mild, moderate, or severe. Based on this classification, essential management modalities included physiatry interventions, medications, and rehabilitation sessions, supported by outcomes evaluation. Conclusion A framework is proposed to guide the design and implementation of benefits and health insurance coverage. Awareness and application of this approach among rehabilitation practitioners and health facilities are essential steps for successful uptake and implementation of the upcoming expansion in PhilHealth coverage.
Rehabilitation ; Rehabilitation of Speech and Language Disorders ; Neurobehavioral Manifestations ; Cognitive Behavioral Therapy ; Behavioral Symptoms ; Communication Disorders ; Insurance, Major Medical

Mindfulness-based psychotherapy, known as the third-wave cognitive behavior therapy, showed a multi-cultural integration trend. As part of it, willing acceptance and commitment therapy not only took root in the discoveries in the fields of evolutionary psychology and cognitive psychology, but also absorbed the concepts of psychotherapy from Chinese traditional culture. As a result, it regards truth and harmony as the essence of health, proposes a triangle model (health/pain-willing acceptance-striving) to elucidate the mechanism of psychopathology and psychotherapy in theory. Operationally, it contains four principles of psychotherapy, which are as follow: "knowing yourself and others, reaction but adequately, reality as well as harmony, willing acceptance and striving". Furthermore, it proposes eight therapeutic procedures including "understand yourself, recognize suffering, check coping style, keep openness and acceptance, mindfulness and flexibility, live in the moment, clarify the value, and commit action". With these principles and procedures, willing acceptance and commitment therapy aims to fade the neural trace of patients' painful memories, improve their psychological flexibility and rebuild their lifestyles consistent with their values.
Acceptance and Commitment Therapy ; Adaptation, Psychological ; Cognitive Behavioral Therapy ; Humans ; Mindfulness ; Stress, Psychological

To investigate psychological characteristics in different clinical subgroups of insomniacs, and to provide the basis for the accurate simplification of cognitive behavioral therapy for insomnia.
 Methods: A total of 212 insomniacs from November 2014 to June 2017 in Clinical Psychology Department or Sleep Department of 2 general hospitals in Hunan Province were included in convenient and classified into sleep onset insomnia (SOI), difficulty maintaining insomnia (DMI), early morning awakening insomnia (EMAI), and combined insomnia (CI) subgroups. Ford Insomnia Response to Stress Test (FIRST), Simplified Coping Style Questionnaire (SCSQ), Dysfunctional Beliefs and Attitudes about Sleep Scale 16 version (DBAS-16), Sleep-Related Behavior Questionnaire (SRBQ), Pre-sleep Arousal Scale (PSAS), Center for Epidemiological Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI) were used to investigate the psychological characteristics.
 Results: SOI and CI insomniacs had a higher frequency in use of sleep-related behavior than those with DMI; CI had a higher frequency in use of sleep-related behavior than those with EMAI (all P<0.05). Both SOI and CI insomniacs had a higher level of pre-sleep cognitive arousal than DMI and EMAI (all P<0.05). CI insomniacs noticed more consequences of insomnia and had more worries on insomnia than DMI, and CI insomniacs had more expectations of sleep than SOI (all P<0.05).
 Conclusion: Insomniacs with different clinical subgroups have different features of psychological characteristics. Both the insomnia subgroups and the psychological characteristics should be taken into account when we simplify cognitive behavioral therapy for insomnia (CBT-I) precisely.
Anxiety ; Arousal ; Cognitive Behavioral Therapy ; Humans ; Sleep ; Sleep Initiation and Maintenance Disorders ; Surveys and Questionnaires

ABSTRACT The first dental examination is a major step that is affected by many factors and determines the dental treatment process. The main objective of this study was to evaluate the association of child temperament with child dental anxiety, parental dental anxiety, dental behaviour and dental caries. The study consisted of 100 children aged 3 to 6 who were attending their first dental examination and their accompanying parents. The Facial Image Scale (FIS), Frankl’s Behaviour Scale (FBS), Corah’s Dental Anxiety Scale (CDAS) and the Short Temperament Scale for Children (STSC) were used for assessment. The DMFT (decayed, missing and filled teeth) score of each child was recorded. Children who exhibited negative behaviour on the FBS had the highest rhythmicity scores (p = 0.008). The mean DMFT score of children in the rhythmicity temperamental dimension was relatively high (p = 0.008). The parents of children defined as negative on the FBS had high dental anxiety levels on CDAS (p < 0.001). Children whose parents had higher dental anxiety levels showed higher dental anxiety (p = 0.007). The success rate of dental treatment procedures may be increased by improving dentists’ knowledge of dental anxiety related to the child’s temperament and integrating parental support to reduce dental anxiety.
Dental Care for Children ; Dental Anxiety ; Cognitive Behavioral Therapy ; Temperament ; Dental Caries

OBJECTIVE: To investigate the characteristics of cognitive impairment in critical patients, and to explore the role of early cognitive intervention training in improving cognitive impairment in critical patients. METHODS: A prospective cohort study was conducted. 133 patients in conscious and normal intelligence admitted to intensive care unit (ICU) of Hefei Second People's Hospital from January 2015 to June 2018 were enrolled. The patients were divided into control group (n = 66) and cognitive intervention group (n = 67) according to random number table based on chronological number for entry into the study. Cognitive function was assessed by Montreal cognitive assessment scale (MoCA scale) within 24 hours after ICU admission. The patients in the cognitive intervention group received a series of scientifically designed cognitive training sessions (playing electronic musical keyboard, learning simple Spanish, clock-drawing, psychological intervention) for 2 months, and follow-up was completed if the patient was discharged from ICU. While the patients in the control group did not undertake any cognitive training. After 2 months, the cognitive function of patients in both groups were assessed with MoCA scale. Subgroup analysis was conducted according to different age groups (20-40 years old, 41-60 years old, 61-80 years old) to explore the effect of cognitive intervention training in different age groups. According to the subjective evaluation of the patient's ability to live 2 months after cognitive intervention by the patient or his relatives, receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of the total score of MoCA for patients' ability to live after cognitive intervention. RESULTS: 133 critical patients were enrolled in the final analysis. There was no significant difference in gender, age, education, complications, ICU hospitalization, sedative or analgesic drug usage between the two groups, indicating that the data of the two groups were balanced and comparable. No significant difference in MoCA scale total score or sub-item cognitive domain score within 24 hours of ICU admission was found between the two groups. After 2 months of intervention, the incidence of cognitive impairment in the cognitive intervention group was significantly lower than that in the control group [38.8% (26/67) vs. 60.6% (40/66), χ² = 6.321, P = 0.015]. The total score of MoCA scale and four sub-item cognitive domain scores including visual space and execution power, protection of memory, attention execution, and orientation in the cognitive intervention group were significant higher than those in the control group (MoCA scale total score: 26.73±1.92 vs. 24.95±2.26, visual space and executive power score: 4.39±0.70 vs. 3.95±0.88, protection of memory score: 8.91±1.03 vs. 8.24±1.37, attention execution score: 5.21±0.77 vs. 4.79±1.00, orientation score: 5.67±0.53 vs. 5.44±0.68, all P < 0.05), but no significant difference was found in verbal skills score (2.55±0.56 vs. 2.53±0.56, P > 0.05). Subgroup analysis showed that the total MoCA scale score of the younger sample (20-40 years old, n = 20) was recovered by 2.10±1.55 in the cognitive intervention group after 2 months of cognitive intervention, which was significantly higher than that in the control group (n = 21; 0.24±2.76, P < 0.05). In the middle-aged and the older population [aged 41-60 years old (n = 20) and 61-80 years old (n = 27)], the total MoCA scale scores were recovered slightly after cognitive intervention as compared with those in the younger sample (0.43±1.47, -1.91±2.20 vs. 2.10±1.55, both P < 0.05), which were significantly lower than those in the control group [aged 41-60 years old (n = 21) and 61-80 years old (n = 24), -0.78±1.38, -4.41±2.17, both P < 0.01]. It was suggested that cognitive intervention training played an active role in the recovery of cognitive function in young critical patients. It was shown by ROC curve analysis that the area under ROC curve (AUC) of MoCA scale total score for predicting daily life ability after cognitive intervention was 0.732 with 95% confidence interval (95%CI) of 0.646-0.819. When the best cut-off value was 24.5, the sensitivity was 89.3%, the specificity was 60.2%, the positive predictive value was 85.7%, and the negative predictive value was 80.8%. CONCLUSIONS Early cognitive intervention could efficiently abate the deterioration of cognitive function in critical patients in ICU and had significant effects on the visual space and executive power, protection of memory, attention execution and orientation. Cognitive intervention exerted significantly positive effects on the recovery of cognitive function in the younger sample population (aged 20-40 years old).
Adult ; Aged ; Aged, 80 and over ; Cognitive Behavioral Therapy ; Cognitive Dysfunction/prevention & control* ; Critical Care ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult