Recent research: mindfulness (mechanisms & practice), prevalence (abuse & suicidality), health anxiety imagery & CBT for kids

Here are half a dozen recent research studies - two on aspects of mindfulness, two on sobering prevalence rates, one on imagery in health anxiety, and one on CBT with children.  Fuller details, links and abstracts for all studies are listed further down this page.  Willem Kuyken and colleagues looked at "How does mindfulness-based cognitive therapy (MBCT) work?" in helping recurrent depression sufferers.  They came up with some fascinating and provocative findings.  For example it appears that MBCT acts differently from standard CBT, although they are both helpful in reducing risk of depressive relapse.  Standard CBT (and maintenance antidepressants too) reduce cognitive reactivity to experiences of induced low mood, and this appears important in how they lessen relapse risk.  MBCT however seems to act not by reducing cognitive reactivity so much as by decoupling the reactivity from a tendency then to slide into depression.  It appears this decoupling is mediate

Handouts & questionnaires for increasing access to psychological therapies (IAPT) outcomes toolkit, an upgrade

Over nearly 35 years of practice as a doctor and psychotherapist I've assembled a collection of 300 to 400 handouts and questionnaires that I use in my work.  I'm gradually uploading most of these handouts to this website so people can use any that they'd like to.  The collection is searchable in the Good Knowledge section of the site at Handouts, questionnaires and other leaflets.  Of the twenty two subsections on this part of the website, one of the more frequently visited areas is the Increasing access to psychological therapies (IAPT) outcomes toolkit.  This is a pretty full hand of cards for the recommended IAPT assessment measures.  I've recently updated the list of downloadable questionnaires available by including:

Handouts & questionnaires for health anxiety disorder

Here are the two main questionnaires currently used to assess Health Anxiety Disorder - the HAI and the HAQ.  The HAI is the one recommended by the NHS Improving Access to Psychological Therapies (IAPT) initiative.  I've also added a scale put together by Adrian Wells that assesses safety behaviours and extent of disease belief.  Finally there is a classic CBT thoughts record.  I don't use these kinds of records much any more, but I've added it for 'completeness'.

Health anxiety inventory (HAI) - the 18 item (short form) HAI is the disorder specific scale recommended by the IAPT initiative.  The third page of the download gives typical scores for a Health Anxiety group, a more general anxiety group, a control group, and so on.   

Health anxiety questionnaire (HAQ) - this 21 item health anxiety questionnaire yields four subscales, which can make it easier therapeutically to target specific behaviours like reassurance seeking.  The third page of the download gives some idea of likely scores in different disorders.

Recent research: half a dozen studies on cognitive therapy

Here are half a dozen recent studies involving cognitive therapy (CBT).  The first by Craigie et al explores the use of mindfulness-based cognitive therapy (MBCT) to treat generalized anxiety disorder (GAD).  Although, as one would expect, MBCT helped GAD sufferers, it was noteworthy that results "fall well short of outcomes achieved by past research".  This adds to my concern that mindfulness training may at times be being over-hyped - see a blog I wrote in September for for more on this.  The next study by Cuijpers et al also suggests limitations to the march of CBT with interpersonal psychotherapy looking a somewhat better candidate for prevention of depression onset.  I guess one could argue that CBT can - and probably more often should - include  behavioural interventions to promote improved relationships.  Click here for tools that can help this approach.   The third piece of research by Grey et al is exciting.  It challenges the Alice in Wonderland dodo bird suggestion that "everyone has won, and all must have prizes"

Handouts & questionnaires for “outcomes toolkit” (IAPT)

The "Improving Access to Psychological Therapies" (IAPT) initiative is very ambitious and exciting.  It states its principal aim is to support English Primary Care Trusts in implementing "National Institute for Health and Clinical Excellence" (NICE) guidelines for people suffering from depression and anxiety disorders.  IAPT go on to say that "At present, only a quarter of the 6 million people in the UK with these conditions are in treatment, with debilitating effects on society."

One aspect of this carefully planned initiative is strong encouragement to assess and monitor the progress of those who are getting help.  Visiting the IAPT "Outcomes Toolkit and FAQ" web page provides access to several freely downloadable documents.  The emphasis is on good assessment measures that are free to use.  See below:

IAPT Outcomes Toolkit 2008/9 PDF - this 81 page 1.1Mb Adobe PDF is the September 08 version with amended IAPT Paper Based Data Set Questionnaires.

I thank You God for most this amazing day: for the leaping greenly spirits of trees and a blue true dream of sky; and for everything which is natural which is infinite which is yes.
- E E Cummings

Somatoform disorders

Sufferers from somatoform disorders report physical symptoms that, despite full investigation, are not adequately explained by a medical illness, substance abuse, or another psychological disorder. The somatoform disorders category includes health anxiety disorder (hypochondriasis), somatization disorder, body dysmorphic disorder, and other related conditions.

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