“Life coaching” is a rapidly expanding profession born out of an unmet need for help effecting change, frustration with traditional models, the stigma attached to seeking care, and the online ...“Uberization” of many new services. But the distinctions often drawn between life coaching and psychotherapy are increasingly blurry, raise important questions about where coaching ends and therapy begins, and risk confusion between the two helping professions among vulnerable patients. This is potentially serious, in part because life coaching operates in a regulatory vacuum, with no education, training, licensing, or supervision requirements for coaches and no specific legal protections for any harmed clients. Although increased access to new forms of help is a positive development, the risk that mentally ill patients may undergo life coaching rather than receive proven psychotherapy treatments raises concerns about patient safety. It can also trigger fears of professional replacement among mental health providers whose education, preparation, and practice parameters are rigorously defined and closely scrutinized. More research is needed to prove the efficacy and safety of life-coaching modalities, and meaningful action is required at the level of training, oversight, and legislation to help protect patients and clarify roles.
Compulsive buying disorder (CBD) refers to the chronic purchasing of unneeded or unwanted items, causing significant negative consequences. There are no established criteria for CBD, and operational ...definitions have relied on similarities with OCD, substance use disorders, and impulse control disorders. Compulsive buying disorder is common, affecting 5.8% of the general population, according to one study. Typically, CBD has early onset, frequent comorbidities, and a chronic course. The etiology of CBD is unknown, with biological, psychological and sociocultural factors proposed as likely contributors. Treatment data are limited and suggest addressing comorbid conditions and considering cognitive behavioral therapy, financial and family counseling, selective serotonin reuptake inhibitors, and naltrexone, among other possible interventions, to target CBD. Beyond treatment, educational, legislative and family-based public policy initiatives can likely help individuals with CBD and other excessive spenders.
Cyberbullying: Review of an Old Problem Gone Viral Aboujaoude, Elias, M.D., M.A; Savage, Matthew W., Ph.D; Starcevic, Vladan, M.D., Ph.D ...
Journal of adolescent health,
07/2015, Letnik:
57, Številka:
1
Journal Article
Recenzirano
Abstract Purpose Despite being relatively new, cyberbullying is now well recognized as a serious public health problem affecting children and adolescents. Scientific exploration has lagged media ...attention, but a synthesis of studies across several disciplines permits an understanding of its epidemiology, phenomenology, mental health dimensions, and management tools. Methods To assess current knowledge of cyberbullying, we searched the MEDLINE, PubMed and PsycINFO databases for articles on “cyberbullying” and related designations. The Google search engine was used to capture otherwise unpublished legislative, governmental, and community response data and to help identify relevant books and book chapters. Results A significant proportion of children and adolescents (20%–40%) have been victims of cyberbullying, with females and sexual minorities seemingly at higher risk. Perpetrators are more likely to be male. By nature of the electronic platform, there seems to be an easier path to the bully-victim phenomenon (victims who become bullies or vice versa) than that in traditional bullying. A nonlinear relationship with age is suggested, but demographic data overall are preliminary. Accompanying psychopathology, including an increasingly well-established link to suicidality, is common. Several prevention and management approaches have been proposed to help prevent cyberbullying or mitigate its effects. Discussion Cyberbullying's seeming ubiquity, its disproportionate toll on vulnerable populations (e.g., children and sexual minorities), the link with suicidality, and the expected continued rise in Internet penetrance and connectivity make confronting it an urgent matter. A multipronged approach is most likely to succeed and would include: educational media campaigns; school-based programs; parental oversight and involvement; legislative action; and screening and evidence-based interventions by health care providers, especially pediatricians and mental health professionals. Conclusions More research is needed into cyberbullying, but available data suggest a serious problem whose consequences are real and should not be dismissed as a “virtual” by-product of an increasingly digitalized childhood and adolescence.
Treatment-resistant OCD: Pharmacotherapies in adults van Roessel, Peter J.; Grassi, Giacomo; Aboujaoude, Elias N. ...
Comprehensive psychiatry,
January 2023, 2023-Jan, 2023-01-00, 20230101, 2023-01-01, Letnik:
120
Journal Article
Recenzirano
Odprti dostop
Serotonin reuptake inhibitor (SRI) medications are well established as first-line pharmacotherapeutic treatment for Obsessive-Compulsive Disorder (OCD). However, despite the excellent safety profile ...and demonstrated efficacy of these medications, a substantial proportion of individuals with OCD fail to attain sufficient benefit from SRIs.
In this narrative review, we discuss clinical features of OCD that have been associated with poorer response to SRIs, and we present pharmacotherapeutic interventions that have been explored as augmenting or alternative treatments for treatment-resistant OCD. We additionally highlight non-SRI interventions for OCD that are currently under investigation.
Pharmacotherapeutic interventions were identified via expert consensus. To assess the evidence base for individual pharmacotherapies, targeted searches for relevant English-language publications were performed on standard biomedical research databases, including MEDLINE. Information relevant to ongoing registered clinical trials in OCD was obtained by search of ClinicalTrials.gov. Pharmacotherapies are grouped for review in accordance with the general principles of Neuroscience-based Nomenclature (NbN).
Clinical features of OCD that may suggest poorer response to SRI treatment include early age of onset, severity of illness, duration of untreated illness, and the presence of symmetry/ordering or hoarding-related symptoms. Based on evolving pathophysiologic models of OCD, diverse agents engaging serotonin, dopamine, norepinephrine, glutamate, and anti-inflammatory pathways have been explored as alternative or adjunctive therapies for treatment-resistant OCD and have at least preliminary evidence of efficacy.
Medications with dopamine antagonist activity remain the most robustly evidence-based of augmenting interventions, yet dopamine antagonists benefit only a minority of those who try them and carry elevated risks of adverse effects. Interventions targeting glutamatergic and anti-inflammatory pathways are less well evidenced, but may offer more favorable benefit to risk profiles. Ongoing research should explore whether specific interventions may benefit individuals with particular features of treatment-resistant OCD.
•Many individuals with OCD do not sufficiently benefit from first-line treatment with serotonin reuptake inhibitors.•A broad range of pharmacotherapies have been explored as adjunctive or alternative interventions for treatment-resistant OCD.•Glutamatergic and anti-inflammatory interventions, among others, may offer favorable benefit to risk profiles.•Dopamine antagonist treatments remain the best evidenced augmentation strategy for treatment-resistant OCD.
We report the case of a biological female with gender identity-related doubts that were misconstrued as suggesting obsessive-compulsive disorder (OCD). The patient's parent seemed to favor an OCD ...explanation for the gender-based self-questioning over acceptance of possible transgender identity. We discuss what OCD is and what it is not in the context of gender identity-based doubt; analogy with the better studied sexual orientation-related OCD; cultural flashpoints around sex and gender that can become the object of OCD; how confusion about biological sex, assigned gender and gender identity can lead to clinical harm; and the role of mental health professionals in fighting the stigma faced by gender minorities.
Scientific literature from the last two decades indicates that, when it comes to mental health, technology is presented either as panacea or anathema. This is partly because researchers, too ...frequently, have planted themselves either in the field of digital mental health interventions (variably called "telepsychiatry", "digital therapeutics", "computerized therapy", etc.), or in that of the problems arising from technology, with little cross-fertilization between the two. Yet, a closer look at the two fields reveals unifying themes that underpin both the advantages and dangers of technology in mental health. This article discusses five such themes. First, the breakneck pace of technology evolution keeps digital mental health interventions updated and creates more potentially problematic activities, leaving researchers perennially behind, so new technologies become outdated by the time they are studied. Second, the freedom of creating and using technologies in a regulatory vacuum has led to proliferation and choice, but also to a Wild-West online environment. Third, technology is an open window to access information, but also to compromise privacy, with serious implications for online psychology and digital mental health interventions. Fourth, weak bonds characterize online interactions, including those between therapists and patients, contributing to high attrition from digital interventions. Finally, economic analyses of technology-enabled care may show good value for money, but often fail to capture the true costs of technology, a fact that is mirrored in other online activities. The article ends with a call for collaborations between two interrelated fields that have been-till now-mutually insular.
We aimed to assess the popularity and perceived effectiveness of smartphone tools that track and limit smartphone use. We also aimed to explore how a set of variables related to mental health, ...smartphone use, and smartphone addiction may influence the use of these tools. First, we conducted a web-based survey in a representative sample of 1989 US-based adults using the crowdsourcing platform Prolific. Second, we used machine learning and other statistical tools to identify latent user classes; the association between latent class membership and demographic variables; and any predictors of latent class membership from covariates such as daily average smartphone use, social problems from smartphone use, smartphone addiction, and other psychiatric conditions. Smartphone tools that monitor and control smartphone use were popular among participants, including parents targeting their children; for example, over two-thirds of the participants used sleep-related tools. Among those who tried a tool, the highest rate of perceived effectiveness was 33.1% (58/175). Participants who experienced problematic smartphone use were more likely to be younger and more likely to be female. Finally, 3 latent user classes were uncovered: nonusers, effective users, and ineffective users. Android operating system users were more likely to be nonusers, whereas younger adults and females were more likely to be effective users. The presence of psychiatric symptoms did not discourage smartphone tool use. If proven effective, tools that monitor and control smartphone use are likely to be broadly embraced. Our results portend well for the acceptability of mobile interventions in the treatment of smartphone-related psychopathologies and, potentially, non–smartphone-related psychopathologies. Better tools, targeted marketing, and inclusive design, as well as formal efficacy trials, are required to realize their potential.
There is wide agreement that the Internet can serve as a tool that enhances well-being. It is more difficult, however, to find consensus around the issue of problematic Internet use. That may be in ...part because scientific investigation has lagged far behind technological advances and media attention. The diagnostic schemas that have been proposed since 1996, and the screening tools that have been developed, stress similarities with substance use, impulse control disorders, and obsessive-compulsive disorder. Prevalence figures vary as a function of the diagnostic definition used, the age group studied, and whether the surveys were conducted online. Studies suggest high comorbidity rates with mood disorders and, among younger individuals, attention-deficit/hyperactivity disorder. Treatment should address any comorbid conditions present, as those may be causing, or exacerbating, problematic Internet use. Interventions that may specifically target problematic Internet use include cognitive behavioral therapy and selective serotonin reuptake inhibitors, but detailed guidelines must await further studies. For a medium that has so radically changed how we conduct our lives, the Internet's effects on our psychology remain understudied. More research is needed into the pathophysiology, epidemiology, natural course, and treatment of problematic Internet use. In addition, the more subtle psychological changes, such as disinhibition, that seem to characterize people's online behavior also deserve attention, even if they cannot be seen as necessarily pathological.
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