1,721,046 research outputs found
Allostatic load in children and adolescents: a systematic review.
No full textThe concept of allostatic load encompasses the cumulative effects of both ordinary daily life events as well as major challenges, and also includes related health-damaging behavior. Allostatic overload ensues when environmental challenges exceed the individual's ability to cope. Identification of allostatic load is carried out through the use of biomarkers and clinimetric criteria. Studies are increasingly reported on allostatic load in younger populations, yet a systematic review is missing.
The aim of the present systematic review was to summarize the current knowledge on allostatic load/overload among children and adolescents.
PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to April 2023. A manual search of the literature was also performed. We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical populations younger than 18 years.
A total of 38 original investigations were included in this systematic review. Studies reported an association between allostatic load and sociodemographic characteristics (e.g., poverty, ethnicity, perceived discrimination, adverse childhood experiences) and environmental factors, as well as consequences of allostatic load on both physical and mental health among children and adolescents.
The findings indicate that greater allostatic load is associated with poorer health outcomes in both clinical and non-clinical pediatric populations, with possible enduring effects. The results support the clinical utility of the transdiagnostic identification of allostatic load and overload in children and adolescents across a variety of settings, with a number of potential clinical implications
Emerging trends in clinical psychology
No full textThe potential growth of clinical psychology lie in its capacity to progress in emerging lines of research that have been developed. The first line is concerned with psychological assessment. A second line of research is concerned with psychobiologic exploration of clinical states. A third line of research is concerned with psychotherapy. These emerging trends of clinical psychology provide important opportunities for development
The psychosomatic practice
No full textThere is increasing awareness of the limitations of the disease-oriented approach in medical care. The primary goal of psychosomatic medicine is to correct this inadequacy by incorporation of innovative operational strategies into clinical practice. Psychosomatic practice can be recognized by 2 distinctive features: the holistic approach to patient management (encompassing psychosocial factors) and the clinical model of reasoning (which reflects a multifactorial frame of reference). A basic psychosomatic assumption is the consideration of patients as partners in managing disease. The partnership paradigm includes collaborative care (a patient-physician relationship in which physicians and patients make health decisions together) and implementation of self-management (a plan that provides patients with problem-solving skills to enhance their self-efficacy). Pointing to strategies that focus on individual needs may improve patient quality of life and final outcomes
The clinical role of well-being therapy
No full textPurpose: There are several clinical areas where psychological well-being may play an important role: the assessment of the dynamic balance between ill-being and well-being; reduction of incidence, prevention of recurrence and achievement of full recovery in psychiatric disorders such as depression; patient’s satisfaction and perceived change after treatment. The aim of this article is to discuss the clinical role of Well-Being Therapy (WBT). Materials and methods: A critical review of the literature concerned with psychological well-being and its treatment was performed. WBT is a short-term psychotherapeutic strategy that emphasizes self-observation of psychological well-being, with the use of a structured diary, cognitive restructuring of interfering thoughts and/or behaviors through cognitive behavioral techniques, and homework assignments (i.e. pursuing optimal experiences). WBT is based on a multidimensional model of psychological well-being that was originally developed by Marie Jahoda and it is aimed at achieving a state of euthymia. Results: WBT has been validated in a number of randomized controlled trials. The sequential combination of cognitive behavior therapy (CBT) and WBT has mainly characterized its use so far. Illustration of a clinical case exemplifies its application and the potential role of psychological well-being in the clinical process. Conclusions: Even though more randomized controlled trials concerned with WBT are needed, consideration of psychological well-being may unravel innovative approaches to the prevention, assessment and treatment of mood and anxiety disorders
The Clinical Utility of the Diagnostic Criteria for Psychosomatic Research: A Review of Studies
No full textBackground: The Diagnostic Criteria for Psychosomatic Research (DCPR) are a set of 12 psychosomatic syndromes and are provided with a reliable diagnostic structured interview. The DCPR have been proposed 20 years ago as an integrative assessment strategy that supplements the traditional psychiatric nosography for identifying patients within a given illness population whose psychosocial factors have clinical significance. This paper reviews their clinical utility, conceived as the degree and the amount of influence that the instrument has on multiple decisions and outcomes in clinical practice. Methods: Published reports which involved the use of the DCPR were identified by searching electronic databases. Studies which best displayed the clinical utility of the DCPR system were then selected and reviewed. Results: The DCPR system showed its clinical utility regarding the following clinical issues: (1) subtyping medical patients, (2) identifying subthreshold or undetected syndromes, (3) evaluating the burden of somatic syndromes, and (4) predicting treatment outcomes and identifying risk factors. Conclusions: The DCPR may help clinicians during the assessment process to recognize clinical conditions underlying symptom presentation, with important therapeutic and prognostic implications
Understanding Health Attitudes and Behavior
No full textIndividual attitudes and behavior related to health and disease are major components of clinical encounters. These factors shape lifestyle, presentation of symptoms, access to patient care, interactions between patients and physicians, adherence to medical advice, response to treatment. Health attitudes and behavior may range from anxiety and worry about illness, to various forms of denial, such as delay of seeking care and lack of adherence to treatment. When attitudes result in health-damaging behavior they may be particularly difficult to understand and become a source of frustration to both physicians and patients. Devising appropriate responses by health care providers may contribute to improving final outcomes and decrease health care costs. In particular, health behavior is likely to play a major role in the process of convalescence, in self-management of chronic conditions, in determining a state of recovery, and whenever a rehabilitation process is involved. Understanding the spectrum of health attitudes and behavior is also crucial for motivating people to make beneficial changes (lifestyle medicine), as well as for implementing safety procedures in the community.</p
Incremental Validity of the Diagnostic Criteria for Psychosomatic Research – Revised (DCPR-R) to Clinical Assessment in Primary Care
Full text linkPsychosocial problems are highly prevalent among primary care (PC) patients, but they often remain undetected using traditional classification systems. The aim of the present study was to test the incremental validity of the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R), in addition to standard psychiatric assessment based on DSM-5, with regard to the prediction of psychosocial functioning of PC patients. Two-hundred PC patients were consecutively recruited. A comprehensive assessment was performed using two clinical interviews and three self-rating questionnaires (the PsychoSocial Index [PSI], the Short-Form Health Survey [SF-12] and the Illness Attitude Scales [IAS]) for the assessment of psychopathology and psychosocial
functioning. Adding the DCPR-R to DSM-5, the amount of explained variance significantly increased by 9% to 16% in the PSI subscales, by 13% in the SF-12 mental component summary, and by 2% to 6% in the IAS scales. The joint use of DCPR-R and DSM-5 thus significantly increased the prediction of psychosocial functioning of primary care patients. These findings further support the use of the DCPR-R in PC settings, particularly in patients who do not satisfy DSM-5 criteria and yet present with high psychological distress, maladaptive illness behavior, impaired psychological well-being and quality of life
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