what are the implications for treatment?

Implications for treatment: GABAA receptors in aging, Down syndrome and Alzheimer's disease In addition to progressive dementia, Alzheimer's disease (AD) is characterized by increased incidence of seizure activity.

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What are the implications of clinical practice guidelines on medication safety?

Naltrexone. Naltrexone is available as an oral medication (Revia ®) and in two injectable forms (Vivitrol ® and Naltrel ®).Its primary use is for the treatment of alcohol dependence, and it is well tolerated with primarily gastrointestinal side effects (O’Malley et al. 1992; Volpicelli et al. 1992).Naltrexone’s efficacy in reducing alcohol drinking is believed to be mediated through ...

What are the implications for practice across research papers?

The biology of trauma: implications for treatment During the past 20 years, the development of brain imaging techniques and new biochemical approaches has led to increased understanding of the biological effects of psychological trauma. New hypotheses have been generated about brain development and the roots of antisocial behavior.

How can clinicians and policymakers improve medication-taking?

Craving Research: Implications for Treatment. Many researchers and clinicians consider craving an important contributor to the development and maintenance of alcoholism (1). Craving has been described as a powerful urge to drink or as intense thoughts about alcohol. The International Classification of Diseases (ICD–10) includes craving as an ...

What are the concerns about overmedicalisation of medications?

Jul 07, 2015 ·

What is the treatment for alcoholism?

In alcoholism treatment, this approach helps the patient recognize the cues that lead to drinking so as to be better prepared to deal with them when encountered.

How does alcohol affect the brain?

Alcohol consumption may initiate the process of reinforcement by activating a "reward center" located deep within the brain. The reward center is linked to other brain areas involved in aspects of emotion, learning, and memory. Interactions among these sites could account for the processes by which (1) emotion-laden memories of past positive drinking experiences become associated with cues, and (2) exposure to such cues can activate the reward center in the absence of alcohol, potentially leading to craving during abstinence. These processes are unconscious. However, the reward center also communicates with brain areas that appear to underlie higher intellectual (i.e., cognitive) functions such as judgment and decisionmaking. Because of this, heavy drinking may ultimately impair conscious processes that support the ability to cope with drinking urges (6).

What is the best treatment for verbal alcoholism?

Pharmacotherapy . The results of craving research have spurred the development of new medications to supplement verbal alcoholism therapies. Among the most promising of such medications are naltrexone (ReViaT) and acamprosate.

What are the risks of transgender youth?

Transgender female youth (age 16–24) are at high risk for polysubstance abuse and HIV infection with comorbid concerns such as PTSD, gender-related discrimination, psychological distress, and parental drug and alcohol problems [ 95 ].

Is substance use disorder heterogeneous?

Individuals with substance use disorders (SUD) are heterogeneous, making comprehensive assessment an essential part of treatment planning. Since a variety of pharmacological and psychosocial treatments are available, patient needs and characteristics, as well as substance-specific treatment options must be taken into account.

Is a woman at greater risk for a variety of medical and psychosocial consequences?

Women are at greater risk for a variety of medical and psychosocial consequences , and may benefit from pharmacological and/or behavioral therapies that differ from those most beneficial for men. Pregnancy and gender identity also warrant special consideration.

Does endocrinology cause SUD?

These data indicate endocrinology contributes to a person’s risk for developing SUD. Recent findings underscore our need to focus on female populations, particularly those experiencing fluctuations and shifts in hormone levels such as puberty, pregnancy, and during menopause.

How does the autonomic threat response system affect mental health?

The human nervous system is tuned to detect safety and danger, integrating body and brain responses via the autonomic nervous system. Shifts in brain-body states toward danger responses can compromise mental health. For those who have experienced prior potentially traumatic events, the autonomic threat response system may be sensitive to new dangers and these threat responses may mediate the association between prior adversity and current mental health. Method: The present study collected survey data from adult U.S. residents (n = 1,666; 68% female; Age M = 46.24, SD = 15.14) recruited through websites, mailing lists, social media, and demographically-targeted sampling collected between March and May 2020. Participants reported on their adversity history, subjective experiences of autonomic reactivity, PTSD and depression symptoms, and intensity of worry related to the COVID-19 pandemic using a combination of standardized questionnaires and questions developed for the study. Formal mediation testing was conducted using path analysis and structural equation modeling. Results: Respondents with prior adversities reported higher levels of destabilized autonomic reactivity, PTSD and depression symptoms, and worry related to COVID-19. Autonomic reactivity mediated the relation between adversity and all mental health variables (standardized indirect effect range for unadjusted models: 0.212–0.340; covariate-adjusted model: 0.183–0.301). Discussion: The data highlight the important role of autonomic regulation as an intervening variable in mediating the impact of adversity on mental health. Because of the important role that autonomic function plays in the expression of mental health vulnerability, brain-body oriented therapies that promote threat response reduction should be investigated as possible therapeutic targets.

What is CASe formulation incorporating risk assessment?

Craig and Rettenberger proposed an etiological approach to sexual offender assessment integrating the key developmental, offending behavior, and risk‐assessment theory into one model, referred as the CAse Formulation Incorporating Risk Assessment (CAFIRA) model. This chapter seeks to update the model by incorporating neurobiological and neuropsychological influences taken from the neuroscience literature. One case formulation approach commonly discussed in the literature and already adapted to the field of sexual offender assessment is the “Five Ps” method, which encompasses presenting problem, predisposing factors, precipitating factors, perpetuating factors, and protective/positive factors. The chapter describes each of the Five Ps in more detail with specific reference to sexual offender risk assessment. It argues that protective factors should be more incorporated in risk formulations, particularly where they relate to the potential value that protective factors have for evaluating the treatment effectiveness.

How does eye movement affect episodic memory?

Two experiments examining effects of eye movements on episodic memory retrieval are reported. Thirty seconds of horizontal saccadic eye movements (but not smooth pursuit or vertical eye movements) preceding testing resulted in selective enhancement of episodic memory retrieval for laboratory (Experiment 1) and everyday (Experiment 2) events. Eye movements had no effects on implicit memory. Eye movements were also associated with more conservative response biases relative to a no eye movement condition. Episodic memory improvement induced by bilateral eye movements is hypothesized to reflect en-hanced interhemispheric interaction, which is associated with superior episodic memory (S. D. Christman & R. E. Propper, 2001). Implications for neuropsychological mechanisms underlying eye movement desensitization and reprocessing (F. Shapiro, 1989, 2001), a therapeutic technique for posttraumatic stress disorder, are discussed. Christman and Propper (2001) reported that the explicit retrieval of episodic memories is facilitated by increased interaction between the two cerebral hemispheres. In one experiment, familial left-handedness, associated with lesser cerebral asymmetry and greater interhemispheric interaction (e.g., Gorynia & Egenter, 2000; Marino & McKeever, 1989; McKeever, VanDeventer, & Suberi, 1973), was associated with superior performance on a test of episodic memory. In a second experiment, inter-versus intrahemispheric pro-cessing was directly manipulated by sequentially presenting input to either the same or a different visual field. Superior episodic memory was associated with between-hemispheres presentation of input, whereas semantic memory was supe-rior for within-hemisphere presentation. These findings pro-vide a complement to research indicating that patients who have undergone a commisurotomy (split-brain procedure), who exhibit no direct interhemispheric interaction, display impaired episodic but normal semantic memory (e.g., Cro-nin-Golomb, Gabrieli, & Keane, 1996; Zaidel, 1995). Further support for an interhemispheric basis of episodic memory comes from brain imaging studies. Cabeza and Nyberg (2000) reviewed 275 studies comparing brain ac-tivity during different memory tasks with activity under baseline conditions. During episodic encoding, "prefrontal activations were always left-lateralized" (p. 23), whereas "prefrontal activations during episodic retrieval are some-times bilateral, but they show a clear tendency for right-lateralization" (p. 26). In contrast, "activity during semantic memory tasks has been almost always found in the left hemisphere but not in the right" (p. 20). Thus, encoding and retrieval of episodic memories is distributed across both hemispheres, whereas semantic encoding and retrieval (at least for verbal material) is restricted to areas within the left hemisphere. These results are consistent with an inter-ver-sus intrahemispheric basis for episodic versus semantic memories, respectively. The current study addressed the inter-versus intrahemi-spheric bases for different types of memory by examining a potential method for enhancing interhemispheric interac-tion, independent of participant (e.g., handedness) and task (e.g., within-vs. between-hemispheres presentation of in-put) manipulations as used by Christman and Propper (2001). Bilateral eye movements were used as a means of temporarily increasing the amount of interhemispheric in-teraction. The underlying logic for the use of bilateral eye movements is as follows. First, there is a link between eye movements and hemi-spheric activation, with lateral eye movements leading to a sustained increase in activation of the contralateral hemi-sphere (Bakan & Svorad, 1969). Thus, sequences of left– right bilateral eye movements presumably result in simul-taneous activation of both cerebral hemispheres. As the protocol used by Bakan and Svorad (1969) was not de-signed to measure the time constant of this activation, it is possible that alternating left–right eye movements might result in rapidly alternating, instead of simultaneous, acti-vation of the two hemispheres. For current purposes, how-ever, it is assumed that either possibility may result in increased bihemispheric activation, which in turn is hypoth-esized to enhance interhemispheric interaction. Research from our lab (Christman & Garvey, 2001) dem-onstrated that engaging in 30 s of bilateral saccadic eye

What does it mean to have symptoms in therapy?

So they are not only the means of access to the underlying problem but also indicators of the resolution of the problem. Sometimes in the early stages of therapeutic work, people experience new symptoms or an increase of existing ones. This can be interpreted in two ways. It may be seen as evidence of an uncovering of what is the underlying problem, or it can be seen as ‘getting worse’. When people have the expectation that symptoms should be eliminated as evidence of progress or ‘getting better’, this may undermine the therapy. Clients who have accepted medication may not expect an increase of symptoms unless this is discussed early on in the process of contracting. It follows that suppression of symptoms with drugs may prevent monitoring of progress.

Why did Ian go to therapy?

Ian had come for therapy to deal with relationship difficulties where he and his partner kept having rows over trivial matters and he finished up devastated for days. He had not discussed the drugs in depth because he did not think they were part of the problem and he was only taking ‘a low dose’. By chance he went away on a business trip and forgot to take the drugs with him and after three days felt nauseous, shaky and dizzy. He rang me and was shocked when I suggested he was having a withdrawal reaction and should restart the drugs immediately which should correct it. Were the drugs connected to the rows and relationship difficulties in any way I wondered?

What does Kahn say about psychotherapy?

Kahn (1993) suggests that most research assumes that psychotherapy and drugs work additively on different aspects of illness; psychotherapy for social functioning and medication for abnormal mood and thought content. This is probably a widely held view and would explain how medication and psychotherapy are so frequently combined. However it assumes that thinking and mood are abnormal and not related to the rest of psychological functioning or what is happening in a person’s life.

What is the Kahn study?

Kahn refers to the Boston–New Haven Collaborative Study of Depression, which produced four negative hypotheses. Firstly they propose that drugs are a negative placebo, increasing dependency and prolonging psychopathology. Secondly they point out that drug relief of symptoms could reduce motivation for therapy. Thirdly they suggest that drugs could eliminate one symptom but create others by substitution if underlying conflicts remain intact. And fourthly, they propose that drugs decrease self-esteem by suggesting that people are not interesting enough, or suited to, or capable of insight-oriented work.

What are the factors that influence medication adherence?

This literature has evolved over the last few decades and has considered populations from all around the world. It has uncovered a variety of important social and behavioural factors that influence medication adherence, including culture, stigma, and ethnicity. There has also been a particular focus on the provision of medications in areas where there are concerns about overmedicalisation, such as opioid overuse [ 12] and overtreatment of mental illnesses such as depression [ 13 ]. Given the complex interplay of biological, psychological and social factors that is likely to be at play when individuals make choices about medication adherence, the in-depth and interpretive nature of qualitative research is well suited to uncover important insights.

Why do people resist medication?

There has been interest in medication choices for several decades [ 39] and observational studies have demonstrated that factors such as low socio-economic status [ 40 ], poor social support [ 41] and depression [ 42] are all associated with lower adherence to prescribed treatments. As demonstrated in this review, there has also been much qualitative research that seeks to understand these choices. Pound and colleagues (2005) synthesised 37 qualitative studies of lay experiences of medication taking [ 43 ], finding that the main reason that people resist medications is an intrinsic preference to avoid them. Their implications for practice closely match those found in this review, including increasing clinician involvement and training although they also suggest there should be an additional policy focus on improving medication safety and tolerability.

Why is it important to review qualitative literature?

Given the relative lack of success of interventions that have been developed to address non-adherence, it is timely to review the qualitative literature to ascertain what insights these might offer future interventions. We undertook a qualitative synthesis of international research on medication taking and sought to determine whether there were consistent messages from these studies that apply regardless of study context (such as disease; method; and geographical setting).

What are the three most commonly reported analytic approaches?

The three most frequently reported analytic approaches were content analysis, reference to grounded theory, and thematic analysis. In about? 20% of cases the analytic approach was described in detail, but not attributed to any particular tradition.

Fda-Approved Treatments For Alcoholism

• Disulfiram
  Disulfiram has been in use for the treatment of alcoholism since the 1940s. This medication produces an aversive effect by disrupting alcohol metabolism. When alcohol is consumed, it is converted to acetaldehyde, which is further broken down by aldehyde dehydrogenase. Disulfira…
• Naltrexone
  Naltrexone is available as an oral medication (Revia®) and in two injectable forms (Vivitrol® and Naltrel®). Its primary use is for the treatment of alcohol dependence, and it is well tolerated with primarily gastrointestinal side effects (O’Malley et al. 1992; Volpicelli et al. 1992). Naltrexone’s ef…

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Other Promising Medications with Some Clinical Evidence of Efficacy

New Directions and Investigational Agents

Summary

Acknowledgements

Financial Disclosure

References