[Show abstract][Hide abstract] ABSTRACT: To examine several methods of determining reliability of change constructs in depressive symptoms in patients with rheumatoid arthritis (RA) and to demonstrate the strengths, weaknesses, and uses of each method.
Data were analyzed from a cohort of 54 persons with RA who participated in a combined behavioral/pharmacologic intervention of 15 months duration. These longitudinal data were used to examine 3 methodologies for assessing the reliability of change for various measures of depression. The specific methodologies involved the calculations of reliable change, sensitivity to change, and reliability of the change score.
The analyses demonstrated differences in reliability of change performance across the various depression measures, which suggest that no single measure of depression for persons with RA should be considered superior in all contexts.
The findings highlight the value of utilizing reliability of change constructs when examining changes in depressive symptoms over time.
[Show abstract][Hide abstract] ABSTRACT: In this article, we describe a cognitive behavioral treatment approach to cases of obsessive-compulsive disorder (OCD) that have not responded to standard outpatient evidence-based treatment. The approach begins with an assessment of the reasons why patients have not responded to treatment, which can be grouped into two categories: (a) inadequacies in the level of OCD treatment the patient has received; and (b) The presence of treatment-interfering behaviors that have obstructed the patient's ability to participate adequately in treatment. Treatment is then assigned according to category. Patients in Category 1 receive a more intensive level of evidence-based OCD treatment. Patients in Category 2 receive readiness treatment, a cognitive behavioral treatment designed to help patients get ready for OCD treatment by modifying treatment-interfering behaviors. Case examples are provided to illustrate this treatment approach.
Cognitive and Behavioral Practice 12/2005; 12(1):30-39. DOI:10.1016/S1077-7229(05)80037-9 · 1.33 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine the level of anxiety experienced by individuals with rheumatoid arthritis (RA).
Data from 2 previous studies were used to compare the level of anxiety (measured by the State-Trait Anxiety Inventory) in the following 4 subgroups: a general RA sample, a general osteoarthritis sample, a sample with both RA and major depression, and a normative sample of age-equivalent, working adults. Canonical correlations were used to examine associations between measures of anxiety and measures of both stress and depression. The relationship between anxiety and duration of RA was also explored.
The general RA sample had state anxiety levels that were comparable to the normative sample, although trait anxiety levels were significantly higher (P < 0.001). In addition, individuals with RA who also met criteria for depression exhibited significantly higher levels of both state anxiety (P < 0.0001) and trait anxiety (P < 0.0001) than was observed in the normative sample. Canonical correlations revealed that measures of anxiety were correlated with both measures of depression (r = 0.83) and measures of stress (r = 0.50). Anxiety was not found to be significantly related to RA disease duration.
These findings demonstrated that individuals with RA, especially if concomitantly depressed, tend to exhibit levels of anxiety that are generally higher than a normative group of age-equivalent, working adults. The substantial canonical correlations between anxiety and both depression and stress revealed that anxiety shares variance with these more frequently studied variables in RA. However, anxiety was not found to be related to RA disease duration.