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Harvard Review of Psychiatry

Brian Theyel
No abstract text is available yet for this article.
September 2018: Harvard Review of Psychiatry
Abigail M Judge
In recent years, heightened attention has been paid to commercial sexual exploitation, including domestic human sex trafficking (HST), with mental health concerns named the most dominant health concern among survivors. Human sex trafficking is associated with significant and long-term mental health consequences. Research to date has emphasized ways to identify survivors in health care settings. Once identified, however, few specialized services are available to help survivors exit and recover. The current services infrastructure for HST has been compared to the disjointed social response to intimate partner violence before the women's movement helped develop a system of battered women's shelters...
September 2018: Harvard Review of Psychiatry
Michelle S Friedman-Yakoobian, Michelle L West, Kristen A Woodberry, Keira E O'Donovan, Suzannah V Zimmet, Andréa Gnong-Granato, Anthony J Giuliano, Margaret E Guyer, Janine Rodenhiser-Hill, Matcheri S Keshavan, Larry J Seidman
Over the past two decades, increasing attention has been given to the importance of early intervention for psychosis. This article describes the development of the Center for Early Detection, Assessment and Response to Risk (CEDAR), which focuses on early identification and treatment of youth at clinical high risk for psychosis. There are relatively few models in the United States for such programs, and we present our developmental story, focusing mainly on the CEDAR Clinic, as a case study of how such a program can develop...
September 2018: Harvard Review of Psychiatry
Lauren B Gerlach, Ilse R Wiechers, Donovan T Maust
OBJECTIVES: Despite evidence for many potential risks, use of benzodiazepines (BZDs) among older adults is common. The authors evaluated the available evidence for BZD effectiveness and tolerability for use in older adults in three psychiatric conditions for which BZDs are commonly prescribed: insomnia, anxiety disorders, and behavioral and psychological symptoms of dementia. DESIGN: Electronic databases, including PubMed/MEDLINE, were searched to identify articles that (1) included patients ≥50 years of age, (2) focused on patients diagnosed with insomnia, anxiety disorders, or behavioral and psychological symptoms of dementia, and (3) were either a randomized, placebo-controlled trial or a randomized trial comparing a BZD with either another psychotropic medication or psychotherapy...
September 2018: Harvard Review of Psychiatry
Nayla M Khoury, Jacqueline Lutz, Zev Schuman-Olivier
Interoception, or the process of sensing, interpreting, and integrating internal bodily signals, has increasingly been the subject of scientific research over the past decade but is still not well known in clinical practice. The aim of this article is to review clinical treatment interventions that use interoception, to synthesize the current research knowledge, and to identify the gaps where future research is needed. We conducted a comprehensive literature search on randomized, controlled trials that both include interoception in treatment interventions for individuals with psychiatric disorders and measure aspects of interoception using self-report measures...
September 2018: Harvard Review of Psychiatry
Roger S McIntyre, Yena Lee, Nicole E Carmona, Mehala Subramaniapillai, Danielle S Cha, JungGoo Lee, Jae-Hon Lee, Asem Alageel, Nelson B Rodrigues, Caroline Park, Renee-Marie Ragguett, Joshua E Rosenblat, Fahad Almatham, Zihang Pan, Carola Rong, Rodrigo B Mansur
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Characterize cognitive dysfunction in patients with major depressive disorder.• Evaluate approaches to treating cognitive dysfunction in patients with major depressive disorder. ABSTRACT: Cognitive dysfunction is a core psychopathological domain in major depressive disorder (MDD) and is no longer considered to be a pseudo-specific phenomenon. Cognitive dysfunction in MDD is a principal determinant of patient-reported outcomes, which, hitherto, have been insufficiently targeted with existing multimodal treatments for MDD...
September 2018: Harvard Review of Psychiatry
Omar Fattal, Hossam Mahmoud, Lama Bazzi
No abstract text is available yet for this article.
July 2018: Harvard Review of Psychiatry
Lux Ratnamohan, Laurie MacKinnon, Melissa Lim, Richard Webster, Karen Waters, Kasia Kozlowska, Joyanna Silberg, Ricky Greenwald, Monique Ribeiro
No abstract text is available yet for this article.
July 2018: Harvard Review of Psychiatry
Nina F Lewis-Schroeder, Kathryn Kieran, Beth L Murphy, Jonathan D Wolff, Matthew A Robinson, Milissa L Kaufman
First responders are regularly confronted with exposure to traumatic events, including potentially life-threatening situations as well as the grave injuries and deaths of colleagues and civilians. Evidence indicates that the prevalence of posttraumatic stress disorder (PTSD) is substantially higher among first responders than the general population. This article provides information about the outpatient trauma services at McLean Hospital's LEADER (Law Enforcement, Active Duty, Emergency Responder) program to assist clinicians who encounter these first responders in their practices or who are specifically interested in working with this patient population...
July 2018: Harvard Review of Psychiatry
Johannes Graser, Ulrich Stangier
OBJECTIVES: This article presents a brief overview of the empirical evidence of well-established mindfulness interventions and an in-depth review of less-established compassion-based interventions (CBIs) and loving-kindness meditation (LKM). Definitions, cognitive and physiological mechanisms, and methods of assessment are discussed. METHOD: A literature review using the databases Google Scholar, PsycINFO, and PubMed was conducted. RESULTS: Whereas the efficacy of mindfulness-based stress reduction and mindfulness-based cognitive therapy has been documented in many trials, only seven randomized, controlled trials have been completed on CBIs and LKM...
July 2018: Harvard Review of Psychiatry
Holly Greer, Jacqueline N Cohen
Over a third of individuals with borderline personality disorder (BPD) are in long-term romantic partnerships, yet little is known about the experiences of their partners. Because difficulties in interpersonal relationships are a hallmark of BPD, it is especially important to understand the support needs of their romantic partners. This systematic review investigates the experiences of romantic partners of adult individuals with BPD and the interventions designed to support them. Twenty-two articles were found, 13 of which pertained to partner experiences and 9 to interventions...
July 2018: Harvard Review of Psychiatry
Christopher M Celano, Ana C Villegas, Ariana M Albanese, Hanna K Gaggin, Jeff C Huffman
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Identify the relationships between depression, anxiety, and heart failure (HF).• Assess methods for accurately diagnosing depression and anxiety disorders in patients with HF.• Evaluate current evidence for treatment of anxiety and depression in patients with HF. BACKGROUND: In patients with heart failure (HF), depression and anxiety disorders are common and associated with adverse outcomes such as reduced adherence to treatment, poor function, increased hospitalizations, and elevated mortality...
July 2018: Harvard Review of Psychiatry
Sarah R Horn, Adriana Feder
Resilience is defined as the dynamic ability to adapt successfully in the face of adversity, trauma, or significant threat. Some of the key early studies of resilience were observational studies in children. They were followed by research in adults, studies testing interventions to promote resilience in different populations, and a recent upsurge of studies on the underlying genomic and neurobiological mechanisms. Neural and molecular studies in preclinical models of resilience are also increasingly identifying active stress adaptations in resilient animals...
May 2018: Harvard Review of Psychiatry
Philip R Szeszko, Amy Lehrner, Rachel Yehuda
This review examines the putative link between glucocorticoid and hippocampal abnormalities in posttraumatic stress disorder (PTSD). Increased glucocorticoid receptor (GR) sensitivity in PTSD may permit enhanced negative feedback inhibition of cortisol at the pituitary, hypothalamus, or other brain regions comprising the hypothalamic-pituitary-adrenal (HPA) axis and would be expected to affect other physiological systems that are regulated by glucocorticoids. Molecular and transcriptional studies of cortisol are consistent with the hypothesis that cortisol actions may be amplified in PTSD as a result of enhanced GR sensitivity in monocytes and some brain regions, although cortisol levels themselves are unchanged and oftentimes lower than normal...
May 2018: Harvard Review of Psychiatry
Seth Davin Norrholm, Tanja Jovanovic
The processing and regulation of fear is one of the key components of posttraumatic stress disorder (PTSD). Fear can involve both acute and potential threats that can manifest in different behaviors and result from activity within different neural nodes and networks. Fear circuits have been studied extensively in animal models for several decades and in human neuroimaging research for almost 20 years. Therefore, the centrality of fear processing to PTSD lends the disorder to be more tractable to investigation at the level of brain and behavior, and provides several observable phenotypes that can be linked to PTSD symptoms...
May 2018: Harvard Review of Psychiatry
Jacklynn M Fitzgerald, Julia A DiGangi, K Luan Phan
Posttraumatic stress disorder (PTSD) is a devastating disorder, linked to profound mental, physical, occupational, and functional impairment. In addition, it is a highly complex disorder, characterized by symptom heterogeneity across multiple domains. Nevertheless, emotion dysregulation arising from the exaggerated response to threat or from the inability to regulate negative emotional states plays a defining role in the pathophysiology of PTSD. In order to improve our understanding of how emotion dysregulation manifests in this illness, functional neuroimaging research over the past 20 years provides great insight into underlying neuroanatomy of each component of emotion dysregulation in the context of PTSD...
May 2018: Harvard Review of Psychiatry
Meredith E Charney, Samantha N Hellberg, Eric Bui, Naomi M Simon
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Evaluate psychotherapeutic and pharmacologic approaches to treating patients with posttraumatic stress disorder. ABSTRACT: A strong evidence base exists for psychological and pharmacological interventions for the treatment of posttraumatic stress disorder (PTSD). The published literature investigating the effectiveness of these treatments in reducing the symptoms and impairments associated with PTSD has expanded substantially in recent years...
May 2018: Harvard Review of Psychiatry
Kerry J Ressler
No abstract text is available yet for this article.
May 2018: Harvard Review of Psychiatry
Brent M Kious, Douglas G Kondo, Perry F Renshaw
After participating in this activity, learners should be better able to:• Assess epidemiologic evidence that increased altitude of residence is linked to increased risk of depression and suicide• Evaluate strategies to address hypoxia-related depression and suicidal ideation ABSTRACT: Suicide and major depressive disorder (MDD) are complex conditions that almost certainly arise from the influences of many interrelated factors. There are significant regional variations in the rates of MDD and suicide in the United States, suggesting that sociodemographic and environmental conditions contribute...
March 2018: Harvard Review of Psychiatry
John R Peteet
No abstract text is available yet for this article.
March 2018: Harvard Review of Psychiatry
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