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Biomedical subjects

A T Beck

Publications and source records attributed to A T Beck.

At least 37 records · Page 2Linked to original sources
PubMed1999

Screening for major depression disorders in adolescent medical outpatients with the Beck Depression Inventory for Primary Care.

PURPOSE: To ascertain the psychometric characteristics of the Beck Depression Inventory for Primary Care (BDI-PC) among adolescents (12-17 years old) scheduled for health maintenance examinations, and to determine the effectiveness of the BDI-PC in screening the adolescents for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, major depression disorders (MDD). METHODS: The BDI-PC was administered to 50 male and 50 female adolescents who received pediatric health maintenance examinations. The diagnosis of MDD was established with the Mood Module from the Primary Care Evaluation of Mental Disorders. RESULTS: The internal consistency of the BDI-PC was high (Cronbach alpha = .88), and it was not significantly associated with gender, ethnicity, age, or having a medical disorder. A cutoff score of > or = 4 had both 91% sensitivity and specificity rates for identifying adolescents with and without MDD. CONCLUSIONS: The BDI-PC is a useful instrument for screening for clinical depression in adolescents receiving routine medical examinations.

Adolescent↗
PubMed1999

Physiological hyperarousal: construct validity of a central aspect of the tripartite model of depression and anxiety.

Physiological hyperarousal (PH) is an understudied component of the tripartite model of depression and anxiety. This study contributes to the literature on PH, the tripartite model, and anxiety and its disorders, using data from psychotherapy outpatients (n = 2,448), air force cadets (n = 1,335), and undergraduates (n = 284). Psychometrics and exploratory and confirmatory factor analyses showed that PH is a reliable, cohesive, discriminable, and valid construct. Compared with subjective anxiety, PH was more associated to panic versus mood disordered status, and to panic versus generalized anxiety disordered status. As hypothesized, an aspect of anxiety sensitivity (i.e., fear of body sensations) was particularly related to subjective anxiety in the presence of PH. Results support the PH construct as replicable, valid, and clinically important and support the utility of the tripartite and related models for understanding the relation of depressive and anxious syndromes.

Adolescent↗
PubMed1999

Suicide ideation at its worst point: a predictor of eventual suicide in psychiatric outpatients.

Scales for measuring current suicide ideation (SSI-C), suicide ideation at its worst point in the patient's life (SSI-W), and hopelessness (BHS) were administered to 3,701 outpatients seeking psychiatric treatment. Thirty patients from this sample eventually committed suicide, within a mean of 4 years from the initial assessment. Based on cut-off scores derived from receiver operating characteristic (ROC) analyses, the SSI-W had an odds ratio of 13.84 for predicting suicide, whereas the SSI-C and the BHS had odds ratios of 5.42 and 6.43, respectively. The assessment of suicide ideation at its worst point identifies a subgroup of patients at relatively high risk for eventual suicide. Robust interventions and periodic monitoring for suicide ideation and hopelessness are recommended to reduce long-term suicide risk.

Adult↗
PubMed1998

Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.

This study assessed the effects of training on the performance of 65 therapists in delivering manual-guided therapies to 202 cocaine-dependent patients. Changes in ratings of therapists' adherence and competence was assessed in 3 treatment modalities: supportive-expressive dynamic therapy (SE), cognitive therapy (CT), and individual drug counseling. Effects of manual-guided training on the therapeutic alliance were also assessed. Training effects were examined through a hierarchical linear modeling approach that examined changes both within cases and across training cases. A large effect across cases was detected for training in CT. Supportive-expressive therapists and individual drug counselors demonstrated statistically significant learning trends over sessions but not over training cases. Training in SE and CT did not have a negative impact on the therapeutic alliance, although alliance scores for trainees in drug counseling initially decreased but then rebounded to initial levels.

Adult↗
PubMed1998

Inadequate response to therapy as a predictor of suicide.

The role of response to cognitive therapy as a predictor of suicide was investigated by comparing 17 outpatients with mood disorders who committed suicide with 17 matched patients who did not commit suicide. The suiciders attended significantly fewer sessions of cognitive therapy and dropped out of therapy more frequently: 88% of the suiciders, compared to 53% of the controls, were rated by their therapists as requiring more treatment at termination. They also had higher levels of hopelessness at the termination of therapy. The results suggest that premature termination of therapy and inadequate response to treatment have unfavorable prognostic significance for eventual suicide.

Adult↗
PubMed1997

The National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Rationale and methods.

The National Institute on Drug Abuse Collaborative Cocaine Treatment Study is a large, multisite psychotherapy clinical trial for outpatients who meet the DSM-IV criteria for cocaine dependence. For 480 randomized patients, the outcomes of 4 treatments are compared for an 18-month period. All treatments include group drug counseling. One treatment also adds cognitive therapy, one adds supportive-expressive psychodynamic therapy, and one adds individual drug counseling; one consists of group drug counseling alone. In addition, 2 specific interaction hypotheses, one involving psychiatric severity and the other involving degree of antisocial personality characteristics, are being tested. This article describes the main aims of the project, the background and rationale for the study design, the rationale for the choice of treatments and patient population, and a brief description of the research plan.

Ambulatory Care↗
PubMed1997

An information processing model of anxiety: automatic and strategic processes.

A three-stage schema-based information processing model of anxiety is described that involves: (a) the initial registration of a threat stimulus; (b) the activation of a primal threat mode; and (c) the secondary activation of more elaborative and reflective modes of thinking. The defining elements of automatic and strategic processing are discussed with the cognitive bias in anxiety reconceptualized in terms of a mixture of automatic and strategic processing characteristics depending on which stage of the information processing model is under consideration. The goal in the treatment of anxiety is to deactivate the more automatic primal threat mode and to strengthen more constructive reflective modes of thinking. Arguments are presented for the inclusion of verbal mediation as a necessary but not sufficient component in the cognitive and behavioral treatment of anxiety.

Anxiety↗
PubMed1997

Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care.

To ascertain how effective the Beck Depression Inventory for Primary Care (BDI-PC) was for differentiating medical inpatients who were and were not diagnosed with DSM-IV major depression disorders (MDD), this 7-item self-report instrument composed of cognitive and affective symptoms was administered to 50 medical inpatients along with the Depression subscale (HDS) from the Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983, Acta Psychiatrica Scandinavica, 67, 361-370). The Mood Module from the Primary Care Evaluation of Mental Disorders (Spitzer et al., 1995, Prime-MD instruction manual updated for DSM-IV) was used to diagnose MDD. The internal consistency of the BDI-PC was high (alpha = 0.86), and it was moderately correlated with the HDS (r = 0.62, P < 0.001). The BDI-PC was not significantly correlated with sex, age, ethnicity, or type of medical diagnosis. A BDI-PC cut-off score of 4 and above yielded the maximum clinical efficiency with both 82% sensitivity and specificity rates. The clinical utility of the BDI-PC for identifying medical inpatients who should be evaluated for MDD is discussed.

Adolescent↗
PubMed1997

Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients.

The psychometric properties of the Scale for Suicide Ideation--Current (SSI-C; Beck, Kovacs & Weissman, 1979, Journal of Consulting and Clinical Psychology, 47, 343-352) and the Scale for Suicide Ideation--Worst (SSI-W; Beck, Brown, Steer, Dahlsgaard & Grisham, 1997, in press) were explored. These 19-item clinician-administered scales measure current suicide ideation (SSI-C) as well as suicide ideation at its worst point in the patient's life (SSI-W). For a sample of 4063 outpatients, both scales were positively correlated with a diagnosis of a principal mood disorder, a diagnosis of a personality disorder, and measures of depression and hopelessness. The relationship between the SSI-W and a history of suicide attempts was stronger (r = 0.50, P < 0.001) than the relationship between the SSI-C and previous suicide attempts (r = 0.31, P < 0.001). For 444 current and 1764 past suicide ideators, the SSI-C and the SSI-W had high internal consistencies (coefficient alpha s = 0.84 and 0.89, respectively). The SSI-C and the SSI-W were moderatedly correlated with each other (r = 0.51, P < 0.001). Iterated maximum-likelihood principal-factor analyses identified comparable Preparation and Motivation dimensions underlying both scales.

Adolescent↗
PubMed1997

Cognitive therapy with inpatients.

Psychotherapeutic interventions often play a major role in the treatment of patients who are hospitalized for depression. Much of the "therapeutic milieu" of the inpatient unit includes patient participation in group psychotherapy and in one-on-one psychotherapy with staff members. These interventions are designed not only to be primary treatments for depression, but are also used to enhance patients' compliance with pharmacotherapy. Cognitive therapy (CT) has been adapted for use with inpatients and has been used as an organizing theory for the hospital milieu in several inpatient units. Research on inpatient CT suggests that it is a beneficial treatment that enhances continuity of care after discharge from the hospital. This paper describes the general principles of inpatient CT, and discusses the various types of inpatient cognitive therapy units (CTUs) that have been developed. The benefits of such programs are described, and research regarding the effectiveness of inpatient CT is discussed.

Antidepressive Agents↗
PubMed1997

Expectations and motives for alcohol use in a psychiatric outpatient population.

The purpose of the study was to assess alcohol expectancies and motives of psychiatric outpatients with and without comorbid current or lifetime substance use disorders. Seventy-five psychiatric outpatients with diagnoses of mood disorders, anxiety disorders, and substance use disorders were administered the Alcohol Effect Expectancy Questionnaire-Abridged Version and the Drinking Motives Measure. Results demonstrated that the internal reliabilities for the two scales were comparable with those reported for these measures in the general population. Psychiatric outpatients with a history of comorbid substance use disorders reported greater expectancies and motives for using alcohol than did patients with no such history. In addition patients with comorbid alcohol and drug use disorders, and only comorbid alcohol use disorder, showed significantly greater expectancies and motives for alcohol use than patients with only comorbid drug use disorders and patients with no history of comorbid substance use disorder. We discuss the implications of the findings for role of expectancies and motives in the maintenance and treatment of substance abuse in psychiatric patients.

Adolescent↗
PubMed1997

Further evidence for the construct validity of the Beck depression Inventory-II with psychiatric outpatients.

To provide further information about the construct validity of the Beck Depression Inventory-II the inventory was administered to 210 psychiatric outpatients along with Derogatis' SCL 90-R. As hypothesized, the Beck Depression Inventory-II was more positively correlated with scores on the Depression subscale (r = .89) than it was with scores on the Anxiety subscale of the SCL-90-R (r = .71).

Adolescent↗
PubMed1997

Back to basics: fundamental cognitive therapy skills for keeping drug-dependent individuals in treatment.

Cognitive therapists who treat drug-dependent patients are likely to lose at least 50 percent of their patients to dropout. This chapter has presented a cognitive model for conceptualizing missed sessions and dropout, along with strategies for reducing the likelihood of missed sessions and dropout. The following should serve to highlight these strategies. 1. Therapists are encouraged to offer warm, empathetic, collaborative relationships in which drug-dependent patients can feel accepted, understood, and validated. 2. Therapists are encouraged to develop comprehensive, accurate case conceptualizations, with attention paid to the potential for missed sessions and dropout. Case conceptualizations should ultimately guide cognitive and behavioral techniques. 3. Therapists are encouraged to structure sessions and elicit feedback regarding their patient's thoughts and beliefs about therapy and the therapist. This feedback is facilitated by such questions as, "What do you like most about therapy?" "What do you like least?" "What has changed in your life as a result of therapy?" "How do you view our relationship?" 4. Therapists are encouraged to socialize patients in a timely, appropriate manner. 5. Similar to the process of socialization, therapists are encouraged to use cognitive and behavioral techniques in a timely, appropriate manner. It is unrealistic to think that the problems of missed sessions and dropout from drug treatment will ever be fully resolved. Nonetheless, the authors believe that the conceptual models and fundamental strategies presented in this chapter represent a significant step in addressing these problems.

Cognitive Behavioral Therapy↗
PubMed1997

The past and future of cognitive therapy.

The author describes his personal odyssey in cognitive-behavioral therapy (CBT). He shares his earliest clinical experience responsible for the evolution of CBT and reviews the application of CBT to depression, anxiety, personality disorders, and schizophrenia. According to the author, the future of CBT will be tested with severe psychiatric disorders such as schizophrenia, bipolar disorder, and severe personality disorders; in the treatment of children and adolescents; and within the practice of primary care.

Cognitive Behavioral Therapy↗
PubMed1996

Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients.

The amended (revised) Beck Depression Inventory (BDI-IA; Beck & Steer, 1993b) and the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) were self-administered to 140 psychiatric outpatients with various psychiatric disorders. The coefficient alphas of the BDI-IA and the BDI-II were, respectively, .89 and .91. The mean rating for Sadness on the BDI-IA was higher than it was on the BDI-II, but the mean ratings for Past Failure, Self-Dislike, Change in Sleeping Pattern, and Change in Appetite were higher on the BDI-II than they were on the BDI-IA. The mean BDI-II total score was approximately 2 points higher than it was for the BDI-IA, and the outpatients also endorsed approximately one more symptom on the BDI-II than they did on the BDI-IA. The correlations of BDI-IA and BDI-II total scores with sex, ethnicity, age, the diagnosis of a mood disorder, and the Beck Anxiety Inventory (Beck & Steer, 1993a) were within 1 point of each other for the same variables.

Adjustment Disorders↗