Browsing by Subject "yleistynyt ahdistuneisuushäiriö"
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(2019)This review will address how individual symptomology may be used to model a person’s psychological disorder. The discussed disorders are depression, generalised anxiety disorder and social anxiety disorder, which will be discussed separately and as simultaneous compositions of symptoms. Traditionally mental health disorders have been elucidated by dividing them into separate categories. In 2010s network analysis has risen as an alternative method, where the relationship between symptoms is examined in time and visualised as a network. The network analysis viewpoint suggests that psychological symptoms cause each other and that activation spreads through the network via the interactions between those symptoms. Two disorders that occur simultaneously are thought to constitute separate clusters of symptoms, which are united by bridge symptoms that mediate activation from one cluster to another. This review will focus particularly on idiographic, personalised networks. These personalised models aspire to take into consideration all the variation in a person’s symptomology. These models are formulated from occurring symptoms in several points in time, so it is possible to speculate, although not prove, the direction of an interaction between symptoms. The symptoms that affect several other symptoms strongly spread activation all around them when activated, whereas those symptoms that receive several effects from other symptoms particularly often associate with other symptoms. The application of network models to clinical practice is based on this idea. To demonstrate idiographic modelling, two different cases will be considered. In both examples the person is afflicted with both depression and an anxiety disorder, and for each person an idiographic network model is formed. The observation can be made from these cases that the symptoms described as most central in categorical models are not equal to the symptoms in these networks that most maintain its activation. The idiographic networks of the example cases also do not indicate bridge symptoms, but rather the symptoms form a single cluster and maintain each other across disorder category boundaries. The conclusions made from personalised network analyses cannot be generalised to the population or even the same person in other points in time. In addition, conclusions cannot be made about the validity of DSM categories or the concept of comorbidity. Nevertheless, they open windows to the individual variation and complexity of symptomology, which categorical diagnostic classifications cannot consider. From these observations different study questions and designs can be formulated and novel clinical interventions developed.
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(2019)Objectives: Generalized anxiety disorder (GAD) is a common and chronic disorder that causes significant burden for both patients and the society. There are particular challenges associated with the treatment of GAD compared to other anxiety disorders. Cognitive-behavioral therapy is considered the preferred treatment for GAD, but many patients continue to suffer from residual symptoms after treatment, and relapses are common. Many researchers have emphasized the need for research and development of new approaches to treating GAD. The purpose of this review is to examine the basis for using mindfulness and in particular mindfulness-based cognitive therapy in the treatment of GAD, to go through existing research on effectiveness of MBCT for GAD, and to discuss methodological questions that ought to be considered in future research. Methods: Studies were found using search terms mindfulness-based cognitive therapy, generalized anxiety disorder and mindfulness-based cognitive therapy + generalized anxiety disorder. In addition, articles were discovered by conducting a manual search from the reference lists of the studies searched from the databases. Results and conclusions: There was not yet enough research to determine whether MBCT could be considered effective in the treatment of GAD. However, there were conceptual bases and initial positive findings that encourage further research. Practicing mindfulness seemed particularly promising in the reduction of worrying, which is the defining symptom of GAD. Mindfulness had been found effective in treating other central symptoms of GAD as well, such as difficulty in concentrating, restlessness and disturbed sleep. Cost-effective MBCT could lessen the financial burden associated with treating GAD and make treatment available for more patients. Future studies should better consider special characteristics of MBCT such as its group format and the central role of mindfulness. If found effective, MBCT could be utilized as it is or as complementary to other interventions.
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