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NICE guidelines – early management of persistent non-specific low back pain

I'm a bit slow on reporting this, but at the end of May the UK's National Institute for Health and Clinical Excellence (NICE) published a guideline on "Early management of persistent non-specific low back pain".   I've blogged before about NICE.  They publish very widely with, for example, 82 guidelines on musculoskeletal disorders generally.  They have also recently launched NHS evidence which aims " ... to provide easy access to a comprehensive evidence base for everyone in health and social care who takes decisions about treatments or the use of resources - including clinicians, public health professionals, commissioners and service managers - thus improving health and patient care. It will build on NICE's significant international reputation for developing high quality evidence-based guidance.

Recent research: articles from June journals

I read a lot of research.  When I find an article of particular interest I download it to my bibliographic database - EndNote - which currently contains over 13,000 abstracts. 

Every few weeks I scan through all the articles I've found interesting in the previous month (in the general areas of stress, health & wellbeing) and then filter them into three narrower, more specific mailings.  One is to the British Association for Behavioural & Cognitive Psychotherapies (BABCP) communal email list.  This set of abstracts focuses particularly on cognitive therapy in its many applications (anxiety, depression, psychotic disorders, etc).  Click on BABCP mailing to see the 26 papers (mostly from June journals) that I recently sent out.

“Smile intensity in photographs predicts divorce later in life”

I do think that Matt Hertenstein and colleagues came up with an eye catching title here:

Hertenstein, M., C. Hansel, et al. (2009). "Smile intensity in photographs predicts divorce later in life." Motivation and Emotion 33(2): 99-105.  [Abstract/Full Text]  [Free Full Text]

Recent research: free June edition of "Clinical Psychology: Science and Practice" focuses on bipolar disorder

The June edition of the journal "Clinical psychology: science and practice"  focused on bipolar disorder.  This is very valuable and the fact that all the articles are freely viewable in full text makes the publication even more helpful.  As Youngstrom & Kendall write in their introductory article (see below) "Knowledge about bipolar disorder is rapidly advancing. One consequence is that current evidence about the diagnostic definitions, prevalence, phenomenology, associated features and underlying processes, risk factors and predictors, and assessment or treatment strategies for bipolar disorder is often markedly different than the conventional wisdom reflected even in recent textbooks and clinical training."  Karam & Fayyad (see below for all articles mentioned, with abstracts and links) discuss diagnosis and the boundaries of the bipolar spectrum.  Merikangas & Pato review recent research on bipolar epidemiology and write "During the past decade, there has been increasing recognition of the dramatic personal and societal impact of bipolar disorder I and II (DSM-IV).

Handouts & questionnaires for compassion & criticism (third post)

This is the third of three posts giving handouts & questionnaires on compassion & criticism.  There are a dozen MP3 recordings listed below.  It would be possible to use these tracks as a "compassionate mind training" sequence, although I've listed them more to illustrate the kind of approach that it's probably sensible to use.  The twelve recordings make up a four exercise training.  Each exercise includes a brief (1 to 3 minute) introductory track and then a medium length (15 to 18 minute) and longer (24 to 28 minute) meditation.  If you want to follow this sequence, please read the Suggestions for goodwill practice handout (below) first. 

Recent research: two papers on mindfulness, two on insomnia & two on antidepressants in pregnancy

Here are six recently published research papers.  Barnhofer and colleagues report on encouraging results using mindfulness-based cognitive therapy (MBCT) for sufferers from chronic-recurrent depression while they are still depressed.  The three major studies published already have used MBCT for recurrent depression while the sufferers are reasonably well.  The next step will clearly be a fuller randomized controlled trial.  Heeren and colleagues report on the how MBCT acts to reduce overgeneral autobiographical memoriy in formerly depressed patients. 

Archer and colleagues describe the successful development and assessment of a group-based cognitive behavioural intervention for sleep problems.  Participants' satisfaction ratings with the training were very high and there were very encouraging reductions in their sleep problems and depressive symptoms.  Morin and coworkers also report on CBT for sleep problems, this time singly or combined with sleep medication.  They concluded that "In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT."

Handouts & questionnaires for compassion & criticism (second post)

This the second of three posts on handouts & questionnaires for Compassion & criticism. It contains a series of loosely linked downloads about compassion, self-criticism, hostility, self-esteem and related subjects.  To see the earlier post on this subject click on Compassion & criticism (first post).

Compassionate/self-image goals scale and background - this is a scale from Crocker's fascinating work on compassionate and self-image goals.  See too the "Self and social motivation laboratory" website at http://rcgd.isr.umich.edu/crockerlab

Contingencies of self-worth scale - this is another questionnaire from the Crocker lab (see above).  Interesting way of probing what people's self-worth is based on ... and what the subsequent effects then are.

Social integration and a midsummer potluck lunch

We have fifty to sixty people due for lunch today.  I better not hang around writing blog postings for too long.  There's still lots of preparation work to do.  It's great.  I love these midsummer potluck lunches that we've been hosting for many years now.  It's such fun to invite most of our local social network and see them all mixing up together in a chaotic "soup".  Hard work.  Heart warming.  If we invite ninety or so people we normally reckon that about half of them will be able to make it, so today's "catch" is a pretty good one.  Nearly all our closest local friends will be here and mixed up with them will be other friends, acquaintances, new partners, a couple of children.  Fantastic.  There's plenty of preparation and dear Catero has done a lot of cooking but, since it's potluck, we're not trying to feed them all just from our own efforts.

The Ben Lui group (second post): how to know when to change direction on a walk or in treatment for psychological difficulties!

A couple of lines from the Bruce Springsteen song "Hungry heart" kept going through my head - "Like a river that don't know where it's flowing, I took a wrong turn and I just kept going."  Something was wrong.  I couldn't work out where I'd got to on my map.  The line of pylons shouldn't have been where they were - and certainly not where they were in relation to the stream and rough track I could see across the valley. 

I'd started walking fine in the morning.  I left Edinburgh early and before 9.00am was heading out from Dalrigh on the long walk up the valley to Ben Lui.  Two hours walking saw me at the bottom of the hill.  Then a steady tramp up and into the low lying cloud. 

Walking up into the mist on Ben Lui