Optimizing Pain Management Through Collaborations With Behavioral and Addiction Medicine in Primary Care.

Optimizing Pain Management Through Collaborations with Behavioral and Addiction Medicine in Primary Care.

Filed under: Addiction Rehab

Prim Care. 2012 Dec; 39(4): 661-669
Brensilver M, Tariq S, Shoptaw S

Chronic noncancer pain (CNCP) affects many primary care patients, and carries a large human and economic burden. In response to the widespread perception that pain is underdiagnosed and undertreated, regulatory bodies have encouraged more comprehensive services to address pain syndromes. Significant hurdles exist in treating CNCP in primary care settings, and interventional therapies and pharmacotherapy often do not provide complete symptomatic relief. This article describes a multidimensional and interdisciplinary approach to the treatment of CNCP. The utility of collaborations with behavioral and addiction medicine specialists optimizes care and advances models of patient treatment within a primary care patient-centered medical home.
HubMed – addiction


Integration of Behavioral Medicine in Primary Care.

Filed under: Addiction Rehab

Prim Care. 2012 Dec; 39(4): 605-614
Bholat MA, Ray L, Brensilver M, Ling K, Shoptaw S

The health care system in the United States is inefficient and there are many incentives for sustainable changes in the delivery of care. Incorporating behavioral medicine offers a wide range of opportunities. Within primary care settings, pain disorders, addiction, depression, and anxiety disorders are highly prevalent. Numerous chronic health conditions also require behavioral support for lifestyle change. These disorders are optimally managed through interdisciplinary collaborations that include a behavioral medicine component. This article discusses the effective integration of behavioral medicine within a primary care patient-centered medical home and describes the organizational planning and structure required for success.
HubMed – addiction


Effects of functional impairment on internalizing symptom trajectories in adolescence: A longitudinal, growth curve modelling study.

Filed under: Addiction Rehab

J Adolesc. 2012 Nov 10;
Cleverley K, Bennett K, Duku E

Despite the fact that psychosocial and functional impairment has long been acknowledged as an important aspect of psychiatric diagnosis and treatment, relatively little is known about the longitudinal relationship between psychiatric symptoms and functional impairment. This is particularly true in childhood and adolescence. Understanding how symptoms relate to functional impairment is of great importance to clinicians and researchers as it is essential to nosology, treatment, and prognosis. This study sought to understand the developmental relationship between internalizing symptoms, functional impairment and gender in a sample of youth aged 10-15 using growth curve methods. Key findings indicate that the presence of functional impairment was associated with increased baseline internalizing symptoms scores but had no effect on the slope of internalizing symptoms trajectories during adolescence. The study highlights that the association between internalizing symptoms and functional impairment appears to be constant, linear and does not vary by gender.
HubMed – addiction


Decisions During Negatively-Framed Messages Yield Smaller Risk-Aversion-Related Brain Activation in Substance-Dependent Individuals.

Filed under: Addiction Rehab

Psychol Addict Behav. 2012 Nov 12;
Fukunaga R, Bogg T, Finn PR, Brown JW

A sizable segment of addiction research investigates the effects of persuasive message appeals on risky and deleterious behaviors. However, to date, little research has examined how various forms of message framing and corresponding behavioral choices might by mediated by risk-related brain regions. Using event-related functional MRI, we investigated brain regions hypothesized to mediate the influence of message appeals on decision making in substance-dependent (SD) compared with nonsubstance-dependent (non-SD) individuals. The Iowa Gambling Task (IGT) was modified to include positively-framed, negatively-framed, and control messages about long-term deck payoffs. In the positively-framed condition, the SD and non-SD groups showed improved decision-making performance that corresponded to higher risk-aversion-related brain activity in the anterior cingulate cortex (ACC) and anterior insula (AI). In contrast, in the negatively-framed condition, the SD group showed poorer performance that corresponded to lower risk-aversion-related brain activity in the AI region. In addition, only the non-SD group showed a positive association between decision quality and greater risk-related activity in the ACC, regardless of message type. The findings suggest substance-dependent individuals may have reduced neurocognitive sensitivity in the ACC and AI regions involved in risk perception and aversion during decision-making, especially in response to framed messages that emphasize reduced prospects for long-term gains. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
HubMed – addiction



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