Promoting Validation and Acceptance: Clinical Applications of Dialectical Behavior Therapy With Pediatric Populations and Systems
Petsagourakis, Despina; Driscoll, Colleen; Viswanadhan, Katya; Lois, Becky H.
Youth living with chronic medical conditions and their families face several challenges (e.g., adjustment to a new diagnosis, ongoing daily condition management, coping with potential long-term consequences of illness). Traditional CBT approaches emphasize collaborative problem-solving with a core focus on change. At times, these approaches may feel inaccessible or unhelpful for pediatric patients and their families who are facing illness-related challenges that they cannot change or control. Dialectical behavior therapy integrates CBT-based change interventions with acceptance-based strategies to normalize challenging thoughts and emotions and help individuals feel validated. Medical providers working with pediatric patients and families can also benefit from a DBT-based conceptualization and approach to improve patient/family-provider relationships. This article summarizes the current evidence base for and justifies the use of adaptations of DBT for patients with medical illness. Further, through clinical case examples, it illustrates the use of DBT skills and concepts in improving outcomes for pediatric patients and their families.
SCOPUS:85186632584
ISSN: 1077-7229
CID: 5693962
Differential roles of the dorsal and ventral hippocampus in predator odor contextual fear conditioning
Wang, Melissa E; Fraize, Nicolas P; Yin, Linda; Yuan, Robin K; Petsagourakis, Despina; Wann, Ellen G; Muzzio, Isabel A
The study of fear memory is important for understanding various anxiety disorders in which patients experience persistent recollections of traumatic events. These memories often involve associations of contextual cues with aversive events; consequently, Pavlovian classical conditioning is commonly used to study contextual fear learning. The use of predator odor as a fearful stimulus in contextual fear conditioning has become increasingly important as an animal model of anxiety disorders. Innate fear responses to predator odors are well characterized and reliable; however, attempts to use these odors as unconditioned stimuli in fear conditioning paradigms have proven inconsistent. Here we characterize a contextual fear conditioning paradigm using coyote urine as the unconditioned stimulus. We found that contextual conditioning induced by exposure to coyote urine produces long-term freezing, a stereotypic response to fear observed in mice. This paradigm is context-specific and parallels shock-induced contextual conditioning in that it is responsive to extinction training and manipulations of predator odor intensity. Region-specific lesions of the dorsal and ventral hippocampus indicate that both areas are independently required for the long-term expression of learned fear. These results in conjunction with c-fos immunostaining data suggest that while both the dorsal and ventral hippocampus are required for forming a contextual representation, the ventral region also modulates defensive behaviors associated with predators. This study provides information about the individual contributions of the dorsal and ventral hippocampus to ethologically relevant fear learning.
PMID: 23460388
ISSN: 1098-1063
CID: 4951292