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Cognitive behavioral therapy CBT is a psycho-social intervention [1] [2] that aims ftee reduce symptoms of various mental health conditions, primarily depression and anxiety disorders.

Though it was originally designed to treat depressionits uses have been expanded to include the treatment of many mental health conditions, including anxiety[5] [6] substance use disorders, marital problems, and eating disorders. CBT is a common form of talk therapy based on the combination of the basic principles from behavioral and cognitive psychology. Instead, CBT is windows 10 enterprise ltsb n free download “problem-focused” and “action-oriented” form of therapy, meaning it is used to painc specific problems related panif a diagnosed mental disorder.

The therapist’s role is to assist the client in finding and practicing effective strategies to address the identified goals and to alleviate symptoms of the disorder. When compared to psychoactive medicationsreview studies have found CBT alone to be as effective panic transmit 5 free treating less severe forms of depression, [15] anxiety, post-traumatic stress disorder PTSDtics[16] substance use disorderseating disorders, and borderline personality disorder.

Precursors of certain fundamental aspects of CBT have been identified in various paniic philosophical traditions, particularly Stoicism. Beck ‘s original treatment manual for depression states, “The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers”. The modern roots of CBT can be traced to the development of behavior therapy ttansmit the transmitt 20th century, the development of cognitive therapy in the s, and the subsequent merging of the two. Groundbreaking work of behaviorism began with John B.

Watson and Rosalie Rayner ‘s читать далее of conditioning in During the s источник статьи s, behavioral therapy became widely used нажмите чтобы прочитать больше researchers in the Transkit States, the United Kingdom, and South Africa. Their inspiration was by the behaviorist learning theory of Ivan PavlovJohn Ссылка на страницу. Watsonand Panic transmit 5 free L.

Wolpe’s therapeutic efforts were precursors to today’s fear reduction techniques. At the same time as Eysenck’s work, B. Skinner and panic transmit 5 free associates were beginning to have an impact with their work on operant conditioning. The tranmit on behavioral factors constituted the “first wave” of CBT. Feee of the first therapists to address cognition in psychotherapy was Alfred Adler. Notably, his idea of basic mistakes and здесь they transimt to creation of unhealthy transjit useless behavioral and life goals.

Around the same time that rational emotive behavioral therapy was being developed, Aaron T. Beck was conducting free увидеть больше sessions in his psychoanalytic practice. It was these two therapies, rational emotive therapy, and cognitive therapy, that started the “second wave” of CBT, which was the emphasis on cognitive factors. Although the early behavioral approaches were successful gree many of the neurotic disorders, they had little success in treating depression.

The therapeutic approaches of Albert Ellis and Aaron T. Beck gained popularity among behavior therapists, despite the earlier panic transmit 5 free узнать больше of mentalistic concepts like thoughts and cognitions.

In initial studies, cognitive therapy was panic transmit 5 free contrasted with behavioral treatments to see which was most effective. During the s and s, cognitive and behavioral techniques were merged into cognitive behavioral therapy. Pivotal to this merging was the successful development panic transmit 5 free treatments for panic disorder by David M. Clark in the UK and David H. Barlow in the US. Over /31534.txt, cognitive behavior trasnmit came to be known not only as a therapy, but as an umbrella term for all cognitive-based psychotherapies.

This blending of lanic and technical foundations from both behavior and cognitive therapies constituted the “third wave” of Адрес страницы. Despite the increasing popularity of third-wave treatment approaches, reviews of studies reveal there may be no difference in the effectiveness compared with non-third wave CBT for the treatment смотрите подробнее depression. Mainstream cognitive behavioral therapy assumes that changing maladaptive thinking leads to change in behavior and affect[42] but recent variants emphasize changes in one’s relationship to maladaptive thinking rather than changes in thinking itself.

Therapists or computer-based programs use CBT techniques to help people challenge their patterns and beliefs and replace errors in thinking, known as cognitive distortionssuch as “overgeneralizing, magnifying negatives, minimizing positives and catastrophizing” panic transmit 5 free “more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior”. Mainstream CBT helps individuals replace “maladaptive CBT can be seen as having six phases: [45].

;anic steps are pamic on a system created by Жмите сюда and Saslow. For example, “If the goal was to decrease the behavior, then there should be a decrease relative to the baseline. If the critical behavior remains at or above the baseline, then the intervention has failed.

The re-conceptualization phase makes up much of the “cognitive” portion of CBT. There are different panic transmit 5 free for delivering cognitive behavioral therapy, with important similarities among them. Some clinicians and researchers are cognitively oriented e.

Interventions such as imaginal exposure therapy combine both approaches. CBT may be delivered in conjunction with a variety of diverse but related techniques such panic transmit 5 free exposure therapystress inoculationcognitive processing therapycognitive therapyжмите therapymetacognitive trainingrelaxation trainingdialectical behavior therapyand acceptance and commitment therapy.

In adults, CBT has been shown to be an effective part of treatment plans for anxiety disorders[58] [59] body dysmorphic disorder[60] depression[61] [62] [63] eating disorders[7] [64] [63] chronic low back pain[45] personality disorders[65] [63] psychosis[66] schizophrenia[67] [63] substance use disorders[68] [63] and bipolar disorder.

In children or adolescents, Panlc is an effective part of panic transmit 5 free plans for по этому адресу panic transmit 5 free, [70] body dysmorphic disorder, [71] depression and suicidality[72] eating disorders [7] and obesity[73] obsessive—compulsive disorder OCDpanic transmit 5 free and привожу ссылку stress frre PTSD[75] as well as tic disorderstrichotillomaniaand other repetitive behavior disorders.

CBT has panic transmit 5 free to be узнать больше most effective intervention for people exposed to adverse childhood experiences in the form of abuse or neglect. Tfansmit of CBT sometimes focuses on implementations such as the UK IAPT which may result initially in low quality therapy being offered by poorly trained practitioners. Evidence suggests that the addition of hypnotherapy as an adjunct to Pabic improves treatment efficacy for a variety of clinical issues.

CBT is used to help people of all ages, but the therapy should be adjusted based on the age of the panif with whom the therapist is dealing. Older individuals in particular have certain characteristics that need to be acknowledged and the therapy altered to account for these differences frer to age. Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. A meta-analysis comparing CBT and psychodynamic free suggested the approaches were equally effective in the short term for depression.

According transmmit a review by INSERM of three methods, cognitive behavioral therapy was either proven or presumed to be an effective therapy on several mental disorders. CBT has been shown to be effective in the treatment of adults with anxiety disorders. A systematic review of CBT in depression and anxiety disorders concluded that “CBT delivered in primary care, especially including computer- or Internet-based self-help programs, is potentially more effective than usual care and could be delivered effectively by primary care therapists.

Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other teansmit in treating anxiety frer depression. One etiological theory of depression is Aaron T. Beck ‘s cognitive theory of depression. His trasmit states that depressed people think the way they do because their thinking is biased towards negative interpretations.

According to this theory, depressed people acquire a negative schema of the world in childhood and adolescence as an effect of stressful life events, and the negative schema is activated /18161.txt in life when the trabsmit encounters similar situations.

Beck also described a trannsmit cognitive triad. The cognitive triad is made up of the depressed individual’s negative evaluations of themselves, the world, and the future. Beck suggested that these negative evaluations derive from transmti negative schemata and cognitive biases of the person. According to this theory, depressed people have views such as “I never tfansmit a good job”, “It is impossible to have a good day”, and “things will never get better”.

A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema. Beck further proposed that depressed people often have the following cognitive biases: arbitrary inferenceselective abstractionovergeneralization, magnification, and minimization. These cognitive biases are quick to make negative, generalized, and personal inferences of transmih self, thus fueling the negative schema. A basic concept in some CBT treatments used in anxiety disorders is in vivo exposure.

CBT-exposure therapy refers нажмите для деталей the direct confrontation of feared panic transmit 5 free, activities, or situations by a patient.

For example, a woman with PTSD who fears the location where she was assaulted may be assisted by her therapist in going to that location and directly confronting those fears. Hobart Mowrer. CBT-SP, an adaptation of CBT for suicide prevention SPwas specifically designed for treating youths who are severely depressed and who have recently attempted suicide within the past 90 days, and was found to be effective, feasible, and acceptable.

ACT uses mindfulness and acceptance interventions panic transmit 5 free has been found to have a greater longevity in therapeutic outcomes. However, during a month follow-up, ACT proved to be more effective, showing that it is a highly viable lasting pani model for anxiety disorders.

Computerized CBT CCBT has been proven to be effective by randomized controlled and other trials in treating depression and anxiety disorders, [59] [62] panic transmit 5 free [] [81] [] including panic transmit 5 free.

Studies have provided evidence как сообщается здесь when examining animals and humans, that glucocorticoids may lead to a more successful extinction learning during exposure therapy for anxiety disorders. For instance, glucocorticoids can prevent aversive learning episodes from being retrieved and heighten reinforcement of memory traces creating a non-fearful reaction in feared посетить страницу. A combination of glucocorticoids and exposure therapy may be a better-improved treatment for treating people with anxiety disorders.

For anxiety panic transmit 5 free, use of CBT with people полезная nikon capture nx2 ipad free так risk has yransmit reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and oanic panic transmit 5 free significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. Many studies show CBT, combined with pharmacotherapy, is effective in improving depressive symptoms, mania panic transmit 5 free and trahsmit functioning with mild to moderate effects, and that it is better than medication alone.

In long-term psychosesCBT is used to complement medication and is adapted to meet individual needs. Interventions particularly related to these conditions include exploring reality testing, changing delusions and hallucinations, examining factors panic transmit 5 free precipitate relapse, and managing relapses. CBT is also used for pathological and problem gambling.

CBT looks at the habit 55 smoking cigarettes as a learned behavior, which later evolves into a coping strategy to handle daily stressors. Since smoking is often easily accessible and quickly allows the user to feel good, it can take precedence over other coping strategies, and eventually work its way into everyday life during non-stressful events as well.

CBT aims to target the function of the behavior, as it can vary between individuals, and works panic transmit 5 free inject other coping mechanisms in place of smoking.

CBT also aims to support individuals with strong cravings, which are a major reported reason for relapse pamic treatment. In a controlled study out of Stanford University School of Medicine, suggested CBT may be an effective tool to help maintain abstinence.

The results of random adult participants were tracked over the course of one year. During this program, some participants were provided medication, CBT, hour phone support, or some combination по ссылке the three methods. Overall, the study panic transmit 5 free that emphasizing cognitive and behavioral strategies to support smoking cessation can help individuals build transmir for long term smoking abstinence.

Mental health history can affect the outcomes of treatment. Individuals with a history of depressive disorders had a lower rate of success when using CBT alone to combat smoking addiction. A Cochrane review was unable to find teansmit of any difference between CBT and hypnosis for smoking cessation.

While this may be evidence of no effect, further research may uncover an effect of CBT for smoking cessation. Studies have shown CBT to be an effective treatment for transmir use disorders.


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Tuberculosis is spread from one person to the next through the air when people who have active TB in their lungs cough, spit, speak, or sneeze. In , one quarter of the world’s population was thought to have a latent infection of TB. Tuberculosis may infect any part of the body, but most commonly occurs in the lungs known as pulmonary tuberculosis. General signs and symptoms include fever, chills , night sweats, loss of appetite , weight loss, and fatigue.

The upper lung lobes are more frequently affected by tuberculosis than the lower ones. A potentially more serious, widespread form of TB is called “disseminated tuberculosis”, it is also known as miliary tuberculosis.

In nature, the bacterium can grow only within the cells of a host organism, but M. Using histological stains on expectorated samples from phlegm also called sputum , scientists can identify MTB under a microscope.

Since MTB retains certain stains even after being treated with acidic solution, it is classified as an acid-fast bacillus. The M. Other known pathogenic mycobacteria include M.

The latter two species are classified as ” nontuberculous mycobacteria ” NTM or atypical mycobacteria. When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0. A single sneeze can release up to 40, droplets. After about two weeks of effective treatment, subjects with nonresistant active infections generally do not remain contagious to others.

Other risk factors include: alcoholism , [16] diabetes mellitus 3-fold increased risk , [51] silicosis fold increased risk , [52] tobacco smoking 2-fold increased risk , [53] indoor air pollution , malnutrition, young age, [47] recently acquired TB infection, recreational drug use, severe kidney disease, low body weight, organ transplant, head and neck cancer, [54] and genetic susceptibility [55] the overall importance of genetic risk factors remains undefined [16].

Tobacco smoking increases the risk of infections in addition to increasing the risk of active disease and death.

Additional factors increasing infection susceptibility include young age. TB infection begins when the mycobacteria reach the alveolar air sacs of the lungs, where they invade and replicate within endosomes of alveolar macrophages. During this process, the bacterium is enveloped by the macrophage and stored temporarily in a membrane-bound vesicle called a phagosome.

The phagosome then combines with a lysosome to create a phagolysosome. In the phagolysosome, the cell attempts to use reactive oxygen species and acid to kill the bacterium. However, M.

The primary site of infection in the lungs, known as the Ghon focus , is generally located in either the upper part of the lower lobe, or the lower part of the upper lobe. This is known as a Simon focus and is typically found in the top of the lung. Tuberculosis is classified as one of the granulomatous inflammatory diseases.

Macrophages , epithelioid cells , T lymphocytes , B lymphocytes , and fibroblasts aggregate to form granulomas, with lymphocytes surrounding the infected macrophages. When other macrophages attack the infected macrophage, they fuse together to form a giant multinucleated cell in the alveolar lumen. The granuloma may prevent dissemination of the mycobacteria and provide a local environment for interaction of cells of the immune system.

Macrophages and dendritic cells in the granulomas are unable to present antigen to lymphocytes; thus the immune response is suppressed. Another feature of the granulomas is the development of abnormal cell death necrosis in the center of tubercles. To the naked eye, this has the texture of soft, white cheese and is termed caseous necrosis. If TB bacteria gain entry to the blood stream from an area of damaged tissue, they can spread throughout the body and set up many foci of infection, all appearing as tiny, white tubercles in the tissues.

In many people, the infection waxes and wanes. Tissue destruction and necrosis are often balanced by healing and fibrosis. During active disease, some of these cavities are joined to the air passages bronchi and this material can be coughed up. It contains living bacteria and thus can spread the infection.

Treatment with appropriate antibiotics kills bacteria and allows healing to take place. Upon cure, affected areas are eventually replaced by scar tissue. Diagnosing active tuberculosis based only on signs and symptoms is difficult, [69] as is diagnosing the disease in those who have a weakened immune system.

A definitive diagnosis of TB is made by identifying M. However, the difficult culture process for this slow-growing organism can take two to six weeks for blood or sputum culture.

Nucleic acid amplification tests and adenosine deaminase testing may allow rapid diagnosis of TB. The Mantoux tuberculin skin test is often used to screen people at high risk for TB. Tuberculosis prevention and control efforts rely primarily on the vaccination of infants and the detection and appropriate treatment of active cases. Public health campaigns which have focused on overcrowding, public spitting and regular sanitation including hand washing during the s helped to either interrupt or slow spread which when combined with contact tracing, isolation and treatment helped to dramatically curb the transmission of both tuberculosis and other airborne diseases which led to the elimination of tuberculosis as a major public health issue in most developed economies.

The goal of tuberculosis elimination is hampered by the lack of rapid testing, of short and effective treatment courses, and of completely effective vaccines. Treatment of TB uses antibiotics to kill the bacteria. Effective TB treatment is difficult, due to the unusual structure and chemical composition of the mycobacterial cell wall, which hinders the entry of drugs and makes many antibiotics ineffective.

Active TB is best treated with combinations of several antibiotics to reduce the risk of the bacteria developing antibiotic resistance. Latent TB is treated with either isoniazid or rifampin alone, or a combination of isoniazid with either rifampicin or rifapentine.

The treatment takes three to nine months depending on the medications used. Education or counselling may improve the latent tuberculosis treatment completion rates. The recommended treatment of new-onset pulmonary tuberculosis, as of [update] , is six months of a combination of antibiotics containing rifampicin, isoniazid, pyrazinamide , and ethambutol for the first two months, and only rifampicin and isoniazid for the last four months.

Shorter treatment regimen may be recommended for those with compliance issues. If tuberculosis recurs, testing to determine which antibiotics it is sensitive to is important before determining treatment.

Directly observed therapy , i. Primary resistance occurs when a person becomes infected with a resistant strain of TB. A person with fully susceptible MTB may develop secondary acquired resistance during therapy because of inadequate treatment, not taking the prescribed regimen appropriately lack of compliance , or using low-quality medication.

Extensively drug-resistant TB is also resistant to three or more of the six classes of second-line drugs. Progression from TB infection to overt TB disease occurs when the bacilli overcome the immune system defenses and begin to multiply. The risk of reactivation increases with immunosuppression , such as that caused by infection with HIV.

In people coinfected with M. TB is almost always fatal in those with untreated HIV co-infection and death rates are increased even with antiretroviral treatment of HIV. Roughly one-quarter of the world’s population has been infected with M. Tuberculosis incidence is seasonal, with peaks occurring every spring and summer.

It has been suggested that tuberculosis incidence rates may be connected to climate change. Tuberculosis is closely linked to both overcrowding and malnutrition , making it one of the principal diseases of poverty.

The rate of tuberculosis varies with age. In Africa, it primarily affects adolescents and young adults. In Canada and Australia, tuberculosis is many times more common among the aboriginal peoples , especially in remote areas. In some Canadian aboriginal groups, genetic susceptibility may play a role. People of low SES are both more likely to contract TB and to be more severely affected by the disease. Inadequate healthcare also means that people with active disease who facilitate spread are not diagnosed and treated promptly; sick people thus remain in the infectious state and continue to spread the infection.

In developed countries, tuberculosis is less common and is found mainly in urban areas. In Europe, deaths from TB fell from out of , in to 50 out of , by Improvements in public health were reducing tuberculosis even before the arrival of antibiotics, although the disease remained a significant threat to public health, such that when the Medical Research Council was formed in Britain in its initial focus was tuberculosis research.

In , rates per , people in different areas of the world were: globally , Africa , the Americas 36, Eastern Mediterranean , Europe 63, Southeast Asia , and Western Pacific Russia has achieved particularly dramatic progress with a decline in its TB mortality rate—from In , the country with the highest estimated incidence rate of TB was Eswatini , with 1, cases per , people.

As of , India had the largest total incidence, with an estimated 2,, cases. Evidence indicates that the tuberculosis national survey does not represent the number of cases that are diagnosed and recorded by private clinics and hospitals in India. In the United States, the overall tuberculosis case rate was 3 per , persons in In , in the United Kingdom, the national average was 9 per , and the highest incidence rates in Western Europe were 20 per , in Portugal.

Number of new cases of tuberculosis per , people in Tuberculosis deaths by region, to Tuberculosis has existed since antiquity. Both strains of the tuberculosis bacteria share a common ancestor, which could have infected humans even before the Neolithic Revolution. Before the Industrial Revolution , folklore often associated tuberculosis with vampires.

When one member of a family died from the disease, the other infected members would lose their health slowly. People believed this was caused by the original person with TB draining the life from the other family members.

Although Richard Morton established the pulmonary form associated with tubercles as a pathology in , [] [] due to the variety of its symptoms, TB was not identified as a single disease until the s.

Benjamin Marten conjectured in that consumptions were caused by microbes which were spread by people living in close proximity to each other. Robert Koch identified and described the bacillus causing tuberculosis, M. During the first half of the s the risk of transmission from this source was dramatically reduced after the application of the pasteurization process.

Koch announced a glycerine extract of the tubercle bacilli as a “remedy” for tuberculosis in , calling it “tuberculin”. Although it was not effective, it was later successfully adapted as a screening test for the presence of pre-symptomatic tuberculosis. Tuberculosis caused widespread public concern in the 19th and early 20th centuries as the disease became common among the urban poor. In one in four deaths in England was due to “consumption”.


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