Conrad Lecomte

Biopsychosocial predictors of prognosis in musculoskeletal disorders: a systematic review of the literature

Purpose: To review the prognostic factors of musculoskeletal disorders while adopting a multidimensional perspective and including studies on various pertinent outcomes to the adjustment process. We also aimed to highlight the overall and phase-specific evidence. Methods: We searched the Psychinfo and Ovid Medline(R) databases as well as pertinent periodicals and reviews and retained prospective studies of subjects suffering from specific or non-specific musculoskeletal pain that adopted multivariate statistical analysis. Results: We selected 105 studies, of which 68 included biopsychosocial and sociodemographic variables. For those studies using a biopsychosocial framework, we determined the level of evidence for every prognostic factor with each outcome. Strong evidence was found for recovery expectations and disability management with work participation outcomes. With disability outcomes, strong evidence was also found for recovery expectations, coping and somatization. Comorbidity and duration of episode strongly predicted pain outcomes. Some differences coinciding with phases of chronicity were also identified. Conclusions: Although uncertainty remains about the role of many prognostic factors, we found strong evidence to support the predictive value of clinically significant variables. There is, however, a need for additional research and replication, adopting more homogenous models and measurement methods. Implications for Rehabilitation Despite numerous studies, it remains difficult to identify a clear set of prognostic factors in musculoskeletal disorders. Outcomes in musculoskeletal disorders are determined by biopsychosocial prognostic variables although psychosocial factors appear predominant, as early as in the acute phase. There appears to be negligible differences between prognostic factors in acute, subacute and chronic phases and a biopsychosocial approach should be considered from the acute phase in rehabilitation practice. Outcomes in rehabilitation practice should also be evaluated from a biopsychosocial perspective.

Biopsychosocial predictors of prognosis in musculoskeletal disorders: a systematic review of the literature (corrected and republished)

Purpose: To review the prognostic factors of musculoskeletal disorders while adopting a multidimensional perspective and including studies on various pertinent outcomes to the adjustment process. We also aimed to highlight the overall and phase-specific evidence. Method: We searched the Psychinfo and Ovid Medline(R) databases as well as pertinent periodicals and reviews and retained prospective studies of subjects suffering from specific or non-specific musculoskeletal pain that adopted multivariate statistical analysis. Results: We selected 105 studies, of which 68 included biopsychosocial and sociodemographic variables. For those studies using a biopsychosocial framework, we determined the level of evidence for every prognostic factor with each outcome. Strong evidence was found for recovery expectations and disability management with work participation outcomes. With disability outcomes, strong evidence was also found for recovery expectations, coping and somatization. Comorbidity and duration of episode strongly predicted pain outcomes. Some differences coinciding with phases of chronicity were also identified. Conclusion: Although uncertainty remains about the role of many prognostic factors, we found strong evidence to support the predictive value of clinically significant variables. There is, however, a need for additional research and replication, adopting more homogenous models and measurement methods. Implications for Rehabilitation Despite numerous studies, it remains difficult to identify a clear set of prognostic factors in musculoskeletal disorders. Outcomes in musculoskeletal disorders are determined by biopsychosocial prognostic variables although psychosocial factors appear predominant, as early as in the acute phase. There appears to be negligible differences between prognostic factors in acute, subacute and chronic phases and a biopsychosocial approach should be considered from the acute phase in rehabilitation practice. Outcomes in rehabilitation practice should also be evaluated from a biopsychosocial perspective.

Do people with a first episode of psychosis differ in personality profiles

UNLABELLED Studies on personality profiles in psychosis typically report certain personality traits as linked to the disorder. OBJECTIVES To determine if individuals with a first episode of psychosis: 1) differ from a non-clinical group on the five factor model of personality; 2) all present with similar personality profiles; 3) hold stable personality traits over time. METHOD 79 individuals with a first episode of psychosis were recruited. RESULTS The first episodes significantly differed from the control group on all five personality dimensions. Results also revealed three personality profiles, one linked to psychotic symptoms. Moreover, personality traits of the first episodes showed stability over time.

Personality traits in early psychosis: relationship with symptom and coping treatment outcomes.

Aims: This study aimed to determine personality profiles of individuals with early psychosis based on the Five Factor Model of personality and assess the predictive value of personality traits or profiles on therapeutic outcomes of two group treatments for recent onset psychosis: cognitive behaviour therapy or skills training for symptom management.

Supervision and Instruction in Doctoral Psychotherapy Integration

The movement of rapprochement and integration between different theoretical schools is currently one of the most active and dynamic areas of interest in the field of counseling and psychotherapy (Arkowitz & Messer, 1984; Lecomte & Castonguay, 1987; Marmor & Woods, 1980; Norcross, 1986). In fact, the sheer number of publications dealing with eclecticism, integration, or rapprochement has reached proportions that could have hardly been predicted 15 years ago (Goldfried & Newman, 1986). It can even be argued that the influence of this movement has reached the training boards of major professional associations (American Psychological Association, Canadian Psychological Association), which now expect future clinicians to become familiar with a wide range of assessment and intervention procedures, rather than being restricted to a single modality (APA, 1979; CPA, 1983).

Psychometric Properties of a Perceived Behavioral Control Multiplicative Scale Developed According to Ajzen's Theory of Planned Behavior

The purpose of this study was to test the psychometric properties of a scale to assess perceived behavioral control developed according to a multiplicative procedure. Based upon Ajzens theory of planned behavior, belief-based and global measures of perceived behavioral control and intention to continue with the Certificate program in Law until graduation were assessed among a group of 217 students. Analyses indicated that the psychometric properties of the perceived behavioral control multiplicative scale were appropriate.

Do personality traits matter when choosing a group therapy for early psychosis

OBJECTIVES This study aimed at determining the predictive value of personality traits, based on the Five Factor Model (FFM) of personality, on therapeutic outcomes according to specific group treatments for first episode psychosis: cognitive-behavioural therapy (CBT) or skills training for symptom management (SM). METHODS Individuals experiencing early psychosis were recruited to participate in a randomized- controlled trial (RCT). Participants were randomized to one of two group treatments or to a wait-list control group. Measures included a personality inventory (NEO-FFI) and outcome measures of symptomatology (BPRS-E) and coping strategies (CCS). Pearson correlation analyses were conducted on 78 individuals and linear regression analyses on 66. RESULTS Links were found between personality traits, symptoms, and coping outcome measures, according to specific group treatments. Personality traits were particularly linked to therapeutic changes in active coping strategies, with Conscientiousness accounting for 14% of the variance in the CBT group, Extraversion accounting for 41% of the variance in the SM group, and Openness to experience accounting for 22% of the variance in the control group. CONCLUSIONS Individual differences in personality traits for people experiencing early psychosis should be considered when offering psychosocial treatments, since it appears that those with specific traits might benefit more than others in specific group interventions, particularly for interventions that do not solely aim at improving symptoms.

Self-consciousness and theoretical orientation as mediators of therapist expectancies in psychotherapy

Abstract Correlates of psychotherapy process expectations of 150 psychologists were examined. Transcripts of actual psychotherapeutic sessions from each of the three main schools (psychodynamic, humanistic, behavioural) were used as stimuli to generate a ‘jargon-free’ self-evaluation index of process expectations. Three independent variables were selected: (a) subject self-consciousness; (b) specification or not of the target therapist theoretical affiliation; and (c) subject theoretical affiliation. These variables were arranged in a 2×2×6×3 experimental design. Results showed that when the theoretical orientation of the target therapist was specified in the vignettes, highly self-conscious therapists endorsed, irrespective of their own affiliation, the behaviour of the psychodynamically-oriented therapist. Under all other conditions, no significant differences were observed. The results are discussed in terms of methodological advantages of adopting a more direct, naturalistic approach to our study of s...

L’analyse linguistico-pragma- tique des états mentaux comme méthode d’investigation des discours thérapeutiques

Cette etude presente une nouvelle methode pour analyser les discours des psychotherapeutes. Construite a partir d’une connaissance formelle des processus langagiers, l’analyse linguistico-pragmatique se demarque des methodes d’analyses traditionnelles qui se centrent sur les contenus. L’analyse linguistico-pragmatique des etats mentaux dans le discours des psychotherapeutes est un exemple d’application de cette methode d’analyse. Elle permet d’identifier et de denombrer les indices langagiers renvoyant a l’expression verbale des etats mentaux. Cette methode a ete appliquee a 32 retranscriptions d’entretien (16 entretiens therapeutiques et 16 entretiens de recherche). Les resultats ont montre que les psychotherapeutes utilisent davantage d’indices langagiers d’etats mentaux que les chercheurs et qu’ils font reference a tous les types d’etats mentaux. Les psychotherapeutes Centres sur la Personne ont plus recours aux indices langagiers d’impression-sensation; et les therapeutes d’inspiration psychanalytique...