Tag: Linardon

Reading of the Week: Preventing PTSD – the New AJP Study; Also, AI Hallucinations and Dr. Gollapudi on Stethoscopes

From the Editor

Though years had passed since his peacekeeping service in Bosnia, my patient lucidly described the flashbacks and nightmares that still haunted him. It raises an important question: is it possible to prevent PTSD in the first place?

In a new, important American Journal of Psychiatry paper, Chelsea Dyan Gober Dykan (of Tel Aviv University) and her co-authors attempt to answer that question by drawing on past work showing the effectiveness of response-time-based attention bias modification (RT-based ABM), a cognitive training technique. They describe a three-arm randomized controlled trial involving more than 500 male combat-bound soldiers who, before combat exposure, received one of two cognitive training techniques (RT-based ABM and a variant focused on gaze) or a sham intervention. Participants then reported on PTSD symptoms after it. “Consistent with a previous randomized controlled trial, RT-based ABM reduced risk for PTSD relative to sham ABM when implemented prior to combat exposure.” We consider the paper and its implications.

How common are AI hallucinations? In the second selection, Jake Linardon (of Deakin University) and his co-authors look at hallucinations through the prism of psychiatry, asking ChatGPT to draft writing on several disorders. In their JMIR Mental Health study, hallucinations were frequent. “Citation fabrication and bibliographic errors remain common in GPT-4o outputs, with nearly two-thirds of citations being fabricated or inaccurate.”

Finally, in the third selection from Academic Psychiatry, Dr. Sheba Gollapudi (of the University of Texas) mulls the power of the stethoscope and its psychiatric equivalent. She describes how she developed her listening skills and her use of silence. “Because even though I will not necessarily use a stethoscope in my everyday practice, I know now that the stethoscope is within me.”

DG

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Reading of the Week: The Insomnia Issue with Papers from NEJM & Sleep Med, and Dr. Cannon on Her Cure for Insomnia

From the Editor

With his depressive episode, he can’t sleep. While he thinks cannabis may be worsening his anxiety, in his view, a couple of joints before bed is the only thing that seems to help with the insomnia.

My patient’s problems are common. So many of our patients struggle with insomnia. How should we assess it? What’s evidence-based care? And what can we suggest to replace that cannabis? This week, we open with the new review from The New England Journal of Medicine. Charles M. Morin (of Université Laval) and Dr. Daniel J. Buysse (of the University of Pittsburgh) provide timely advice in their paper. They consider scales that could be incorporated into practice, evidence for CBT-I, and different medications. “Recommended therapies for insomnia produce clinically meaningful reductions in insomnia symptoms, sleep-onset latency, and time awake after sleep onset.” We summarize the paper and weigh its implications.

Counting sheep may not always work

With growing evidence for CBT-I, digital options are increasingly appealing due to their convenience and accessibility. In the second selection, Jake Linardon (of Deakin University) and his co-authors report on a study looking at the effectiveness of app-based interventions for insomnia, just published in Sleep Medicine. In this meta-analysis, they drew on 19 RCTs including different treatments like CBT. “Findings suggest that stand-alone app-based interventions can effectively address insomnia and sleep disturbances, and may play an important role in the management of these symptoms.”

And in the third selection, Dr. Joanna Cannon, a UK physician and bestselling author, discusses her insomnia in an essay for The Guardian. She describes the impact on her life and her unusual way of coping. She also notes the origin of the problem: “It was when I started training as a doctor that my atypical sleeping habits became embedded.”

DG

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