A massive reference work on the scale of MITECS (The MIT Encyclopedia of Cognitive Sciences), The MIT Encyclopedia of Communication Disorders will become the standard reference in this field for both research and clinical use. It offers almost 200 detailed entries, covering the entire range of communication and speech disorders in children and adults, from basic science to clinical diagnosis.

MITECD is divided into four sections that reflect the standard categories within the field (also known as speech-language pathology and audiology): Voice, Speech, Language, and Hearing. Within each category, entries are organized into three subsections: Basic Science, Disorders, and Clinical Management. Basic Science includes relevant information on normal anatomy and physiology, physics, psychology and psychophysics, and linguistics; this provides a scientific foundation for entries in the other subsections. The entries that appear under Disorders offer information on the definition and characterization of specific disorders, and tools for their identification and assessment. The Clinical Management subsection describes appropriate interventions, including behavioral, pharmacological, surgical, and prosthetic.

Because the approach to communication disorders can be quite different for children and adults, many topics include separate entries reflecting this. Although some disorders that are first diagnosed in childhood may persist in some form throughout adulthood, many disorders can have an onset in either childhood or adulthood, and the timing of onset can have many implications for both assessment and intervention.

Topics covered in MITECD include cochlear implants for children and adults, pitch perception, tinnitus, alaryngeal voice and speech rehabilitation, neural mechanisms of vocalization, holistic voice therapy techniques, computer-based approaches to children?s speech and language disorders, neurogenic mutism, regional dialect, agrammatism, global aphasia, and psychosocial problems associated with communicative disorders.

This study investigated the relationship between perfectionism and tinnitus distress. In addition, associations between perfectionism, sleep problems and anxiety/depression were investigated. The study included 256 tinnitus patients who completed measures of perfectionism, tinnitus distress, anxiety, depression, and a measure of insomnia. Gender-differentiated multiple regression analyses showed that anxiety and depressive states were related to tinnitus distress for both genders. However, for the males, the perfectionism subscale Personal Standards was related to tinnitus distress, whereas in females, it was the Organization subscale that was most predictive of tinnitus distress.

Dizziness is a common and often untreated symptom in the general population. The aim of this study was to investigate the effects of a combined cognitive-behavioral/vestibular rehabilitation (VR) program, using a randomized control design. A total of 29 participants were randomized to treatment consisting of psychoeducation, vestibular exercises, relaxation and cognitive interventions, or to serve as waiting list controls. Measures of dizziness-related handicap, dizziness-provoking movements, and daily diary registrations of dizziness symptoms at pre- and post-treatment showed statistically significant improvements in many domains, which translated to moderate effect sizes. These findings provide preliminary support for the combination of Cognitive-behavioral therapy (CBT) and VR methods in the treatment of dizziness. © 2005 Elsevier Ltd. All rights reserved.

Tinnitus: A Multidisciplinary Approach provides a broad account of tinnitus and hyperacusis, detailing the latest research and developments in clinical management, incorporating insights from audiology, otology, psychology, psychiatry and auditory neuroscience. It promotes a collaborative approach to treatment that will benefit patients and clinicians alike.

Purpose of review: The aim of this article is to review the emerging literature on the use of the Internet in the treatment of anxiety disorders. The questions asked are: (1) are Internet-delivered treatments for anxiety disorders supported by the research literature? (2) what is the quality of the evidence as it stands? (3) is there any evidence to suggest that Internet interventions can be harmful? Recent findings: Recent and ongoing trials on panic disorder show that Internet-based self-help with minimal therapist contact is a promising approach in the treatment of panic disorder. However, trials have been small and there is a need for large-scale trials and studies conducted in psychiatric settings as most studies have recruited patients via advertisement. There is no evidence in the literature that Internet intervention is harmful, but most likely a stepped-care approach would be feasible to handle cases who fail to respond. Summary: Internet-delivered interventions for anxiety disorders, and in particular panic disorder, are promising. There is however a need for further research and evaluation and there is also a need to find a proper place for such interventions in the clinical management of anxiety disorders, preferably using a stepped-care approach. © 2005 Lippincott Williams & Wilkins.

Background: Major depression can be treated by means of cognitive-behavioural therapy, but as skilled therapists are in short supply there is a need for self-help approaches. Many individuals with depression use the internet for discussion of symptoms and to share their experience. Aims: To investigate the effects of an internet-administered self-help programme including participation in a monitored, web-based discussion group, compared with participation in web-based discussion group only. Method: A randomised controlled trial was conducted to compare the effects of internet-based cognitive-behavioural therapy with minimal therapist contact (plus participation in a discussion group) with the effects of participation in a discussion group only. Results: Internet-based therapy with minimal therapist contact, combined with activity in a discussion group, resulted in greater reductions of depressive symptoms compared with activity in a discussion group only (waiting-list control group). At 6 months' follow-up, improvement was maintained to a large extent. Conclusions: Internet-delivered cognitive-behavioural therapy should be pursued further as a complement or treatment alternative for mild-to-moderate depression.

In this study, child psychotherapists (N = 31) were asked to retrieve emotionally valenced therapy episodes by using an autobiographical memory approach, with cue words to elicit specific therapy episodes (e.g. irritated, ashamed, loving, and elated). One group of teachers for the disabled (N = 10) and one group of music therapists (N = 9) were also tested and served as comparison groups. Results showed that all participants were able to retrieve memories of episodes. When asked to rate each memory, negative memories were returned to less often, and overall positive memories were rated as more easy to recall and more vivid. Memories derived from positive cue words were also judged to have a more positive compared with negative importance for outcome. Surprisingly, memories derived from the cue word irritated were seen as having more positive than negative importance for outcome. Finally, we checked memory specificity for each memory derived. A high degree of specificity was found overall (72-88%). In conclusion, cue words might be a useful way to generate specific memories of therapy episodes in future research. © 2006 The British Psychological Society.

Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail. Results were analyzed on an intention-to-treat basis, including all randomized participants. From pre- to posttest, treated participants in contrast to controls showed significant improvement on most measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). The overall within- and between-groups effect sizes were Cohen's d = 0.87 and 0.70, respectively. Treatment gains were maintained at 1-year follow-up. The results from this study support the continued use and development of Internet-distributed, self-help programs for people diagnosed with social phobia. Copyright 2006 by the American Psychological Association.

Tinnitus has been associated with psychiatric disorders and more recently diagnostic tools have been used in a systematic manner. In the present study, we administered the World Health Organisation's Composite International Diagnostic Interview - Short form (CIDI-SF) in a computerized Internet-based version to a self-selected sample of tinnitus patients (n=48). Using the cut-off for 'probable case' (12-month prevalence), 69% of the tinnitus patients fulfilled the criteria for depression, 60% for generalized anxiety disorder, 83% for specific phobia, 67% for social phobia, 58% for agoraphobia, 21% panic attack, 83% obsessive - compulsive disorder, 2% alcohol dependence and 0% drug dependence. Decreased percentages were found for depression (4%), specific phobia (62%) and social phobia (27%) when applying a more conservative criteria (maximum case criteria). In conclusion, the findings suggest that the Internet version of CIDI-SF can be used as a screening tool for psychiatric disturbance in somatic patients, but that diagnostic criteria need to be adjusted for Internet use.

The Internet has revolutionized access to health information and made communication over long distances easier. This article reviews the use of the Internet for delivery of cognitive behaviour therapy. As a starting point the concept of guided self-help is introduced. We next present the treatment approach and different protocols briefly. Next, Swedish studies on panic disorder, social phobia, and depression are summarized using meta-analytic techniques. Implementation in regular clinical setting is discussed with a focus on efficacy versus effectiveness, training of therapist, combined treatments and cost-effectiveness. We conclude that Internet treatment is likely to become a treatment option for suitable patients in the future.

Dizziness is commonly associated with anxiety, and is often caused by a dysfunction of the balance system. While a link between dizziness and both anxiety disorders and depression has been established, less is known about information processing in dizziness. In the first experiment we tested whether 15 patients with dizziness would display an emotional Stroop effect for panic-related words. Also included was a control group of 15 persons. The Stroop task was preceded by ratings of personal relevance of the Stroop words and followed by a surprise free recall of the words. Results showed a Stroop effect for panic-related words in the dizziness group, but the interaction did not reach significance (p = 0.08). Separate analysis of dizziness-related panic words however resulted in a significant group × condition interaction. In the free recall of Stroop words a main effect of word category was found, with more panic-related words being recalled. The second experiment investigated autobiographical memories in 14 patients with dizziness and 14 matched controls. Results showed a group × condition interaction with less specific memories being recalled following positive cue-words in the dizziness group. The overall pattern of results suggests that dizziness is related to deficits in information processing, which could be targeted in treatment.

 While a majority of cognitive-behavioural researchers and clinicians adhere to the classification system provided in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994, 2000), strong objections have been voiced among behaviourists who find the dichotomous allocation of patients into psychiatric diagnoses incompatible with the philosophy of behaviorism and practice of functional analysis. The aim of this paper is to give an overview of the current debate and to analyze the tension between the DSM-IV and functional analysis along the following contrasts: Inductive vs. Deductive, Idiographic vs. Nomothetic, Contextualism vs. Mechanism, Social constructions vs. Real Entities, and Dimensions vs. Categories. Finally, some suggested alternatives are discussed. It is concluded that there is a need for alternative systems to the DSM with treatment utility.

Tinnitus is the perception of sound in the absence of any appropriate external stimulus. Based on the clinical observation that tinnitus patients may distract themselves from their sounds, we performed an experimental test on the effects of suppressing thoughts about tinnitus with 45 tinnitus patients, to systematically evaluate the immediate consequences of suppressing thought vs. attending to tinnitus. Suppression instructions tended to lead to a subsequent decrease in tinnitus-related thoughts, whereas attention to tinnitus resulted in an increase in such thoughts. No effects were seen in a control group who neither suppressed nor attended to their tinnitus. In an independent positron emission tomography study of cerebral blood flow with 8 patients we found that silent backward counting ('serial sevens test') led to a decrease in neural activity in auditory cortex, as well as perceived decrease of tinnitus loudness and annoyance. Thus, distraction that altered the tinnitus experience seemed to attenuate auditory cortex activity. Copyright © 2006 S. Karger AG.

Hyperacusis innebär extrem känslighet för vardagens ljud är ett problem som drabbar cirka 8% av befolkningen. I svåra fall uppstår undvikande av många situationer samt en vana att skydda öronen med hörselskydd även i situationer där det inte behövs. Orsakerna till hyperacusis är till viss del kända, men många frågetecken kvarstår. För hyperacusis finns ingen dokumenterat botande behandling, men kognitiv beteendeterapi, samt eventuellt även tinnitus retraining therapy med brusgenerator, kan minska besvären,. Gott omhändertagande och en multidisciplinär utredning är att rekommendera i svåra fall. En av de viktigaste uppgifterna för framtida forskning är att kartlägga naturalförloppet vad gäller hyperacusis, då detta är i stort okänt. Det finns även ett stort behov av kontrollerade behandlingsstudier.

Most clinicians have little experience with tinnitus treatments, and are unsure of how to help a patient suffering from the condition. Filling a significant gap in literature, this book offers a variety of in-depth protocols to treat tinnitus. Beginning with a review of several neurophysiological and psychological models of tinnitus, the book goes on to cover evaluation tools; counseling options and methods; treatment with hearing aids, wearable and non-wearable noise generators, and music; tinnitus-related insomnia; quality-of-life issues; and much more. Highly experienced clinicians give you the practical strategies to apply such therapeutic modalities as cognitive-behavioral therapy, individual and group sessions, sound therapy, habituation therapy, and narrative therapy. You will also find sample handouts to allow for effective communication with patients. With key clinical information for implementing all current therapies, this text is an essential professional tool for audiologists, psychologists, and other practitioners involved in managing otologic disorders.

Richard Tyler, PhD, is a professor in the Department of Otolaryngology-Head Neck Surgery and in the Department of Speech Pathology and Audiology at the University of Iowa. Tyler and Sergei Kochkin, PhD recently sat down to talk about the results of a survey they conducted about tinnitus treatment and the effectiveness of hearing aids, which was published in the December 2008 edition of The Hearing Review. Click here to learn more and to watch a podcast that examines the survey results: http://www.hearingreview.com/podcast/files/ST20081218.asp.

Most clinicians have little experience with tinnitus treatments, and are unsure of how to help a patient suffering from the condition. Filling a significant gap in literature, this book offers a variety of in-depth protocols to treat tinnitus. Beginning with a review of several neurophysiological and psychological models of tinnitus, the book goes on to cover evaluation tools; counseling options and methods; treatment with hearing aids, wearable and non-wearable noise generators, and music; tinnitus-related insomnia; quality-of-life issues; and much more. Highly experienced clinicians give you the practical strategies to apply such therapeutic modalities as cognitive-behavioral therapy, individual and group sessions, sound therapy, habituation therapy, and narrative therapy. You will also find sample handouts to allow for effective communication with patients. With key clinical information for implementing all current therapies, this text is an essential professional tool for audiologists, psychologists, and other practitioners involved in managing otologic disorders

This questionnaire study investigated the role of coping strategies in tinnitus. The Tinnitus Coping Strategy Questionnaire (12) was administered via the internet to a sample of 157 persons with tinnitus who were recruited for participation in a treatment trial. Also included were the Tinnitus Reaction Questionnaire, the Anxiety Sensitivity Index, and the Hospital Anxiety and Depression Scale. Results showed a significant positive correlation between use of coping strategies and tinnitus distress, even when controlling for anxiety sensitivity, and anxiety and depression levels in a multiple regression analysis. In line with previous studies, the role of coping strategies is not uniformly positive for tinnitus patients, and might even be associated with increased distress. Treatment implications are discussed and a possible role of acceptance strategies is put forward.

The aim of the study was to investigate the effects of cognitive behavioral therapy (CBT) in elderly people with tinnitus (<65 years). Thirty-seven patients were called in for a structured interview. Following exclusion, twenty-three participated in the trial. All participants underwent medical ear, nose, and throat (ENT) examination, audiometry, and tinnitus matchings. A randomized controlled design with a waiting list control group was used. A CBT treatment package was delivered in six weekly two hour group sessions. Outcome was measured using validated self-report inventories and daily diary ratings of annoyance, loudness and sleep quality for one week pre-treatment, post-treatment. A three month follow-up was included at which time all participants had received treatment, but in a shorter format for the control group. Results showed statistically significant reductions of tinnitus-related distress. Thus, CBT was better than no treatment, but the particular aspects of CBT that contributed to the effects can not be established. In conclusion, the findings give some support for the use of group CBT for elderly people with tinnitus. © 2005 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.

Cognitive mechanisms have been proposed to play an important role in tinnitus. In the present study, tinnitus participants were administered an emotional Stroop test via the Internet, incorporating words related to tinnitus concerns. In line with previous research using this Web-based version of the emotional Stroop test, faster color naming was demonstrated for concern-relevant words relative to neutral words. The present results thus provided support for a role for cognitive factors that are important for the understanding of tinnitus. However, future research is warranted in order to clarify the precise mechanisms involved in tinnitus-related Stroop effects. 1© Mary Ann Liebert, Inc.

There is accumulating evidence to suggest that social phobia is associated with attentional bias for words related to social threat. Information processing in individuals with social phobia (n = 87) was investigated in the present study using 2 versions of the emotional Stroop task. Results from a standard emotional Stroop task indicated delayed colour naming of socially threatening words relative to neutral words, in line with previous research, whereas results from a Web-based emotional Stroop task indicated a facilitation effect, with faster manual indication of colour choice for socially threatening words than for neutral words. Possible explanations for these contrasting findings and issues for further research are discussed. © 2006 Taylor & Francis.

The purpose of this study was to investigate the effects of an Internet-based cognitive-behavioral intervention with telephone support for chronic back pain. Participants who met the criteria for chronic back pain (N=56) were randomly assigned to either an Internet-based cognitive behavioral self-help treatment or to a waiting-list control condition. The study period lasted 8 weeks and consisted of 1 week of self-monitoring prior to the intervention, 6 weeks of intervention, and 1 week of post-intervention assessment. Treatment consisted of education, cognitive skill acquisition, behavioral rehearsal, generalization and maintenance. The dropout rate was 9% (N=5). Results showed statistically significant improvements in catastrophizing, control over pain and ability to decrease pain. Some improvement was found in both the control group and the treatment group. A follow-up of 3 months after treatment termination was completed in 92% (N=47) of the participants who completed the treatment intervention. Follow-up results showed that some improvement was maintained. Findings indicate that Internet-based self-help with telephone support, based on established psychological treatment methods, holds promise as an effective approach for treating disability in association with pain.

Pathological gambling is a public health problem. Two percent of the Swedish general population has an ongoing gambling problem. Although pathological gambling is associated with depression, anxiety and low quality of life, few sufferers seek treatment. Barriers to accessing expert assistance include shortage of skilled therapists, long waiting lists, cost and sometimes even shame. A major challenge therefore, is to increase the accessibility and affordability of evidence-based psychological treatments. Printed self-help manuals have been developed to assist people with mental health problems who are unwilling or unable to access professional assistance, although there has been little evaluation of their efficacy. A modern alternative to printed self-help manuals is computers. In an attempt to provide a cost-effective treatment for problem and pathological gambling, a randomized controlled trial was conducted. Thirty participants were randomized to either a waiting list or an 8-week internet-based treatment program with minimal therapist contact via e-mail. Each participant also had a weekly 10-minute telephone conversation with a therapist. The web-based treatment program will be presented as well as the preliminary results from the study.

Objective: This study evaluated a 10-week Internet-based bibliotherapy self-help program with short weekly telephone calls for people suffering from panic disorder with or without agoraphobia. Method: After the authors confirmed the diagnosis by administering the Structured Clinical Interview for DSM-IV by telephone, 60 participants were randomly assigned to either a wait-listed control group or a multimodal treatment package based on cognitive behavior therapy plus minimal therapist contact via e-mail. A 10-minute telephone call was made each week to support each participant. Total mean time spent on each participant during the 10 weeks was 3.9 hours. The participants were required to send in homework assignments before receiving the next treatment module. Results: Analyses were conducted on an intention-to-treat basis, which included all randomly assigned participants. From pretreatment to posttreatment, all treated participants improved significantly on all measured dimensions (bodily interpretations, maladaptive cognitions, avoidance, general anxiety and depression levels, and quality of life). Treatment gains on self-report measures were maintained at the 9-month follow-up. A blind telephone interview after the end of treatment revealed that 77% of the treated patients no longer fulfilled the criteria for panic disorder, whereas all of the wait-listed subjects still suffered from it. Conclusions: This study provides evidence to support the use of treatment distributed via the Internet with the addition of short weekly telephone calls to treat panic disorder. Replication should be made to compare self-help and telephone treatment based on cognitive behavior methods with nonspecific interventions.

The aim of this study was to investigate the psychometric properties of Internet administered questionnaires used in panic research. Included were 494 people who had registered for an Internet-based treatment program for panic disorder (PD). Participants were randomly assigned to fill in the questionnaires either on the Internet or the paper-and-pencil versions, and then to fill in the same questionnaires again the next day using the other format. The questionnaires were the body sensations questionnaire [BSQ, Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097], agoraphobic cognitions questionnaire [ACQ, Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097], mobility inventory [MI, Chambless, D. L., Caputo, G., Jasin, S., Gracely, E. J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour Research and Therapy, 23, 35-44], beck anxiety inventory [BAI, Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897], beck depression inventory II [Beck, A. T., & Steer, R. A. (1996). Beck Depression Inventory. Manual, Svensk version (Swedish version). Fagernes, Norway: Psykologiförlaget, AB], quality of life inventory [QOLI, Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the quality of life inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment, 4, 92-101], and montgomery Åsberg depression rating scale [MADRS, Svanborg, P., & Åsberg, M. (1994). A new self-rating scale for depression and anxiety states based on the comprehensive psychopathological rating scale. ACTA Psychiatrica Scandinavica, 89, 21-28]. Results showed largely equivalent psychometric properties for the two administration formats (Cronbach's α between 0.79 and 0.95). The results also showed high and significant correlations between the Internet and the paper-and-pencil versions. Analyses of order effects showed an interaction effect for the BSQ and the MI (subscale Accompanied), a main effect was identified for ACQ, MI-Alone, BAI and BDI II. However, in contrast to previous research, the Internet version did not consistently generate higher scores and effect sizes for the differences were generally low. Given the presence of an interaction effect, we recommend that the administration format should be stable in research across measurement points. Finally, the findings suggest that Internet versions of questionnaires used in PD research can be used with confidence. © 2005 Elsevier Ltd. All rights reserved.

Behandling av spelberoende via Internet - fungerar det?

This study evaluated a nine-week Internet-based self-help program for people suffering from social phobia. After confirming the diagnosis with a structured clinical interview for the DSM-IV (SCID) by telephone, 26 participants were treated with a multimodal treatment package based on cognitive behavioral therapy plus weekly therapist contact via e-mail. Results were analyzed on a basis of intention-to-treat. There were no differences between the two pre-treatment assessment points. However, from pre- to post-test, treated participants improved signi?cantly on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). The overall within-group effect size measured with Cohen-s d was d=0.88. Treatment gains were maintained or improved at the 6-month follow-up (Cohen-s d=1.31). The results of this study support the continued use and development of Internet-distributed self-help programs for people diagnosed with social phobia. 

A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs. © 2004 Elsevier Ltd. All rights reserved.

The focus is on how students construct, deconstruct and reconstruct the meaning of being an engineering student and of becoming an engineer in relation to the concept of employability. Four cohorts of students in a Masters program in Engineering were monitored annually with a “follow up” one year after graduation. Results show that there were differences in the way students talked about their curricular design, career plans, job search, becoming an employee and employable, and job satisfaction. Throughout the interviews certain turning points were identified, where the students had to make various decisions. Many students argued that generic skills and cultural values are best learned in extra-curricular activities and in work contexts, and that doing a thesis project in a firm was the best learning experience . During this thesis process students became conscious of their valuable employability skills, which in the job search process were a good thesis project; a diploma from the program, self-efficacy, problem-solving skills and a broad knowledge base.  On the job, the most valuable acquired key skills were considered to be mathematics and subject specific knowledge; problem solving skills; time management skills; learning skills; and, an ability to manage stress and heavy workloads.