Based on promising results with adults, Acceptance and Commitment Therapy (ACT) presents as a treatment opportunity for depressed adolescents. We present a pilot study that compares ACT with treatment as usual (TAU), using random allocation of participants who were clinically referred to a psychiatric outpatient service. Participants were 30 adolescents, aged M = 14.9 (SD = 2.55), with 73.6% in the clinical range for depression. At posttreatment on measures of depression participants in the ACT condition showed significantly greater improvement statistically (d = 0.38), and 58% showed clinically reliable change with a response ratio of 1.59 in favor of ACT. Outcomes from 3-month follow-up data are tentative due to small numbers but suggest that improvement increased in magnitude. Measures of global functioning showed statistically significant improvement for both conditions, although clinical change measures favored only the ACT condition. The results support conducting a larger trial of ACT for the treatment of adolescent depression.
OBJECTIVE: To investigate the effect of a short-term yoga-based lifestyle intervention on risk factors for cardiovascular disease (CVD) and markers of inflammation and endothelial function in overweight and obese men. DESIGN: Nonrandomized prospective lifestyle intervention study with pre-post design. SETTING AND LOCATION: Integral Health Clinic, an outpatient facility providing yoga-based lifestyle intervention programs for prevention and management of chronic diseases. SUBJECTS: Overweight and obese men (n=51) were enrolled in the study. Subjects who were physically unable to participate and those participating in other interventions were excluded from the study. INTERVENTION: A pretested intervention program including asanas (physical postures), pranayama (breathing exercises), group discussions, lectures, and individualized advice. OUTCOME MEASURES: The primary outcome measure was weight loss, and the secondary outcome measures were clinical and laboratory correlates of CVD risk, levels of interleukin-6 (IL-6), adiponectin, and endothelin-1 (ET-1). RESULTS: Men (n=51, body mass index [BMI] 26.26±2.42 kg/m(2)) were enrolled and underwent a yoga-based lifestyle intervention for 10 days. Of 51 subjects, 30 completed the study. There was a significant reduction in weight from Baseline to Day 10 (74.60±7.98, 72.69±8.37 kg, p<0.001, respectively), BMI (26.26±2.42, 25.69±2.47 kg/m(2), p<0.001, respectively), and systolic BP (121.73±11.58, 116.73±9.00, p=0.042, respectively). There was a significant reduction in plasma IL-6 from Baseline to Day 10 (median 2.24 vs. 1.26 pg/mL, respectively, p=0.012). There was a significant increase in the plasma adiponectin from Baseline to Day 10 (median 4.95 vs. 6.26 μg/mL, respectively, p=0.014). Plasma ET-1 level remained unchanged. CONCLUSION: These findings suggest that even a short-term yoga-based lifestyle intervention may be an important modality to reduce the risk for CVD as indicated by weight loss, reduction in systolic blood pressure, an increase in adiponectin, and decrease in IL-6 in overweight and obese men.
Adolescence is a time of change that can be both exciting and stressful. In this review, we focus on the central role that disturbed sleep and daytime sleepiness occupies in interactions involving substance abuse and negative health, social, and emotional outcomes. As a means of improving sleep and lowering risk for recidivism of substance abuse, we developed and implemented a six-session group treatment to treat sleep disturbances in adolescents who have received treatment for substance abuse. The components of the treatment are stimulus control instructions, use of bright light to regularize sleep, sleep hygiene education, cognitive therapy, and Mindfulness-Based Stress Reduction. Preliminary evidence indicates that participants who completed four or more sessions in the treatment program showed improved sleep and that improving sleep may lead to a reduction in substance abuse problems at the 12-month follow-up.
Children and adolescents with Asperger syndrome occasionally exhibit aggressive behavior against peers and parents. In a multiple baseline design across subjects, three adolescents with Asperger syndrome were taught to use a mindfulness-based procedure called Meditation on the Soles of the Feet to control their physical aggression in the family home and during outings in the community. They were taught to shift the focus of their attention from the negative emotions that triggered their aggressive behavior to a neutral stimulus, the soles of their feet. Prior to training in the mindfulness-based procedure the adolescents had moderate rates of aggression. During mindfulness practice, which lasted between 17 and 24 weeks, their mean rates of aggression per week decreased from 2.7, 2.5 and 3.2 to 0.9, 1.1, and 0.9, respectively, with no instances observed during the last 3 weeks of mindfulness practice. No episodes of physical aggression occurred during a 4-year follow-up. This study suggests that adolescents with Asperger syndrome may successfully use a mindfulness-based procedure to control their aggressive behavior.
Adolescents with conduct disorder frequently engage in aggressive and disruptive behaviors. Often these behaviors are controlled or managed through behavioral or other psychosocial interventions. However, such interventions do not always ensure lasting changes in an adolescent's response repertoire so that he or she does not engage in aggression when exposed to the same situations that gave rise to the behavior previously. Mindfulness training provides a treatment option that helps an individual focus and attend to conditions that give rise to maladaptive behavior.Using a multiple baseline design,we assessed the effectiveness of a mindfulness training procedure in modulating the aggressive behavior of three adolescents who were at risk of expulsion from school because of this behavior. The adolescents were able to learn the mindfulness procedure successfully and use it in situations that previously occasioned aggressive behavior.This led to large decreases in the aggression of all three individuals. Follow-up data showed that the adolescents were able to keep their aggressive behavior at socially acceptable levels in school through to graduation. Maladaptive behaviors, other than aggression, that the adolescents chose not to modify, showed no consistent change during mindfulness training, practice, and follow-up.
An emotion-modulated acoustic startle paradigm for inducing positive and negative affect was used to address pregoal and postgoal affect. Participants played a computerized lottery task in which they chose digits that could match a subsequently displayed, random set of numbers. In the positive conditions, matches led to monetary rewards. In the negative condition, matches led to an aversive noise blast. In three experiments, we found eyeblink startle magnitude was potentiated just prior to feedback concerning reward outcome, suppressed following the feedback that a monetary reward was won, and potentiated when threatened with an aversive noise. When presented with a 0%, 45%, 90%, or 100% chance of winning, higher probabilities suppressed startle response after feedback whereas the 45% trials did not. These data indicate that postgoal positive affect (winning reward) reliably suppressed the startle response whereas pregoal positive affect did not.
<p>Humans often judge others egocentrically, assuming that they feel or think similarly to themselves. Emotional egocentricity bias (EEB) occurs in situations when others feel differently to oneself. Using a novel paradigm, we investigated the neurocognitive mechanisms underlying the developmental capacity to overcome such EEB in children compared with adults. We showed that children display a stronger EEB than adults and that this correlates with reduced activation in right supramarginal gyrus (rSMG) as well as reduced coupling between rSMG and left dorsolateral prefrontal cortex (lDLPFC) in children compared with adults. Crucially, functional recruitment of rSMG was associated with age-related differences in cortical thickness of this region. Although in adults the mere presence of emotional conflict occurs between self and other recruited rSMG, rSMG-lDLPFC coupling was only observed when implementing empathic judgements. Finally, resting state analyses comparing connectivity patterns of rSMG with that of right temporoparietal junction suggested a unique role of rSMG for self-other distinction in the emotional domain for adults as well as for children. Thus, children’s difficulties in overcoming EEB may be due to late maturation of regions distinguishing between conflicting socio-affective information and relaying this information to regions necessary for implementing accurate judgments.</p>
The primary taste cortex consists of the insula and operculum. Previous work has indicated that neurons in the primary taste cortex respond solely to sensory input from taste receptors and lingual somatosensory receptors. Using functional magnetic resonance imaging, we show here that expectancy modulates these neural responses in humans. When subjects were led to believe that a highly aversive bitter taste would be less distasteful than it actually was, they reported it to be less aversive than when they had accurate information about the taste and, moreover, the primary taste cortex was less strongly activated. In addition, the activation of the right insula and operculum tracked online ratings of the aversiveness for each taste. Such expectancy-driven modulation of primary sensory cortex may affect perceptions of external events.
BACKGROUND: Autism is a syndrome of unknown cause, marked by abnormal development of social behavior. Attempts to link pathological features of the amygdala, which plays a key role in emotional processing, to autism have shown little consensus. OBJECTIVE: To evaluate amygdala volume in individuals with autism spectrum disorders and its relationship to laboratory measures of social behavior to examine whether variations in amygdala structure relate to symptom severity. DESIGN: We conducted 2 cross-sectional studies of amygdala volume, measured blind to diagnosis on high-resolution, anatomical magnetic resonance images. Participants were 54 males aged 8 to 25 years, including 23 with autism and 5 with Asperger syndrome or pervasive developmental disorder not otherwise specified, recruited and evaluated at an academic center for developmental disabilities and 26 age- and sex-matched community volunteers. The Autism Diagnostic Interview-Revised was used to confirm diagnoses and to validate relationships with laboratory measures of social function. MAIN OUTCOME MEASURES: Amygdala volume, judgment of facial expressions, and eye tracking. RESULTS: In study 1, individuals with autism who had small amygdalae were slowest to distinguish emotional from neutral expressions (P=.02) and showed least fixation of eye regions (P=.04). These same individuals were most socially impaired in early childhood, as reported on the Autism Diagnostic Interview-Revised (P<.04). Study 2 showed smaller amygdalae in individuals with autism than in control subjects (P=.03) and group differences in the relation between amygdala volume and age. Study 2 also replicated findings of more gaze avoidance and childhood impairment in participants with autism with the smallest amygdalae. Across the combined sample, severity of social deficits interacted with age to predict different patterns of amygdala development in autism (P=.047). CONCLUSIONS: These findings best support a model of amygdala hyperactivity that could explain most volumetric findings in autism. Further psychophysiological and histopathological studies are indicated to confirm these findings.
This article presents an overview of the author's recent electrophysiological studies of anterior cerebral asymmetries related to emotion and affective style. A theoretical account is provided of the role of the two hemispheres in emotional processing. This account assigns a major role in approach- and withdrawal-related behavior to the left and right frontal and anterior temporal regions of two hemispheres, respectively. Individual differences in approach- and withdrawal-related emotional reactivity and temperament are associated with stable differences in baseline measures of activation asymmetry in these anterior regions. Phasic state changes in emotion result in shifts in anterior activation asymmetry which are superimposed upon these stable baseline differences. Future directions for research in this area are discussed.
In this experiment, we combined the measurement of observable facial behavior with simultaneous measures of brain electrical activity to assess patterns of hemispheric activation in different regions during the experience of happiness and disgust. Disgust was found to be associated with right-sided activation in the frontal and anterior temporal regions compared with the happy condition. Happiness was accompanied by left-sided activation in the anterior temporal region compared with disgust. No differences in asymmetry were found between emotions in the central and parietal regions. When data aggregated across positive films were compared to aggregate negative film data, no reliable differences in brain activity were found. These findings illustrate the utility of using facial behavior to verify the presence of emotion, are consistent with the notion of emotion-specific physiological patterning, and underscore the importance of anterior cerebral asymmetries for emotions associated with approach and withdrawal.
<p>Interest in mindfulness-based interventions for children and adolescents is burgeoning, bringing with it the need for validated instruments to assess mindfulness in youths. The present studies were designed to validate among adolescents a measure of mindfulness previously validated for adults (e.g., Brown & Ryan, 2003), which we herein call the Mindful Attention Awareness Scale—Adolescent (MAAS–A). In 2 large samples of healthy 14- to 18-year-olds (N = 595), Study 1 supported a single-factor MAAS–A structure, along with acceptably high internal consistency, test–retest reliability, and both concurrent and incremental validity. In Study 2, with a sample of 102 psychiatric outpatient adolescents age 14–18 years, participants randomized to a mindfulness-based stress reduction intervention showed significant increases in MAAS–A scores from baseline to 3-month follow-up, relative to nonsignificant score changes among treatment-as-usual participants. Increases in MAAS–A scores among mindfulness-based stress reduction participants were significantly related to beneficial changes in numerous mental health indicators. The findings support the reliability and validity of the MAAS–A in normative and mixed psychiatric adolescent populations and suggest that the MAAS–A has utility in mindfulness intervention research.</p>
<p>This article presents 4 studies (N = 1,413) describing the development and validation of the Child and Adolescent Mindfulness Measure (CAMM). In Study 1 (n = 428), the authors determined procedures for item development and examined comprehensibility of the initial 25 items. In Study 2 (n = 334), they reduced the initial item pool from 25 to 10 items through exploratory factor analysis. Study 3 (n = 332) evaluated the final 10-item measure in a cross-validation sample, and Study 4 (n = 319) determined validity coefficients for the CAMM using bivariate and partial correlations with relevant variables. Results suggest that the CAMM is a developmentally appropriate measure with adequate internal consistency. As expected, CAMM scores were positively correlated with quality of life, academic competence, and social skills and negatively correlated with somatic complaints, internalizing symptoms, and externalizing behavior problems. Correlations were reduced but generally still significant after controlling for the effects of 2 overlapping processes (thought suppression and psychological inflexibility). Overall, results suggest that the CAMM may be a useful measure of mindfulness skills for school-aged children and adolescents.</p>
We conducted assessments of 28 children with impaired vision (VI group), with ages ranging from 12 to 17 years, and an equal number of age-matched, normal-sighted children (NS group). The VI group had significantly higher rates of breathing, heart rates, and diastolic blood pressure values compared to the NS group (Mann–Whitney U test). Twenty-four of the VI group formed pairs matched for age and degree of blindness, and we randomly assigned members of the pairs to two groups, viz., yoga and physical activity. Both groups spent an hour each day practicing yoga or working in the garden, depending on their group. After 3 weeks, the yoga group showed a significant decrease in breath rate (Wilcoxon paired signed ranks test). There was no change after the physical activity program. The results showed that children with visual impairment have higher physiological arousal than children with normal sight, with a marginal reduction in arousal following yoga.
Background Early life stress (ELS) can compromise development, with higher amounts of adversity linked to behavioral problems. To understand this linkage, a growing body of research has examined two brain regions involved with socioemotional functioning—amygdala and hippocampus. Yet empirical studies have reported increases, decreases, and no differences within human and nonhuman animal samples exposed to different forms of ELS. This divergence in findings may stem from methodological factors, nonlinear effects of ELS, or both. Methods We completed rigorous hand-tracing of the amygdala and hippocampus in three samples of children who experienced different forms of ELS (i.e., physical abuse, early neglect, or low socioeconomic status). Interviews were also conducted with children and their parents or guardians to collect data about cumulative life stress. The same data were also collected in a fourth sample of comparison children who had not experienced any of these forms of ELS. Results Smaller amygdala volumes were found for children exposed to these different forms of ELS. Smaller hippocampal volumes were also noted for children who were physically abused or from low socioeconomic status households. Smaller amygdala and hippocampal volumes were also associated with greater cumulative stress exposure and behavioral problems. Hippocampal volumes partially mediated the relationship between ELS and greater behavioral problems. Conclusions This study suggests ELS may shape the development of brain areas involved with emotion processing and regulation in similar ways. Differences in the amygdala and hippocampus may be a shared diathesis for later negative outcomes related to ELS.
<p>Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.</p>
Fragile X syndrome (FXS) is the most commonly known genetic disorder associated with autism spectrum disorder (ASD). Overlapping features in these populations include gaze aversion, communication deficits, and social withdrawal. Although the association between FXS and ASD has been well documented at the behavioral level, the underlying neural mechanisms associated with the social/emotional deficits in these groups remain unclear. We collected functional brain images and eye-gaze fixations from 9 individuals with FXS and 14 individuals with idiopathic ASD, as well as 15 typically developing (TD) individuals, while they performed a facial-emotion discrimination task. The FXS group showed a similar yet less aberrant pattern of gaze fixations compared with the ASD group. The FXS group also showed fusiform gyrus (FG) hypoactivation compared with the TD control group. Activation in FG was strongly and positively associated with average eye fixation and negatively associated with ASD characteristics in the FXS group. The FXS group displayed significantly greater activation than both the TD control and ASD groups in the left hippocampus (HIPP), left superior temporal gyrus (STG), right insula (INS), and left postcentral gyrus (PCG). These group differences in brain activation are important as they suggest unique underlying face-processing neural circuitry in FXS versus idiopathic ASD, largely supporting the hypothesis that ASD characteristics in FXS and idiopathic ASD reflect partially divergent impairments at the neural level, at least in FXS individuals without a co-morbid diagnosis of ASD.
The experience of aversion is shaped by multiple physiological and psychological factors including one's expectations. Recent work has shown that expectancy manipulation can alter perceptions of aversive events and concomitant brain activation. Accruing evidence indicates a primary role of altered expectancies in the placebo effect. Here, we probed the mechanism by which expectation attenuates sensory taste transmission by examining how brain areas activated by misleading information during an expectancy period modulate insula and amygdala activation to a highly aversive bitter taste. In a rapid event-related fMRI design, we showed that activations in the rostral anterior cingulate cortex (rACC), orbitofrontal cortex (OFC), and dorsolateral prefrontal cortex to a misleading cue that the taste would be mildly aversive predicted decreases in insula and amygdala activation to the highly aversive taste. OFC and rACC activation to the misleading cue were also associated with less aversive ratings of that taste. Additional analyses revealed consistent results demonstrating functional connectivity among the OFC, rACC, and insula. Altering expectancies of upcoming aversive events are shown here to depend on robust functional associations among brain regions implicated in prior work on the placebo effect.
Purpose Evaluate impact of breathing awareness meditation (BAM), Botvin LifeSkills® Training (LST), and health education control (HEC) on ambulatory blood pressure (BP) and sodium excretion in African American (AA) adolescents. Methods Following three consecutive days of systolic blood pressure (SBP) screenings, 166 eligible participants (i.e., SBP > 50th – 95th percentile) were randomized by school to either BAM (n = 53), LST (n= 69), or HEC (n=44). In-school intervention sessions were administered for three months by health education teachers. Before and after the intervention overnight urine samples and 24-hour ambulatory SBP, diastolic blood pressure (DBP), and heart rate (HR) were obtained. Results Significant group differences were found for changes in overnight SBP and SBP, DBP and HR over the 24-hour period and during school hours. The BAM treatment exhibited the greatest overall decreases on these measures (Bonferroni adjusted, ps <.05). For example, for school-time SBP, BAM showed a change of −3.7 mmHg compared to no change for LST and a change of −0.1 mmHg for HEC. There was a non-significant trend for overnight urinary sodium excretion (p = .07) with the BAM group displaying a reduction of −.92 ± 1.1 mEq/hr compared to increases of .89 ± 1.2 mEq/hr for LST, and .58±0.9 mEq/hr for HEC group. Conclusion BAM appears to improve hemodynamic function and may impact sodium handling among AA adolescents at increased risk for development of cardiovascular disease (CVD).
We evaluated the efficacy of a mindful parenting program for changing parents’ mindfulness, child management practices, and relationships with their early adolescent youth and tested whether changes in parents’ mindfulness mediated changes in other domains. We conducted a pilot randomized trial with 65 families and tested an adapted version of the Strengthening Families Program: For Parent and Youth 10–14 that infused mindfulness principles and practices against the original program and a delayed intervention control group. Results of pre-post analyses of mother and youth-report data showed that the mindful parenting program generally demonstrated comparable effects to the original program on measures of child management practices and stronger effects on measures of mindful parenting and parent–youth relationship qualities. Moreover, mediation analyses indicated that the mindful parenting program operated indirectly on the quality of parent–youth relationships through changes in mindful parenting. Overall, the findings suggest that infusing mindful parenting activities into existing empirically validated parenting programs can enhance their effects on family risk and protection during the transition to adolescence.
Chaotic conditions are a prevalent and threatening feature of social life. Five studies examined whether social class underlies divergent responses to perceptions of chaos in one's social environments and outcomes. The authors hypothesized that when coping with perceptions of chaos, lower class individuals tend to prioritize community, relative to upper class individuals, who instead tend to prioritize material wealth. Consistent with these predictions, when personally confronting chaos, lower class individuals were more communally oriented (Study 1), more connected with their community (Study 2), and more likely to volunteer for a community-building project (Study 3), compared to upper class individuals. In contrast, perceptions of chaos caused upper class individuals to express greater reliance on wealth (Study 4) and prefer financial gain over membership in a close-knit community (Study 5), relative to lower class individuals. These findings suggest that social class shapes how people respond to perceptions of chaos and cope with its threatening consequences.
We propose that cognition is more than a collection of independent processes operating in a modular cognitive system. Instead, we propose that cognition emerges from dependencies between all of the basic systems in the brain, including goal management, perception, action, memory, reward, affect, and learning. Furthermore, human cognition reflects its social evolution and context, as well as contributions from a developmental process. After presenting these themes, we illustrate their application to the process of anticipation. Specifically, we propose that anticipations occur extensively across domains (i.e., goal management, perception, action, reward, affect, and learning) in coordinated manners. We also propose that anticipation is central to situated action and to social interaction, and that many of its key features reflect the process of development.
Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a “mental health” approach feels pathologizing. Nevertheless, these youth have suffered maltreatment and interventions to improve their ability to cope with past trauma and their often uncertain present are clearly needed. Cognitively-Based Compassion Training (CBCT) provides an alternative perspective on suffering and can be framed as a wellness intervention that is appropriate for all humans. The present study examined whether a 6-week CBCT intervention would improve psychosocial functioning among adolescents in foster care. Seventy adolescents were randomized to CBCT (twice weekly) or a wait-list condition. Youth were assessed at baseline and after 6 weeks. Groups did not differ on measures of psychosocial functioning following training; however practice frequency was associated with increased hopefulness and a trend for a decrease in generalized anxiety. Qualitative results indicated that participants found CBCT useful for dealing with daily life stressors. Adolescents in care were willing to engage in CBCT. The majority reported CBCT was very helpful and almost all reported they would recommend CBCT to a friend. Participants reported specific instances of using CBCT strategies to regulate emotion, manage stress, or to respond more compassionately towards others. Standardized self-report measures were not sensitive to qualitative reports of improved functioning, suggesting the need for measures more sensitive to the positive changes noted or longer training periods to demonstrate effects. Practical issues surrounding implementation of such programs in high-risk youth populations are identified. Recommendations are provided for further development.
<p>A tangible support to teachers on Christian meditation for children, this book is the result of a Diocesan-wide programme in Townsville to teach meditation to children from preschool to Year 12.</p>