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.
Zotero Collections:
OBJECTIVE: The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response.
METHOD: Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with extended-release venlafaxine.
RESULTS: Patients with generalized anxiety disorder showed greater anticipatory activity than healthy comparison subjects in the bilateral dorsal amygdala preceding both aversive and neutral pictures. Building on prior reports of pretreatment anterior cingulate cortex activity predicting treatment response, anticipatory activity in that area was associated with clinical outcome 8 weeks later following treatment with venlafaxine. Higher levels of pretreatment anterior cingulate cortex activity in anticipation of both aversive and neutral pictures were associated with greater reductions in anxiety and worry symptoms.
CONCLUSIONS: These findings of heightened and indiscriminate amygdala responses to anticipatory signals in generalized anxiety disorder and of anterior cingulate cortex associations with treatment response provide neurobiological support for the role of anticipatory processes in the pathophysiology of generalized anxiety disorder.
Zotero Collections:
Zotero Collections:
Context
Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce.Objective
To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients.Design, Setting, and Participants
Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo).Main Outcome Measures
Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months.Results
Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Δ], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Δ = −6.8; 95% CI, −4.8 to −8.8; depersonalization, 8.4 to 5.9; Δ = −2.5; 95% CI, −1.4 to −3.6; and personal accomplishment, 40.2 to 42.6; Δ = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Δ = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Δ = −4.1; 95% CI, −1.8 to −6.4); total mood disturbance (33.2 to 16.1; Δ = −17.1; 95% CI, −11 to −23.2), and personality (conscientiousness, 6.5 to 6.8; Δ = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Δ = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = −0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = −0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001).Conclusions
Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.
Zotero Collections:
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.
Zotero Collections:
Zotero Collections:
Zotero Collections:
<p>Publisher's description: Buddha Mind in Contemporary Art documents the growing presence of Buddhist perspectives in contemporary culture. This shift began in the nineteenth century and is now pervasive in many aspects of everyday experience. In the arts especially, the increasing importance of process over product has promoted a profound change in the relationship between artist and audience. But while artists have been among the most perceptive interpreters of Buddhism in the West, art historians and critics have been slow to develop the intellectual tools to analyze the impact of Buddhist concepts. This timely, multi-faceted volume explores the relationships between Buddhist practice and the contemporary arts in lively essays by writers from a range of disciplines and in revealing interviews with some of the most influential artists of our time. Elucidating the common ground between the creative mind, the perceiving mind, and the meditative mind, the contributors tackle essential questions about the relationship of art and life. Among the writers are curators, art critics, educators, and Buddhist commentators in psychology, literature, and cognitive science. They consider the many Western artists today who recognize the Buddhist notion of emptiness, achieved through focused meditation, as a place of great creative potential for the making and experiencing of art. The artists featured in the interviews, all internationally recognized, include Maya Lin, Bill Viola, and Ann Hamilton. Extending earlier twentieth-century aesthetic interests in blurring the boundaries of art and life, the artists view art as a way of life, a daily practice, in ways parallel to that of the Buddhist practitioner. Their works, woven throughout the book, richly convey how Buddhism has been both a source for and a lens through which we now perceive art.</p>
Zotero Collections:
- Buddhist Contemplation by Applied Subject,
- Socially Engaged Buddhism,
- Buddhist Contemplation by Tradition,
- Contemplation by Applied Subject,
- Contemplation by Tradition,
- Art and Buddhist Contemplation,
- Photography and Buddhist Contemplation,
- Art and Contemplation,
- Visual art and Buddhist Contemplation,
- Buddhist Contemplation
Buddhism has made its way into American popular culture, particularly within the arena of death and dying. The growing influence of Buddhism on the American way of dying has been fostered through its connection with the American hospice movement. This paper describes the developing contact between Buddhism and hospice and documents the efforts of several prominent Buddhist organizations to revolutionize American death practices. The Buddhist approach to death has captured the interest of an American public attracted to its nonsectarian language of spirituality and pragmatic techniques for dealing with death.
Zotero Collections:
Zotero Collections:
<p>Many powerful human emotional thoughts are generated in the absence of a precipitating event in the environment. Here, we tested whether we can decode the valence of internally driven, self-generated thoughts during task-free rest based on neural similarities with task-related affective mental states. We acquired functional magnetic resonance imaging (fMRI) data while participants generated positive and negative thoughts as part of an attribution task (Session A) and while they reported the occurrence of comparable mental states during task-free rest periods (Session B). With the use of multivariate pattern analyses (MVPA), we identified response patterns in the medial orbitofrontal cortex (mOFC) that encode the affective content of thoughts that are generated in response to an external experimental cue. Importantly, these task driven response patterns reliably predicted the occurrence of affective thoughts generated during unconstrained rest periods recorded one week apart. This demonstrates that at least certain elements of task-cued and task-free affective experiences rely on a common neural code. Furthermore, our findings reveal the role that the mOFC plays in determining the affective tone of unconstrained thoughts. More generally, our results suggest that MVPA is an important methodological tool for attempts to understand unguided subject driven mental states such as mind-wandering and daydreaming based on neural similarities with task-based experiences.</p>
Zotero Collections:
Zotero Collections:
Functional neuroimaging research has demonstrated that retrieving information about object-associated colors activates the left fusiform gyrus in posterior temporal cortex. Although regions near the fusiform have previously been implicated in color perception, it remains unclear whether color knowledge retrieval actually activates the color perception system. Evidence to this effect would be particularly strong if color perception cortex was activated by color knowledge retrieval triggered strictly with linguistic stimuli. To address this question, subjects performed two tasks while undergoing fMRI. First, subjects performed a property verification task using only words to assess conceptual knowledge. On each trial, subjects verified whether a named color or motor property was true of a named object (e.g., TAXI-yellow, HAIR-combed). Next, subjects performed a color perception task. A region of the left fusiform gyrus that was highly responsive during color perception also showed greater activity for retrieving color than motor property knowledge. These data provide the first evidence for a direct overlap in the neural bases of color perception and stored information about object-associated color, and they significantly add to accumulating evidence that conceptual knowledge is grounded in the brain's modality-specific systems.
Zotero Collections:
<p>This new and up-to-the-minute compendium of reliable and authoritative information on complementary and alternative therapies seeks to provide information that older adults may use as they seek to improve their health and quality of life. Covering dietary means; physical, mental, and spiritual methods of treatment; and various types of therapies, this handbook is the most comprehensive and up-to-date resource on complementary and alternative medicine available today.</p>
Zotero Collections:
Electroencephalographic (EEG) recordings from 19 scalp recording sites were used to differentiate among two posited unique forms of mediation, concentration and mindfulness, and a normal relaxation control condition. Analyzes of all traditional frequency bandwidth data (i.e., delta 1–3 Hz; theta, 4–7 Hz; alpha, 8–12 Hz; beta 1, 13–25 Hz; beta 2, 26–32 Hz) showed strong mean amplitude frequency differences between the two meditation conditions and relaxation over numerous cortical sites. Furthermore, significant differences were obtained between concentration and mindfulness states at all bandwidths. Taken together, our results suggest that concentration and mindfulness “meditations” may be unique forms of consciousness and are not merely degrees of a state of relaxation.
Zotero Collections:
<p>Mindfulness meditation is increasingly recognized as a health promotion practice across many different kinds of settings. Concomitantly, contemplative education is being integrated into colleges and universities in order to enhance learning through reflection and personal insight. The confluence of these trends provides an opportunity to develop experiential curriculum that promotes both health and learning through the teaching of contemplative practices in higher education settings. Such curriculum, if indeed it is believed to be a valuable development in higher education, must not be reserved only for elite and highly competitive schools serving traditional college students, but must be integrated into campuses of all kinds and made accessible to any student. This emphasis on accessibility will need to consider the growing interest in contemplative learning across economic, religious, and ethnic groups, geographic contexts, and individual differences, including disability. The growth of contemplative curriculum in higher education will also need to be accompanied by meaningful and valid curriculum assessment methods in order to abide by the standards of contemporary university settings as it gently transforms many such settings. This article describes the development of an experiential course in mindfulness that was taught on two very different college campuses. The author's personal experiences and preparation for the course, the course content, the impact of the course on students, and reflections on contemplative practice as a movement in education are offered as an example of the potential for contemplative education in some unexpected places.</p>
Zotero Collections:
This article examines the lay meditation movement occurring in contemporary Buddhism in Sri Lanka. The lay meditation movement represents a different perspective from the nationalistic Sinhala Buddhism that has dominated the discourse in the wake of the intractable ethnic conflict in the country. The lay meditation movement reflects the contemporary ferment in Buddhist discourse among the laity. One of the key themes in this movement is the privileging of experience because it gives the lay groups authority to challenge contemporary orthodoxy and it has empowered a new class of spiritual leaders, the lay gurus. Paraphrasing Stirrat, we can say that these lay gurus are leading the lay meditation movement towards ‘a series of different interpretations of what it means’ to be a Buddhist today. In its overall effect the lay meditation movement not only reconstructs what it means to be a Buddhist today but also points in the direction of establishing new forms of sectarianism that could be considered to be ‘new religious movements’ under the umbrella of Buddhism.
Zotero Collections:
Many investigators have hypothesized that brain response to cortisol is altered in depression. However, neural activation in response to exogenously manipulated cortisol elevations has not yet been directly examined in depressed humans. Animal research shows that glucocorticoids have robust effects on hippocampal function, and can either enhance or suppress neuroplastic events in the hippocampus depending on a number of factors. We hypothesized that depressed individuals would show 1) altered hippocampal response to exogenous administration of cortisol, and 2) altered effects of cortisol on learning. In a repeated-measures design, 19 unmedicated depressed and 41 healthy individuals completed two fMRI scans. Fifteen mg oral hydrocortisone (i.e., cortisol) or placebo (order randomized and double-blind) was administered 1 h prior to encoding of emotional and neutral words during fMRI scans. Data analysis examined the effects of cortisol administration on 1) brain activation during encoding, and 2) subsequent free recall for words. Cortisol affected subsequent recall performance in depressed but not healthy individuals. We found alterations in hippocampal response to cortisol in depressed women, but not in depressed men (who showed altered response to cortisol in other regions, including subgenual prefrontal cortex). In both depressed men and women, cortisol's effects on hippocampal function were positively correlated with its effects on recall performance assessed days later. Our data provide evidence that in depressed compared to healthy women, cortisol's effects on hippocampal function are altered. Our data also show that in both depressed men and women, cortisol's effects on emotional memory formation and hippocampal function are related.
Zotero Collections:
How does language reliably evoke emotion, as it does when people read a favorite novel or listen to a skilled orator? Recent evidence suggests that comprehension involves a mental simulation of sentence content that calls on the same neural systems used in literal action, perception, and emotion. In this study, we demonstrated that involuntary facial expression plays a causal role in the processing of emotional language. Subcutaneous injections of botulinum toxin-A (BTX) were used to temporarily paralyze the facial muscle used in frowning. We found that BTX selectively slowed the reading of sentences that described situations that normally require the paralyzed muscle for expressing the emotions evoked by the sentences. This finding demonstrates that peripheral feedback plays a role in language processing, supports facial-feedback theories of emotional cognition, and raises questions about the effects of BTX on cognition and emotional reactivity. We account for the role of facial feedback in language processing by considering neurophysiological mechanisms and reinforcement-learning theory.
Zotero Collections:
Zotero Collections:
Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.
Zotero Collections:
Cyclic AMP (cAMP) is a second messenger involved in many processes including mnemonic processing and anxiety. Memory deficits and anxiety are noted in the phenotype of fragile X (FX), the most common heritable cause of mental retardation and autism. Here we review reported observations of altered cAMP cascade function in FX and autism. Cyclic AMP is a potentially useful biochemical marker to distinguish autism comorbid with FX from autism per se and the cAMP cascade may be a viable therapeutic target for both FX and autism.
Zotero Collections:
Zotero Collections:
Zotero Collections:
OBJECTIVES: Randomized controlled studies on the effectiveness of body-oriented methods of treatment for children with attention-deficit hyperactivity disorder (ADHD) are lacking. Our aim was to compare the effectiveness of two methods of treatment (yoga for children vs. conventional motor exercises) in a randomized controlled pilot study.
METHODS: Nineteen children with a clinical diagnosis of ADHD (according to ICD-10 criteria) were included and randomly assigned to treatment conditions according to a 2x2 cross-over design. Effects of treatment were analyzed by means of an analysis of variance for repeated measurements.
RESULTS: For all outcome measures (test scores on an attention task, and parent ratings of ADHD symptoms) the yoga training was superior to the conventional motor training, with effect sizes in the medium-to-high range (0.60-0.97). All children showed sizable reductions in symptoms over time, and at the end of the study, the group means for the ADHD scales did not differ significantly from those for a representative control group. Furthermore, the training was particularly effective for children undergoing pharmacotherapy (MPH).
CONCLUSIONS: The findings from this pilot study demonstrate that yoga can be an effective complementary or concomitant treatment for attention-deficit hyperactivity disorder. The study advocates further research into the impact of yoga or body-oriented therapies on the prevention and treatment of ADHD.
Zotero Collections:
Pages |