BACKGROUND:Obsessive-compulsive disorder (OCD) is a very disabling condition with a chronic course, if left untreated. Though cognitive behavioral treatment (CBT) with or without selective serotonin reuptake inhibitors (SSRI) is the method of choice, up to one third of individuals with obsessive-compulsive disorder (OCD) do not respond to treatment in terms of at least 35% improvement of symptoms. Mindfulness based cognitive therapy (MBCT) is an 8-week group program that could help OCD patients with no or only partial response to CBT to reduce OC symptoms and develop a helpful attitude towards obsessions and compulsive urges.
METHODS/DESIGN:
This study is a prospective, bicentric, assessor-blinded, randomized, actively-controlled clinical trial. 128 patients with primary diagnosis of OCD according to DSM-IV and no or only partial response to CBT will be recruited from in- and outpatient services as well as online forums and the media. Patients will be randomized to either an MBCT intervention group or to a psycho-educative coaching group (OCD-EP) as an active control condition. All participants will undergo eight weekly sessions with a length of 120 minutes each of a structured group program. We hypothesize that MBCT will be superior to OCD-EP in reducing obsessive-compulsive symptoms as measured by the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) following the intervention and at 6- and 12-months-follow-up. Secondary outcome measures include depressive symptoms, quality of life, metacognitive beliefs, self-compassion, mindful awareness and approach-avoidance tendencies as measured by an approach avoidance task.
DISCUSSION:
The results of this study will elucidate the benefits of MBCT for OCD patients who did not sufficiently benefit from CBT. To our knowledge, this is the first randomized controlled study assessing the effects of MBCT on symptom severity and associated parameters in OCD.
BackgroundCognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the first-line treatment for patients with obsessive-compulsive disorder (OCD). However, not all of them achieve remission on a longterm basis. Mindfulness-based cognitive therapy (MBCT) represents a new 8-week group therapy program whose effectiveness has been demonstrated in various mental disorders, but has not yet been applied to patients with OCD.
The present pilot study aimed to qualitatively assess the subjective experiences of patients with OCD who participated in MBCT.
Method
Semi-structured interviews were conducted with 12 patients suffering from OCD directly after 8 sessions of a weekly MBCT group program. Data were analyzed using a qualitative content analysis.
Results
Participants valued the treatment as helpful in dealing with their OCD and OCD-related problems. Two thirds of the patients reported a decline in OCD symptoms. Benefits included an increased ability to let unpleasant emotions surface and to live more consciously in the present. However, participants also discussed several problems.
Conclusion
The data provide preliminary evidence that patients with OCD find aspects of the current MBCT protocol acceptable and beneficial. The authors suggest to further explore MBCT as a complementary treatment strategy for OCD.
The authors asked breast cancer (BC) patients to participate in 1 of 3 mind-body interventions (cognitive-behavioral therapy (CBT), yoga, or self-hypnosis) to explore their feasibility, ease of compliance, and impact on the participants' distress, quality of life (QoL), sleep, and mental adjustment. Ninety-nine patients completed an intervention (CBT: n = 10; yoga: n = 21; and self-hypnosis: n = 68). Results showed high feasibility and high compliance. After the interventions, there was no significant effect in the CBT group but significant positive effects on distress in the yoga and self-hypnosis groups, and, also, on QoL, sleep, and mental adjustment in the self-hypnosis group. In conclusion, mind-body interventions can decrease distress in BC patients, but RCTs are needed to confirm these findings.
Morse, N. B., P. A. Pellissier, E. N. Cianciola, R. L. Brereton, M. M. Sullivan, N. K. Shonka, T. B. Wheeler, and W. H. McDowell. 2014. Novel ecosystems in the Anthropocene: a revision of the novel ecosystem concept for pragmatic applications. Ecology and Society 19(2): 12. https://doi.org/10.5751/ES-06192-190212
<i>The Odyssey Illustrated Guide to Tibet</i> sets itself apart from other guidebooks on Central and Western Tibet with its narrative and artistic focus. While <i>Odyssey Tibet</i> covers many (if not all) the same topics as standard guidebooks, it also explores some lesser known sites ranging from the Tsedang Elementary School to the Shigatse Gold, Silver, and Craft Factory. As the title states, this book is an illustrated guide to Tibet, meaning descriptions of places are supplemented with pictures of many of the images, symbols, and sights a traveler will encounter at any given location.There are three main parts of <i>Odyssey Tibet</i>. The first provides background information about Tibet and provides useful information for preparing to go to Tibet. The second describes the sights and logistics for a series of particular places like Lhasa, Shigatse, Tsedang, etc. The final section of the book provides supplemental details about language, festivals, and address information for hotels and other services in Central Tibet. Dispersed throughout the book are "Special Topic" and "Excerpt" sections. Typically these sections are short essays provide more depth and perspective on a given topic, such as one author's emotional experience when arriving in Lhasa or details about Milarepa, Tibet's most celebrated spiritual figure. (Zach Rowinski 2008-3-5)
<p><em>The Odyssey Illustrated Guide to Tibet</em> sets itself apart from other guidebooks on Central and Western Tibet with its narrative and artistic focus. While <em>Odyssey Tibet</em> covers many (if not all) the same topics as standard guidebooks, it also explores some lesser known sites ranging from the Tsedang Elementary School to the Shigatse Gold, Silver, and Craft Factory. As the title states, this book is an illustrated guide to Tibet, meaning descriptions of places are supplemented with pictures of many of the images, symbols, and sights a traveler will encounter at any given location.There are three main parts of <em>Odyssey Tibet</em>. The first provides background information about Tibet and provides useful information for preparing to go to Tibet. The second describes the sights and logistics for a series of particular places like Lhasa, Shigatse, Tsedang, etc. The final section of the book provides supplemental details about language, festivals, and address information for hotels and other services in Central Tibet. Dispersed throughout the book are "Special Topic" and "Excerpt" sections. Typically these sections are short essays provide more depth and perspective on a given topic, such as one author's emotional experience when arriving in Lhasa or details about Milarepa, Tibet's most celebrated spiritual figure. (Zach Rowinski 2008-3-5)</p>
<p>The study reported here is seeking to gain enhanced understandings of the acquisition and development of core and generic skills in higher education and employment against a backcloth of continued pressure for their effective delivery from employers, government departments, and those responsible for the management and funding of higher education. This pressure appears to have had little impact so far, in part because of tutors' scepticism of the message, the messenger and its vocabulary, and in part because the skills demanded lack clarity, consistency and a recognisable theoretical base. Any empirical attempt to acquire enhanced understandings of practice thus requires the conceptualisation and development of models of generic skills and of course provision. These models are presented together with evidence of their validity, including exemplars of the patterns of course provision identified.</p>
Zotero Collections:
Objective: Mindfulness-based cognitive therapy (MBCT) has recently been proposed as a treatment option for chronic depression. The cognitive behavioral analysis system of psychotherapy (CBASP) is the only approach specifically developed to date for the treatment of chronically depressed patients. The efficacy of MBCT plus treatment-as-usual (TAU), and CBASP (group version) plus TAU, was compared to TAU alone in a prospective, bicenter, randomized controlled trial. Method: One hundred and six patients with a current DSM–IV defined major depressive episode and persistent depressive symptoms for more than 2 years were randomized to TAU only (N = 35), or to TAU with additional 8-week group therapy of either 8 sessions of MBCT (n = 36) or CBASP (n = 35). The primary outcome measure was the Hamilton Depression Rating Scale (24-item HAM-D, Hamilton, 1967) at the end of treatment. Secondary outcome measures were the Beck Depression Inventory (BDI; Beck, Steer, & Brown, 1996) and measures of social functioning and quality of life. Results: In the overall sample as well as at 1 treatment site, MBCT was no more effective than TAU in reducing depressive symptoms, although it was significantly superior to TAU at the other treatment site. CBASP was significantly more effective than TAU in reducing depressive symptoms in the overall sample and at both treatment sites. Both treatments had only small to medium effects on social functioning and quality of life. Conclusions: Further studies should inquire whether the superiority of CBASP in this trial might be explained by the more active, problem-solving, and interpersonal focus of CBASP.
ObjectiveTo capture any sleep quality changes associated with group psychotherapy.
Patients/methods
Physician-referred, chronically depressed patients (n = 25) were randomized to either eight group sessions of Mindfulness-based Cognitive Therapy (MBCT, n = 9) plus Treatment As Usual (TAU), or the Cognitive Behavioral Analysis System of Psychotherapy (CBASP, n = 8) plus TAU, or to TAU only (control group, n = 8). Participants recorded their sleep at home. The primary outcome variables were: stable and unstable sleep, which were assessed using cardiopulmonary coupling (CPC) analysis, and estimated total sleep and wake time (minutes). Cardiopulmonary coupling measures heart rate variability and the electrocardiogram's R-wave amplitude fluctuations associated with respiration.
Results
By post-treatment night 6, the CBASP group had more stable sleep (p = 0.044) and less wake (p = 0.004) compared with TAU, and less wake vs MBCT (p = 0.039).
Conclusion
The CBASP group psychotherapy treatment improved sleep quality compared with Treatment As Usual.
Bibliography: p. [77]
Being one of the great medicine systems of the world, Tibetan Medicine developed in the 8th century AD and spread throughout central Asia over the intervening centuries. The first European contact with Tibetan remedies started around 1850 in Russia. By and by, they made their way as far a Switzerland where, in the meantime, they have been produced for more than 30 years and licensed by the health authorities. During the last years, comprehensive clinical and experimental research material has been generated on several formulas, especially on Padma 28 and Padma Lax. At the same time, a genuine European pool of experience was gained. Tibetan remedies are multicomponent mixtures. Special requirements on quality assessment, efficacy and safety arise on the path to a modern Tibetan multicompound. The production of such elaborately formulated com-positions has to take into account modern demands of GMPas well as traditional sources. In recent years, a rising popularity of Asian medicine can be observed. This need of patients, physicians and therapists also demands answers from the regulatory part. Aspects such as the justification of the composition (rationale of combination) and certain quality standards have to be newly defined by the authorities in this context. Only with adapted regulatory frameworks Tibetan medicines can find their place in Europe and, together with other medical traditions and biomedical research, integratively enrich the arsenal of intervention and prevention of Western industrial societies.
<p>This article looks at some of the influences, theoretical characteristics, and elements of practice in Tibetan medicine. (Mark Premo-Hopkins 2004-04-13)</p>
Mindfulness and ruminative thinking have been shown to mediate the effects of mindfulness-based treatments on depressive symptoms. Yet, the dynamic interplay between these variables in daily life during mindfulness-based treatment has received little attention. The present study focuses on the sequence of daily changes taking place within individuals during a mindfulness-based treatment. Using a replicated single-subject time-series design, we examined the within-person temporal associations between day-to-day changes in mindfulness, repetitive thinking, and depressive symptoms. Study participants were six women with depressive symptoms who filled out diary questionnaires during a mindfulness-based treatment. A separate vector autoregressive (VAR) model was estimated for each participant. Changes in mindfulness and repetitive thinking preceded changes in depressive symptoms in a few of the six participants. We did not find evidence for reverse causality: changes in depressive symptoms did not predict later changes in mindfulness or repetitive thinking in any of the participants. These results are in accordance with the assumed causal chain of change underlying mindfulness-based treatments. Furthermore, all individuals showed moderate to strong concurrent (within-day) associations between the variables. Possible explanations for this finding include that change processes occur within the day or that the daily self-reports of mindfulness, repetitive thinking, and depressive symptoms overlap and reflect a common underlying state of mind.
Most validation studies of the Freiburg Mindfulness Inventory (FMI) involved healthy subjects. Validation in patients who suffer from a life-threatening medical illness is needed, to investigate the FMI’s validity in medical psychology research and practice. Psychometric properties of the Dutch FMI were examined in two patient groups of two different studies: (Sample 1) cardiac patients (n = 114, M age = 56 ± 7 years, 18% women) and (Sample 2) severely fatigued cancer survivors (n = 158, M age = 50 ± 10 years, 77% women). Confirmatory factor analysis (studied only in Sample 2) provided good fit for the two-factor solution (Acceptance and Presence), while the one-factor solution provided suboptimal fit indices. Internal consistency was good for the whole scale in both samples (Sample 1 α = .827 and Sample 2 α = .851). The two-factor model showed acceptable to good internal consistency in Sample 2 (Presence: α = .823; Acceptance α = .744), but poor to acceptable in Sample 1 (Presence subscale: α = .577, Acceptance subscale: α = .791). Clinical sensitivity was supported in both samples, and construct validity (studied only in Sample 1) was acceptable. The Dutch FMI is an acceptable instrument to measure mindfulness in patients who experienced a life-threatening illness in a Dutch-speaking population.
Most validation studies of the Freiburg Mindfulness Inventory (FMI) involved healthy subjects. Validation in patients who suffer from a life-threatening medical illness is needed, to investigate the FMI’s validity in medical psychology research and practice. Psychometric properties of the Dutch FMI were examined in two patient groups of two different studies: (Sample 1) cardiac patients (n = 114, M age = 56 ± 7 years, 18% women) and (Sample 2) severely fatigued cancer survivors (n = 158, M age = 50 ± 10 years, 77% women). Confirmatory factor analysis (studied only in Sample 2) provided good fit for the two-factor solution (Acceptance and Presence), while the one-factor solution provided suboptimal fit indices. Internal consistency was good for the whole scale in both samples (Sample 1 α = .827 and Sample 2 α = .851). The two-factor model showed acceptable to good internal consistency in Sample 2 (Presence: α = .823; Acceptance α = .744), but poor to acceptable in Sample 1 (Presence subscale: α = .577, Acceptance subscale: α = .791). Clinical sensitivity was supported in both samples, and construct validity (studied only in Sample 1) was acceptable. The Dutch FMI is an acceptable instrument to measure mindfulness in patients who experienced a life-threatening illness in a Dutch-speaking population.
Pages |