Maltreatment during childhood is a major risk factor for anxiety and depression, which are major public health problems. However, the underlying brain mechanism linking maltreatment and internalizing disorders remains poorly understood. Maltreatment may alter the activation of fear circuitry, but little is known about its impact on the connectivity of this circuitry in adolescence and whether such brain changes actually lead to internalizing symptoms. We examined the associations between experiences of maltreatment during childhood, resting-state functional brain connectivity (rs-FC) of the amygdala and hippocampus, and internalizing symptoms in 64 adolescents participating in a longitudinal community study. Childhood experiences of maltreatment were associated with lower hippocampus–subgenual cingulate rs-FC in both adolescent females and males and lower amygdala–subgenual cingulate rs-FC in females only. Furthermore, rs-FC mediated the association of maltreatment during childhood with adolescent internalizing symptoms. Thus, maltreatment in childhood, even at the lower severity levels found in a community sample, may alter the regulatory capacity of the brain’s fear circuit, leading to increased internalizing symptoms by late adolescence. These findings highlight the importance of fronto–hippocampal connectivity for both sexes in internalizing symptoms following maltreatment in childhood. Furthermore, the impact of maltreatment during childhood on both fronto–amygdala and –hippocampal connectivity in females may help explain their higher risk for internalizing disorders such as anxiety and depression.
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Some children show emotion that is not consistent with normative appraisal of the context and can therefore be defined as context inappropriate (CI). The authors used individual growth curve modeling and hierarchical multiple regression analyses to examine whether CI anger predicts differences in hypothalamic-pituitary-adrenal axis activity, as manifest in salivary cortisol measures. About 23% of the 360 children (ages 6-10 years, primarily 7-8) showed at least 1 expression of CI anger in situations designed to elicit positive affect. Expression of anger across 2 positive assessments was less common (around 4%). CI anger predicted the hypothesized lower levels of cortisol beyond that attributed to context appropriate anger. Boys' CI anger predicted lower morning cortisol and flatter slopes. Results suggest that this novel approach to studying children's emotion across varying contexts can provide insight into affective style.
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<p>In this chapter from the book <em>Psychology and Buddhism: From Individual to Global Community</em>, Buddhist scholar Richard P. Hayes looks at the Buddhist process toward transforming from a state of mind which tends toward harming oneself and others to one that is healing and able to benefit. He looks at the traditional Buddhist three-fold process of ethics, contemplation, and wisdom. Ethics provides a basis for contemplation by helping the individual avoid actions which may be a cause of gulit, shame, harm, and other obstacles to mental peace. During contemplation, the individual refines mental awareness and eventually applies this refined state of mind to the development of wisdom. Wisdom itself can be looked at as a three-fold process of (1) study, (2) reflection, and (3) cultivation. Through study, the individual learns about the stages of the path and their correct order etc. Reflection begins the process of deep internalization by questioning oneself and comparing oneself to one's spiritual teachers. Cultivation is the process whereby one infuses in one's state of being attitudes and insight conducive to fulfillment. This, in turn affects one's way of acting and speaking so that one's behavior is spontaneously and naturally virtuous and beneficial to oneself and others. (Zach Rowinski 2005-01-02)</p>
Managing classroom behavior is an important prerequisite to effective teaching and a salient need in alternative schools. Unfortunately, students from these schools are often underrepresented in the intervention literature. The primary aim of this study was to compare the effectiveness of two different theoretical approaches to classroom management, one behavioral (i.e., the good behavior game) and the other mindfulness-based (i.e., mindfulness skills training), with a sample of fifth-grade, predominantly African American students from an urban, high-poverty alternative school. The study examined the effectiveness of the two interventions in comparison to each other and a treatment-as-usual control using a quasi-experimental group design with blocked random assignment. Results revealed that neither intervention led to significant improvements in student internalizing behavior, externalizing behavior, or wellbeing. Though, some practically meaningful treatment effects were found through examination of effect sizes. Mindfulness skills training was the only condition to yield meaningful pre–post change in student outcomes, including a moderate therapeutic effect for externalizing behavior and an iatrogenic effect with respect to student wellbeing. These findings provide preliminary evidence that mindfulness skills training might have differential effects on student mental health outcomes, compared with education as usual and a traditional classwide behavioral intervention. Additionally, study findings make clear the importance of careful deliberation when transporting evidence-based interventions to unique student populations and intervention contexts.
Managing classroom behavior is an important prerequisite to effective teaching and a salient need in alternative schools. Unfortunately, students from these schools are often underrepresented in the intervention literature. The primary aim of this study was to compare the effectiveness of two different theoretical approaches to classroom management, one behavioral (i.e., the good behavior game) and the other mindfulness-based (i.e., mindfulness skills training), with a sample of fifth-grade, predominantly African American students from an urban, high-poverty alternative school. The study examined the effectiveness of the two interventions in comparison to each other and a treatment-as-usual control using a quasi-experimental group design with blocked random assignment. Results revealed that neither intervention led to significant improvements in student internalizing behavior, externalizing behavior, or wellbeing. Though, some practically meaningful treatment effects were found through examination of effect sizes. Mindfulness skills training was the only condition to yield meaningful pre–post change in student outcomes, including a moderate therapeutic effect for externalizing behavior and an iatrogenic effect with respect to student wellbeing. These findings provide preliminary evidence that mindfulness skills training might have differential effects on student mental health outcomes, compared with education as usual and a traditional classwide behavioral intervention. Additionally, study findings make clear the importance of careful deliberation when transporting evidence-based interventions to unique student populations and intervention contexts.
Complementary and Alternative Medicine (CAM) therapies such as herbal therapy, acupuncture, yoga, homeopathy, chiropractic medicine, and massage therapy, continue to gain popularity as modalities for the treatment of asthma. In the Chinese, Japanese, Korean, Indian, and Western cultures, herbal therapies appear to be commonly used for allergies. Although well-controlled scientific studies have not been performed on many of the Asian herbal therapies and some basic studies have been performed on various herbal components (active ingredients), more needs to be done to assess the composite effects of many herbal remedies. An important part of the assessment of CAM modalities is the therapeutic-toxicologic safety profile (risk-benefit ratio), and further research evaluating the clinical efficacy and mechanism of action of various CAM interventions for asthma is greatly needed. This paper focuses on clinical and laboratory research regarding various CAM therapies that have been used in the treatment of asthma. The references cited are confined to literature originally published or translated into English.
The trance states in yoga and hypnosis are associated with similar phenomena like relaxation, disinclination to talk, unreality, misrepresentation, alterations in perception, increased concentration, suspension of normal reality testing, and the temporary nature of the phenomena. While some researchers consider yoga to be a form of hypnosis, others note that there are many similarities between the trance in yoga and the hypnotic trance. The present study aimed to find similarities between the trance states of hypnosis and Patanjali's yoga sutras. The trance states were compared with the understanding of the phenomena of trance, and the therapeutic techniques and benefits of both. An understanding of the concept of trance in Patanjali's yoga sutras was gained through a thematic analysis of the book Four Chapters on Freedom by Swami Satyananda Saraswati. This led to an understanding of the concept of trance in the yoga sutras. The obtained concepts were compared to the concepts of trance in hypnosis (obtained through the literature on hypnosis) to investigate whether or not there exist similarities. The findings of the study show that there are similarities between the trance in hypnosis and the trance in Patanjali's yoga sutras in the induction and deepening of the trance states in hypnosis and that of Samadhi, the phenomena present in hypnosis and the kinds of siddhis that are obtained through Samadhi, and the therapeutic techniques and the therapeutic process in Patanjali's yoga sutra and hypnosis.
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. (c) 2017 American Cancer Society.
BACKGROUND: The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies. METHODS: Following the Institute of Medicine's guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system. RESULTS: The search (January 1, 1990-December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (n = 32) had weaker evidence of benefit (Grade C). Some interventions (n = 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (n = 138) did not have sufficient evidence to form specific recommendations (Grade I). CONCLUSIONS: Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes.
Mindfulness-based interventions have exploded in popularity due to their success in treating everything from everyday stress to more serious mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD).This breakthrough book provides professionals with a comprehensive, session-by-session guide to teaching mindfulness, complete with the scripts and training materials needed to teach introductory mindfulness in a wide variety of settings, despite theoretical background. Mindfulness—once an ancient practice honed in Buddhist monasteries—is now a mainstream, evidence-based, secular intervention employed by trained health and mental health professionals worldwide. The rapid spread of mindfulness increasingly involves psychologists, physicians, social workers, therapists, counselors, spiritual advisers, life coaches, and education professionals trained in their respective disciplines. Additionally, research continues to show that mindfulness is an effective treatment for anxiety, depression, stress, pain relief, and many other illnesses.If you are a professional interested in teaching mindfulness, this book will provide you with everything you need to get started right away. The introductory, six-week protocol outlined in this book is easy-to-use, and can be implemented in a variety of settings, ranging from an outpatient mental health clinic to an inpatient oncology clinic, from a substance abuse recovery program to educational settings. In addition, this book will tell you what to bring to each class; provides outlines for each session; offers scripts to help you differentiate the weekly meditative practices; and provides invaluable resources for further study and professional development. If you’re looking to integrate mindfulness into your professional work, this is your go-to guide.
Mindfulness-based interventions have exploded in popularity due to their success in treating everything from everyday stress to more serious mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD). This breakthrough book provides professionals with a comprehensive, session-by-session guide to teaching mindfulness, complete with the scripts and training materials needed to teach introductory mindfulness in a wide variety of settings, despite theoretical background.Mindfulness—once an ancient practice honed in Buddhist monasteries—is now a mainstream, evidence-based, secular intervention employed by trained health and mental health professionals worldwide. The rapid spread of mindfulness increasingly involves psychologists, physicians, social workers, therapists, counselors, spiritual advisers, life coaches, and education professionals trained in their respective disciplines. Additionally, research continues to show that mindfulness is an effective treatment for anxiety, depression, stress, pain relief, and many other illnesses.
If you are a professional interested in teaching mindfulness, this book will provide you with everything you need to get started right away. The introductory, six-week protocol outlined in this book is easy-to-use, and can be implemented in a variety of settings, ranging from an outpatient mental health clinic to an inpatient oncology clinic, from a substance abuse recovery program to educational settings.
In addition, this book will tell you what to bring to each class; provides outlines for each session; offers scripts to help you differentiate the weekly meditative practices; and provides invaluable resources for further study and professional development. If you’re looking to integrate mindfulness into your professional work, this is your go-to guide.
Mindfulness-based interventions have exploded in popularity due to their success in treating everything from everyday stress to more serious mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD). This breakthrough book provides professionals with a comprehensive, session-by-session guide to teaching mindfulness, complete with the scripts and training materials needed to teach introductory mindfulness in a wide variety of settings, despite theoretical background.Mindfulness—once an ancient practice honed in Buddhist monasteries—is now a mainstream, evidence-based, secular intervention employed by trained health and mental health professionals worldwide. The rapid spread of mindfulness increasingly involves psychologists, physicians, social workers, therapists, counselors, spiritual advisers, life coaches, and education professionals trained in their respective disciplines. Additionally, research continues to show that mindfulness is an effective treatment for anxiety, depression, stress, pain relief, and many other illnesses.
If you are a professional interested in teaching mindfulness, this book will provide you with everything you need to get started right away. The introductory, six-week protocol outlined in this book is easy-to-use, and can be implemented in a variety of settings, ranging from an outpatient mental health clinic to an inpatient oncology clinic, from a substance abuse recovery program to educational settings.
In addition, this book will tell you what to bring to each class; provides outlines for each session; offers scripts to help you differentiate the weekly meditative practices; and provides invaluable resources for further study and professional development. If you’re looking to integrate mindfulness into your professional work, this is your go-to guide.
Mindfulness-based interventions have exploded in popularity due to their success in treating everything from everyday stress to more serious mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD). This breakthrough book provides professionals with a comprehensive, session-by-session guide to teaching mindfulness, complete with the scripts and training materials needed to teach introductory mindfulness in a wide variety of settings, despite theoretical background.Mindfulness—once an ancient practice honed in Buddhist monasteries—is now a mainstream, evidence-based, secular intervention employed by trained health and mental health professionals worldwide. The rapid spread of mindfulness increasingly involves psychologists, physicians, social workers, therapists, counselors, spiritual advisers, life coaches, and education professionals trained in their respective disciplines. Additionally, research continues to show that mindfulness is an effective treatment for anxiety, depression, stress, pain relief, and many other illnesses.
If you are a professional interested in teaching mindfulness, this book will provide you with everything you need to get started right away. The introductory, six-week protocol outlined in this book is easy-to-use, and can be implemented in a variety of settings, ranging from an outpatient mental health clinic to an inpatient oncology clinic, from a substance abuse recovery program to educational settings.
In addition, this book will tell you what to bring to each class; provides outlines for each session; offers scripts to help you differentiate the weekly meditative practices; and provides invaluable resources for further study and professional development. If you’re looking to integrate mindfulness into your professional work, this is your go-to guide.
This study evaluated the results of a social and emotional learning (SEL) program on academic achievement among students attending a large, urban, high-risk school district. Using a cluster-randomized design, 24 elementary schools were assigned to receive either the intervention curriculum (Promoting Alternative Thinking Strategies, or PATHS) or a curriculum that delivered few if any SEL topics (i.e., the control group). In addition to state mastery test scores, demographic data, school attendance, and dosage information were obtained from 705 students who remained in the same group from the 3rd to the 6th grade. Analyses of odds ratios revealed that students enrolled in the intervention schools demonstrated higher levels of basic proficiency in reading, writing, and math at some grade levels. Although these between-groups differences held for race/ethnicity, gender, and socioeconomic status, significant within-group differences also were noted across these variables. Collectively, these findings indicated that social development instruction may be a promising approach to promote acquisition of academic proficiency, especially among youth attending high-risk school settings. Implications of these findings with respect to SEL programs conclude the article.
Bringing an awareness of emotions to the fore through mindfulness-based breathing and providing a space to discuss them is a way of promoting teacher and student agency in collectively developing structures specific to their learning environment. The authors explore students', teachers', and researchers' collective sensemaking through cogenerative dialoguing (cogen) about a mindfulness-based breathing practice at the start of mathematics lessons in an elementary classroom. They found that the power of cogen as hybridized space enabled the generation of collective understanding and the potential for all cogen participants to become engaged in an authentic and transformative way in discussing classroom life. The authors argue that the mindfulness-based breathing practice itself acted as a heuristic for thinking about learning environments and, during the reflexive process of thinking about the breathing practice, new forms of classroom culture unfolded both expanding classroom structures and the practice itself, and laying bare otherwise taken-for-granted practices.
Background:Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound.
Purpose:
The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches.
Research Design:
Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch.
Results:
A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was established, and evidence was found to be robust enough to guide clinical practice.
Conclusions:
Treatment strategy might best be CBT-based, moving toward a more multidisciplinary approach. There is room for the involvement of different disciplines, using a stepped-care approach. This may provide brief and effective treatment for a larger group of tinnitus patients, and additional treatment steps can be provided for those suffering on a more severe level.
BACKGROUND:Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance.
AIM:
The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions.
DESIGN, PARTICIPANTS AND SETTING:
After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9).
RESULTS:
Both interventions decreased significantly stress and burnout. The within-group effect sizes were large in both interventions (CBT, g = 1.28-1.64; MF, g = 1.25-2.20).
CONCLUSIONS:
Hence, the results of this pilot study show that treating a group using either CBT or mindfulness can be an efficient intervention for reducing stress levels and burnout in parents of children with chronic conditions.
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Mindfulness-Based Cognitive Therapy (MBCT) is a promising intervention to prevent depressive relapse. Yet beyond efficacy studies, little is known regarding the mechanisms that could be modified through MBCT. Objectives of the present study were twofold: determine whether cognitive functioning was altered among patients remitted from depression at admission in a MBCT trial; and document possible changes during the trial and follow-up. In a cross-sectional perspective, cognitive functioning (autobiographical memory, shifting capacities, dysfunctional attitudes, mindful attention awareness and rumination habits) was first compared between 36 patients remitted from depression, 20 acutely depressed patients and 20 control participants. In a longitudinal perspective, changes in the remitted sample were explored during a MBCT plus Treatment As Usual versus Treatment As Usual randomized controlled trial and 9-month follow-up. Performances of remitted patients were similar to the ones of control participants for autobiographical memories, shifting capacities, and mindful attention awareness, whereas levels of rumination and dysfunctional attitudes were significantly elevated. Participation in the MBCT program was accompanied with a significant decrease of dysfunctional attitudes that continued up to 9-month postintervention. No other change was observed that was specific to MBCT. Results suggest that MBCT might help people to identify dysfunctional attitudes at a very early stage and to avoid engaging further in these attitudes.
The present study examined whether pretreatment mindfulness exerts an indirect effect on outcomes following cognitive-behavioral therapy (CBT). Cognitive processes of probability and cost bias (i.e., overestimations of the likelihood that negative social events will occur, and that these events will have negative consequences when they do occur) were explored as potential mediators of the relation between mindfulness and social anxiety symptom change. People with higher levels of mindfulness may be better able to benefit from treatments that reduce biases because mindfulness may aid in regulation of attention. Sixty-seven individuals with a primary diagnosis of social phobia identifying public speaking as their greatest fear received eight sessions of one of two types of exposure-based CBT delivered according to treatment manuals. Participants completed self-report measures of mindfulness, probability bias, cost bias, and social anxiety symptoms. Mediation hypotheses were assessed by a bootstrapped regression using treatment outcome data. Pretreatment mindfulness was not related to change in social anxiety symptoms from pre- to posttreatment. However, mindfulness had an indirect effect on treatment outcome via its association with probability bias, but not cost bias, at midtreatment. These findings were consistent across three metrics of social anxiety symptoms. Mindfulness may play a role in response to CBT among individuals with social phobia through its relation with probability bias--even when the treatment does not target mindfulness.
Major depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy (MBCT) with treatment-as-usual (TAU) on cognitive reactivity in recurrently depressed patients (N = 115). Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group (d = .51). The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminary evidence that cognitive reactivity is a working mechanism of MBCT.
BackgroundCognitive problems frequently occur in patients with multiple sclerosis (MS) and profoundly affect their quality of life. So far, the best cognitive treatment options for MS patients are a matter of debate. Therefore, this study aims to investigate the effectiveness of two promising non-pharmacological treatments: cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT). Furthermore, this study aims to gain additional knowledge about the aetiology of cognitive problems among MS patients, since this may help to develop and guide effective cognitive treatments.
Methods/design
In a dual-centre, single-blind randomised controlled trial (RCT), 120 MS patients will be randomised into one of three parallel groups: CRT, MBCT or enhanced treatment as usual (ETAU). Both CRT and MBCT consist of a structured 9-week program. ETAU consists of one appointment with an MS specialist nurse. Measurements will be performed at baseline, post-intervention and 6 months after the interventions. The primary outcome measure is the level of subjective cognitive complaints. Secondary outcome measures are objective cognitive function, functional brain network measures (using magnetoencephalography), psychological symptoms, well-being, quality of life and daily life functioning.
Discussion
To our knowledge, this will be the first RCT that investigates the effect of MBCT on cognitive function among MS patients. In addition, studying the effect of CRT on cognitive function may provide direction to the contradictory evidence that is currently available. This study will also provide information on changes in functional brain networks in relation to cognitive function. To conclude, this study may help to understand and treat cognitive problems among MS patients.
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