Few studies have examined changes of diurnal cortisol profiles prospectively, in relation to non-pharmacological interventions such as mindfulness-based cognitive therapy (MBCT). Fifty-six patients remitted from recurrent depression (≥3 episodes) were included in an 8-week randomized controlled trial comparing MBCT plus treatment as usual (TAU) with TAU for depression relapse prophylaxis. Saliva samples (0, 15, 30, 45, 60 min post-awakening, 3 PM, 8 PM) were collected on six occasions (pre- and post-intervention, 3-, 6-, 9-, 12-month follow-up). Cortisol awakening response (CAR), average day exposure (AUCday) and diurnal slope were analyzed with mixed effects models (248 profiles, 1-6 per patient). MBCT (n = 28) and TAU groups (n = 28) did not significantly differ with respect to baseline variables. Intra-individual variability exceeded inter-individual variability for the CAR (62.2% vs. 32.5%), AUC(day) (30.9% vs. 23.6%) and diurnal slope (51.0% vs. 34.2%). No time, group and time by group effect was observed for the CAR and diurnal slope. A significant time effect (p = 0.003) was detected for AUCday, which was explained by seasonal variations (p = 0.012). Later wake-up was associated with lower CAR (-11.7% per 1-hour later awakening, p < 0.001) and lower AUCday (-4.5%, p = 0.014). Longer depression history was associated with dampened CAR (-15.2% per 10-year longer illness, p = 0.003) and lower AUCday (-8.8%, p = 0.011). Unchanged cortisol secretion patterns following participation in MBCT should be interpreted with regard to large unexplained variability, similar relapse rates in both groups and study limitations. Further research is needed to address the scar hypothesis of diminished HPA activity with a longer, chronic course of depression.
Objectives: This study focused on patients with bipolar disorder (BD), several years after their participation in mindfulness-based cognitive therapy (MBCT). It aimed at documenting sustained mindfulness practice, perceived long-term benefit from the program, and changes regarded as direct consequences of the intervention.Design: This cross-sectional survey took place at least 2 years after MBCT for 70.4% of participants.
Location: It was conducted in two specialized outpatient units for BDs that are part of the Geneva University Hospitals (Switzerland) and the Sainte-Anne Hospital in Paris (France).
Subjects: Eligibility criteria were a diagnosis of BD according to DSM-IV and participation in at least four MBCT sessions. Response rate was 66.4%. The final sample included 71 outpatients (71.8% bipolar I, 28.2% bipolar II).
Outcome measures: A questionnaire retrospectively assessed patient-perceived change, benefit from MBCT, and current mindfulness practice.
Results: Proportions of respondents who practiced mindfulness at least once a week were 54.9% for formal practice (body scan, sitting meditation, mindful walking, or movements) and 57.7% for informal practice (mindful daily activities). Perceived benefit for the prevention of relapse was moderate, but patients acknowledged long-lasting effects and persistent changes in their way of life. Formal mindfulness practice at least once a week tended to be associated with increased long-lasting effects (p = 0.052), whereas regular informal practice and mindful breathing were significantly associated with persistent changes in daily life (p = 0.038) and better prevention of depressive relapse (p = 0.035), respectively. The most frequently reported positive change was increased awareness of being able to improve one's health.
Conclusions: Despite methodological limitations, this survey allowed documenting mindfulness practice and perceived sustained benefit from MBCT in patients with BD. Participants particularly valued increased awareness that they can influence their own health. Both informal and formal practices, when sustained in the long term, might promote long-lasting changes.
Dissecting the new theoretical buzzword of the “Anthropocene”The Earth has entered a new epoch: the Anthropocene. What we are facing is not only an environmental crisis, but a geological revolution of human origin. In two centuries, our planet has tipped into a state unknown for millions of years.How did we get to this point? Refuting the convenient view of a “human species” that upset the Earth system, unaware of what it was doing, this book proposes the first critical history of the Anthropocene, shaking up many accepted ideas: about our supposedly recent “environmental awareness,” about previous challenges to industrialism, about the manufacture of ignorance and consumerism, about so-called energy transitions, as well as about the role of the military in environmental destruction. In a dialogue between science and history, The Shock of the Anthropocene dissects a new theoretical buzzword and explores paths for living and acting politically in this rapidly developing geological epoch.
In recent decades, empathy research has blossomed into a vibrant and multidisciplinary field of study. This text collects cross-disciplinary, cutting-edge work on human empathy from the perspectives of social, cognitive, developmental and clinical psychology and cognitive/affective neuroscience.
<p>Contains a Tibetan-Sanskrit vocabulary from a chapter of the <em>Aṣṭāṅgahṛdaya</em>. Le Kumaratantra de Ravana et les textes parallèles indiens, tibétains, chinois, cambodgien et arabe. (Michael Walter and Manfred Taube 2006-05-15, revised by Bill McGrath 2008-01-03)</p>
While social cognition (SC) is widely recognized as being impaired in schizophrenia, little is known about the potential heterogeneity in individuals’ functioning. Using a wide range of SC measures and a cluster-analytic approach, we compared SC profiles in the general population and in people with schizophrenia. A total of 131 healthy controls and 101 participants with schizophrenia were included. Groups were compared on sociodemographic, neurocognition, anxiety and depressive mood variables. Three profiles were identified in healthy controls: one with good SC abilities (Homogeneous SC group) and two with specific weaknesses in complex Facial Emotion Recognition (Low FER group) or Affective Theory of Mind (Low AToM group). However, these patterns were not found in participants with schizophrenia, who were characterized rather by levels of SC functioning (i.e., Low, Medium and High SC groups). Importantly, while the High SC group (47.9% of the sample) exhibited normal performances, the two others were underpinned by different pathological processes (i.e., alexithymia for Medium SC group or neurocognition dysfunctioning for Low SC group). These results have important implications for future research as well as for clinical practice regarding assessment methodology and therapeutic interventions.
A popular and critical success when it first appeared in France, Yoga and the Hindu Tradition has freed Yoga from the common misconceptions of the recent Yoga vogue. Jean Varenne, the distinguished French Orientalist, presents the theory of classical Yoga, in all its richness, as a method—a concrete way to reach the Absolute through spiritual exercises—which makes possible the transition from existence to essence.This excellent translation, including line drawings and charts, a glossary of technical terms, and a complete translation of the Yoga Darshana Upanishad, begins with a brief description of the metaphysical and religious history on which Yoga is based. Varenne discusses the theoretical conception of Yoga as the search for liberating knowledge, concluding with a brief indication of the physical practices and extra Yogic themes such as Kundalini and Tantrism. It is the author’s hope that "those who read [this book] will come to realize that it is in fact dishonest to reduce Yoga to some sort of physical training, or to just an occult doctrine; it is a ’world view’ a Weltanschauung that comprehends reality in its totality."
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