A young girl learns a technique for dealing with anger--and it works
Illustrations and rhyming text tell of Bentley, a bee from a busy, crowded, and noisy hive who teaches others to meditate in order to handle stress. Includes note for parents
Objective To investigate whether placebo effects can experimentally be separated into the response to three components—assessment and observation, a therapeutic ritual (placebo treatment), and a supportive patient-practitioner relationship—and then progressively combined to produce incremental clinical improvement in patients with irritable bowel syndrome. To assess the relative magnitude of these components.
Design A six week single blind three arm randomised controlled trial.
Setting Academic medical centre.
Participants 262 adults (76% women), mean (SD) age 39 (14), diagnosed by Rome II criteria for and with a score of ≥150 on the symptom severity scale.
Interventions For three weeks either waiting list (observation), placebo acupuncture alone (“limited”), or placebo acupuncture with a patient-practitioner relationship augmented by warmth, attention, and confidence (“augmented”). At three weeks, half of the patients were randomly assigned to continue in their originally assigned group for an additional three weeks.
Main outcome measures Global improvement scale (range 1-7), adequate relief of symptoms, symptom severity score, and quality of life.
Results At three weeks, scores on the global improvement scale were 3.8 (SD 1.0) v 4.3 (SD 1.4) v 5.0 (SD 1.3) for waiting list versus “limited” versus “augmented,” respectively (P<0.001 for trend). The proportion of patients reporting adequate relief showed a similar pattern: 28% on waiting list, 44% in limited group, and 62% in augmented group (P<0.001 for trend). The same trend in response existed in symptom severity score (30 (63) v 42 (67) v 82 (89), P<0.001) and quality of life (3.6 (8.1) v 4.1 (9.4) v 9.3 (14.0), P<0.001). All pairwise comparisons between augmented and limited patient-practitioner relationship were significant: global improvement scale (P<0.001), adequate relief of symptoms (P<0.001), symptom severity score (P=0.007), quality of life (P=0.01).Results were similar at six week follow-up.
Conclusion Factors contributing to the placebo effect can be progressively combined in a manner resembling a graded dose escalation of component parts. Non-specific effects can produce statistically and clinically significant outcomes and the patient-practitioner relationship is the most robust component.
Trial registration Clinical Trials NCT00065403.
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This paper presents a selective review of the literature addressing the influence of young children's conversational environments and interactions on their psychological understanding of persons. Our dual purposes are to reveal some consensus on the current state of knowledge and to foster a programmatic approach to future research. The initial sections clarify what is meant by conversation and describe the nature of theory-of-mind development. We adopt the term socio-cognitive development to convey the fact that children's theory-of-mind understanding becomes more elaborate and flexible throughout childhood, and we discuss issues of measurement. The following sections deal directly with the influence of conversational environments and interactions on children's socio-cognitive understanding. We present findings that suggest that conversational interactions are of fundamental importance for the development of children's socio-cognitive understanding, and we examine the particular aspects of the former that have been shown to be the most effective in promoting the latter. We discuss the relationship between children's conversational references to thoughts and feelings and experimental assessments of their socio-cognitive understanding, and we offer a detailed list of considerations for future research. In the remaining sections, we highlight the important roles of (i) young children's expanding linguistic competence and (ii) their relationships, and we discuss implications for individual differences in children's developing social competence.
ABSTRACTTheory of mind describes the ability to engage in perspective-taking, infer mental states, and predict intentions, behavior, and actions in others. Theory of mind performance is associated with foundational cognitive and socioemotional skills, including verbal ability (receptive and expressive vocabulary), executive function (inhibitory control and working memory), and emotion knowledge. In a sample of 354 children from low-income households, theory of mind and foundational skills were directly assessed before and after kindergarten. Results indicate emotion knowledge, inhibitory control, and expressive language predicted improvement in theory of mind. Expressive language also served as a moderator such that children with low expressive language failed to improve in theory of mind regardless of initial theory of mind performance.
Designed by a partnership of UN agencies, international scientific organizations, and development agencies, the Millennium Ecosystem Assessment (MA) is the most extensive study ever of the linkages between the world’s ecosystems and human well-being. The goal of the MA is to establish the scientific basis for actions needed to enhance the contribution of ecosystems to human well-being without undermining their long-term productivity. With contributions by more than 500 scientists from 70 countries, the MA has proven to be one of the most important conservation initiatives ever undertaken, and the ecosystem services paradigm on which it is based provides the standard for practice. This manual supplies the specific tools that practitioners of the paradigm need in order to extend their work into the future.The manual is a stand-alone “how to” guide to conducting assessments of the impacts on humans of ecosystem changes. In addition, assessment practitioners who are looking for guidance on particular aspects of the assessment process will find individual chapters of this manual to be useful in advancing their understanding of best practices in ecosystem assessment. The manual builds on the experiences and lessons learned from the Millennium Ecosystem Assessment global and sub-global assessment initiatives, with chapters written by well-known participants in those initiatives. It also includes insights and experiences gained from a wider range of ecosystem service-focused assessment activities since the completion of the MA in 2005.
BACKGROUND:Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.
OBJECTIVES:
To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT's acceptability and mechanism of action.
DESIGN:
Single-blind, parallel, individual randomised controlled trial.
SETTING:
UK general practices.
PARTICIPANTS:
Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.
INTERVENTIONS:
Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT's acceptability and mechanism of action.
MAIN OUTCOMES MEASURES:
The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.
RESULTS:
In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.
CONCLUSIONS:
There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.
Objective: To compare the efficacy of Mindfulness-Based Addiction Treatment (MBAT) to a Cognitive Behavioral Treatment (CBT) that matched MBAT on treatment contact time, and a Usual Care (UC) condition that comprised brief individual counseling. Method: Participants (N = 412) were 48.2% African American, 41.5% non-Latino White, 5.4% Latino, and 4.9% other, and 57.6% reported a total annual household income < $30,000. The majority of participants were female (54.9%). Mean cigarettes per day was 19.9 (SD = 10.1). Following the baseline visit, participants were randomized to UC (n = 103), CBT (n = 155), or MBAT (n = 154). All participants were given self-help materials and nicotine patch therapy. CBT and MBAT groups received 8 2-hr in-person group counseling sessions. UC participants received 4 brief individual counseling sessions. Biochemically verified smoking abstinence was assessed 4 and 26 weeks after the quit date. Results: Logistic random effects model analyses over time indicated no overall significant treatment effects (completers only: F(2, 236) = 0.29, p = .749; intent-to-treat: F(2, 401) = 0.9, p = .407). Among participants classified as smoking at the last treatment session, analyses examining the recovery of abstinence revealed a significant overall treatment effect, F(2, 103) = 4.41, p = .015 (MBAT vs. CBT: OR = 4.94, 95% CI: 1.47 to 16.59, p = .010, Effect Size = .88; MBAT vs. UC: OR = 4.18, 95% CI: 1.04 to 16.75, p = .043, Effect Size = .79). Conclusion: Although there were no overall significant effects of treatment on abstinence, MBAT may be more effective than CBT or UC in promoting recovery from lapses.
Although numerous studies of preschoolers report robust associations between performance on tests of executive function (EF) and theory of mind (ToM), a lack of developmentally appropriate tasks so far has limited research on these cognitive skills in younger children. Here, we present new batteries of EF and ToM tasks that were administered to 140 two-year-olds from predominantly disadvantaged families, with analyses based on 129 children. Our results showed a strong association between EF and ToM, which remained significant when effects of verbal ability were controlled. Individual differences in EF and ToM were also examined in relation to both distal family factors (social disadvantage, number of siblings) and proximal family factors (quality of child's relationships with parents and siblings). Social disadvantage predicted significant variance in both EF and ToM but did not contribute to the association between these domains. Associations between positive parent-child relationships and both EF and ToM were nonsignificant when verbal ability was controlled. In contrast, positive sibling relationships predicted significant variance in ToM, even controlling for age, verbal ability, EF, social disadvantage, and parent-child relationships.
Background: This paper describes the experiences of 8 licensed acupuncturists in a placebo-controlled randomized clinical trial (RCT). This information is important to the design and conduct of high-quality trials. Methods: We conducted a RCT (N = 135) with a 2-week placebo run-in followed by 4 weeks of twice-weekly treatments comparing genuine to sham acupuncture (using the Streitberger placebo needle) in the treatment of arm pain caused by repetitive use. At the end of this study, we conducted written structured interviews with 8 participating acupuncturists. The acupuncturists were not aware of the study's results at the time of these interviews. The questions focused on their experiences in the study, adherence to study protocols, their thoughts about the technical and ethical issues involved in using a sham needling device, and their expectations of trial outcomes. The questions were motivated by expressions of concerns the acupuncturists raised in feedback groups during the course of the study, and our desire to improve further trials. Results: The acupuncturists differed widely in their comfort levels with the research methods used, their adherence to the study protocol, and their expectations of trial outcomes. Conclusions: We conclude that careful monitoring of acupuncturists, including observation of treatments and frequent meetings to support them throughout the trial, is necessary to maintain a high degree of quality control.
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The relationship between cigarette smoking and depressive symptoms is well established. Dispositional mindfulness has been associated with lower depressive symptoms, lower smoking dependence, and higher odds of smoking cessation. Given that mindfulness is multi-faceted, the current study examined which facets of mindfulness might mediate the relationship between depressive symptoms and smoking behavior. Participants (n = 72) completed the Smoking Consequences Questionnaire (SCQ), Center for Epidemiologic Studies Depression Scale (CESD), and Kentucky Inventory of Mindfulness Skills (KIMS; subscales-Observe, Describe, Acting with Awareness, Accepting without Judgment) and indicated number of cigarettes smoked per day (CPD). Simple mediation models (followed by multiple mediation when more than one facet was significant) tested whether mindfulness facets mediated the relationship between CESD and smoking behavior (CPD and SCQ subscales). Results indicated that (1) lower depressive symptoms were associated with higher Accepting without Judgment, which was related to lower Negative Reinforcement expectancies, (2) lower depressive symptoms were associated with increased Describe, which was associated with greater perceived Negative Consequences, (3) lower depressive symptoms were associated with higher Accepting without Judgment, which was associated with lower Negative Consequences expectancies, and (4) higher depressive symptoms were associated with higher scores on Observe, which related to both greater Positive Reinforcement and Negative Consequences expectancies. Greater Accepting without Judgment and Describe aspects of mindfulness may serve as protective factors in the relationship of depressive symptoms and smoking.
This article describes contemplative education as practiced at the Buddhist-inspired Naropa University in Boulder, Colorado. It highlights the importance of students’ intentions and of integrating Eastern” and Western” ideas to the success of such an education. For U.S. scholar-practitioners Naropa is a model non-denominational, secular approach to contemplative teaching and learning.
Reviews the book "Medicine and Compassion: A Tibetan Lama's Guidance for Caregivers," by Chokyi Nyima Rinpoche and David R. Shlim.
In this chapter, we begin to explore the wealth of research and theory on the implications of mindfulness for emotional experience by examining a variety of models of mindfulness and how they inform mindful emotion regulation. Then, we provide an empirical overview of the role of mindfulness in general emotional states, emotional reactions to stimuli and events, and emotions over time. Within this overview, we provide evidence for several distinct avenues through which mindfulness benefits emotion regulation, including increased willingness to experience negative emotions, reduced reactivity to emotional stimuli and situations, a decentered perspective, and increased emotional stability; we also highlight some research which suggests the neurological underpinnings of mindful emotion regulation. Finally, we link the impact of mindfulness on emotion regulation to behavioral change. Specifically, by highlighting research on smoking, alcohol use, and other addictive behaviors, we demonstrate that emotion regulation serves as a key mechanism in the relationship between mindfulness and some domains of behavioral regulation.
Objective: To explore differences in mindfulness, happiness, and perceived anxiety in a sample of college students before and after taking a meditation course.Participants: Participants were college students at a primarily undergraduate institution enrolled in an experiential meditation class (n = 74) and a non-meditation class comparison group (n = 73).Methods: The study design was a before-after observational study with two groups and three dependent variables: the Mindfulness Attention Awareness Scale, the State Trait Anxiety Inventory and the Subjective Happiness Scale.Results: Students in the meditation course increased average subjective happiness and mindfulness attention awareness. Mindfulness scores increased and anxiety decreased more for students in the meditation class compared to students in the psychosocial class.Conclusions: This research provides evidence that taking a semester long meditation course is associated with improvements in college student well-being.
BackgroundMindfulness‐based therapies have been shown to be effective in treating depression and reducing cognitive biases. Anxiety sensitivity is one cognitive bias that may play a role in the association between mindfulness and depressive symptoms. It refers to an enhanced sensitivity toward symptoms of anxiety, with a belief that these are harmful. Currently, little is known about the mechanisms underpinning the association between mindfulness, depression, and anxiety sensitivity. The aim of this study was to examine the role of genetic and environmental factors in trait mindfulness, and its genetic and environmental overlap with depressive symptoms and anxiety sensitivity.
Methods
Over 2,100 16‐year‐old twins from a population‐based study rated their mindfulness, depressive symptoms, and anxiety sensitivity.
Results
Twin modeling analyses revealed that mindfulness is 32% heritable and 66% due to nonshared environmental factors, with no significant influence of shared environment. Genetic influences explained over half of the moderate phenotypic associations between low mindfulness, depressive symptoms, and anxiety sensitivity. About two‐thirds of genetic influences and almost all nonshared environmental influences on mindfulness were independent of depression and anxiety sensitivity.
Conclusions
This is the first study to show that both genes and environment play an important role in the etiology of mindfulness in adolescence. Future research should identify the specific environmental factors that influence trait mindfulness during development to inform targeted treatment and resilience interventions. Shared genetic liability underpinning the co‐occurrence of low mindfulness, depression, and anxiety sensitivity suggests that the biological pathways shared between these traits should also be examined.
Individuals with low socioeconomic status (SES) and members of racial/ethnic minority groups often experience profound disparities in mental health and physical well-being. Mindfulness-based interventions show promise for improving mood and health behaviors in higher-SES and non-Latino White populations. However, research is needed to explore what types of adaptations, if any, are needed to best support underserved populations. This study used qualitative methods to gain information about (a) perceptions of mindfulness, (b) experiences with meditation, (c) barriers to practicing mindfulness, and (d) recommendations for tailoring mindfulness-based interventions in a low-income, primarily African American treatment-seeking sample. Eight focus groups were conducted with 32 adults (16 men and 16 women) currently receiving services at a community mental health center. Most participants (91%) were African American. Focus group data were transcribed and analyzed using NVivo 10. A team of coders reviewed the transcripts to identify salient themes. Relevant themes included beliefs that mindfulness practice might improve mental health (e.g., managing stress and anger more effectively) and physical health (e.g., improving sleep and chronic pain, promoting healthier behaviors). Participants also discussed ways in which mindfulness might be consistent with, and even enhance, their religious and spiritual practices. Results could be helpful in tailoring mindfulness-based treatments to optimize feasibility and effectiveness for low-SES adults receiving mental health services.
The ice core sample that marks the beginning of the geological epoch known as the Holocene is archived in a freezer at the University of Copenhagen.1 Drilled in
<p>Five studies investigated the cognitive and emotional processes by which self-compassionate people deal with unpleasant life events. In the various studies, participants reported on negative events in their daily lives, responded to hypothetical scenarios, reacted to interpersonal feedback, rated their or others' videotaped performances in an awkward situation, and reflected on negative personal experiences. Results from Study 1 showed that self-compassion predicted emotional and cognitive reactions to negative events in everyday life, and Study 2 found that self-compassion buffered people against negative self-feelings when imagining distressing social events. In Study 3, self-compassion moderated negative emotions after receiving ambivalent feedback, particularly for participants who were low in self-esteem. Study 4 found that low-self-compassionate people undervalued their videotaped performances relative to observers. Study 5 experimentally induced a self-compassionate perspective and found that self-compassion leads people to acknowledge their role in negative events without feeling overwhelmed with negative emotions. In general, these studies suggest that self-compassion attenuates people's reactions to negative events in ways that are distinct from and, in some cases, more beneficial than self-esteem.</p>
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Preschool teachers across the country have been charged to prepare children socially and emotionally for kindergarten. Teachers working in preschool centers are supporting childrens social and emotional learning (SEL) within a rich ecology of emotion and social relationships and the present study considers how the supports implemented for childrens SEL at the centerlevel are associated with teachers psychological health and workplace experiences. Hierarchical linear models were constructed using data from the Head Start Family and Child Experiences Survey 2009 cohort. Results indicate that although teachers work in individual classrooms, they share common perceptions at the center-level of their workplace climate, access to support, and, although to a lesser extent, experience commonalities in psychological health and job satisfaction. Furthermore, in centers that had implemented more supports for childrens SEL (including access to mental health consultants, classroom curriculum, and training and resources for teachers) teachers were less depressed, more satisfied with their jobs, felt more supported in managing challenging behavior, and viewed the workplace climate of their center as more positive. Findings are discussed in light of the national efforts to increase and retain a highquality early childhood workforce. Copyright � 2016 Elsevier B.V. or its licensors or contributors. ScienceDirect � is a registered trademark of Elsevier B.V.
Preschool teachers across the country have been charged to prepare children socially and emotionally for kindergarten. Teachers working in preschool centers are supporting children's social and emotional learning (SEL) within a rich ecology of emotion and social relationships and the present study considers how the supports implemented for children's SEL at the center-level are associated with teachers' psychological health and workplace experiences. Hierarchical linear models were constructed using data from the Head Start Family and Child Experiences Survey 2009 cohort. Results indicate that although teachers work in individual classrooms, they share common perceptions at the center-level of their workplace climate, access to support, and, although to a lesser extent, experience commonalities in psychological health and job satisfaction. Furthermore, in centers that had implemented more supports for children's SEL (including access to mental health consultants, classroom curriculum, and training and resources for teachers) teachers were less depressed, more satisfied with their jobs, felt more supported in managing challenging behavior, and viewed the workplace climate of their center as more positive. Findings are discussed in light of the national efforts to increase and retain a high-quality early childhood workforce.
Preschool teachers across the country have been charged to prepare children socially and emotionally for kindergarten. Teachers working in preschool centers are supporting children's social and emotional learning (SEL) within a rich ecology of emotion and social relationships and the present study considers how the supports implemented for children's SEL at the center-level are associated with teachers' psychological health and workplace experiences. Hierarchical linear models were constructed using data from the Head Start Family and Child Experiences Survey 2009 cohort. Results indicate that although teachers work in individual classrooms, they share common perceptions at the center-level of their workplace climate, access to support, and, although to a lesser extent, experience commonalities in psychological health and job satisfaction. Furthermore, in centers that had implemented more supports for children's SEL (including access to mental health consultants, classroom curriculum, and training and resources for teachers) teachers were less depressed, more satisfied with their jobs, felt more supported in managing challenging behavior, and viewed the workplace climate of their center as more positive. Findings are discussed in light of the national efforts to increase and retain a high-quality early childhood workforce.
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