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Background: Neuropathic pain and complex regional pain syndrome are complex responses of the nervous system. The interaction of nociceptive neuropathic input with learned stress responses, beliefs, expectations, and societal pressures make each patient's experience unique. Design: A review of the recent clinical research and scholarly work in the treatment of neuropathic pain was undertaken. Principal Findings: A review of clinical pain research has demonstrated that treatment programs that focus solely on the resolution of neuropathic pain by treating nociceptive generators and symptom modulation have had limited success. Recent studies have demonstrated that coordinated interventions that address the peripheral, central, behavioral, and social generators of the pain experience offer the best opportunity for successful management. Conclusion: A biopsychosocial approach to rehabilitation that uncovers and addresses the nociceptive, psychological, and social triggers of the patient's response is essential to either resolving the pain or building the patient resiliency necessary to manage more persistent pain states. A pain education program structured to the specific needs of the patient is the core component of biopsychosocial rehabilitation. Graded activity, neurosensory training, neuromobilization, bracing/taping, stress management, and pain modulation programs and activities can be important components of the rehabilitation plan. Early intervention after the acute onset of neuropathic pain with an activity-based, comprehensive, biopsychosocial management plan may be effective in preventing more persistent pain states. Rehabilitation plans for both acute and persistent neuropathic pain should focus on building patient self-efficacy, self-management, and resiliency.
BACKGROUND: Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse. OBJECTIVES: Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies. MATERIALS AND METHODS: The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests. RESULTS: The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy. CONCLUSIONS: Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.
BACKGROUND: Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse. OBJECTIVES: Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies. MATERIALS AND METHODS: The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests. RESULTS: The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy. CONCLUSIONS: Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.
OBJECTIVE: This study explored possible mechanisms through which symptoms of posttraumatic stress disorder (PTSD) were reduced in a randomized controlled trial comparing the effect of a yoga intervention with an assessment control. METHOD: We examined whether changes in psychological flexibility, mindfulness, and emotion regulation strategies (expressive suppression and reappraisal) were associated with posttreatment PTSD symptoms for 38 women with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition full or subthreshold PTSD. RESULTS: Hierarchical linear regression models revealed that expressive suppression significantly decreased for the yoga group relative to the assessment control. Psychological flexibility increased significantly for the control but not yoga group. However, increases in psychological flexibility were associated with decreases in PTSD symptoms for the yoga but not control group. CONCLUSION: Preliminary findings suggest that yoga may reduce expressive suppression and may improve PTSD symptoms by increasing psychological flexibility. More research is needed to replicate and extend these findings.
OBJECTIVE: This study explored possible mechanisms through which symptoms of posttraumatic stress disorder (PTSD) were reduced in a randomized controlled trial comparing the effect of a yoga intervention with an assessment control. METHOD: We examined whether changes in psychological flexibility, mindfulness, and emotion regulation strategies (expressive suppression and reappraisal) were associated with posttreatment PTSD symptoms for 38 women with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition full or subthreshold PTSD. RESULTS: Hierarchical linear regression models revealed that expressive suppression significantly decreased for the yoga group relative to the assessment control. Psychological flexibility increased significantly for the control but not yoga group. However, increases in psychological flexibility were associated with decreases in PTSD symptoms for the yoga but not control group. CONCLUSION: Preliminary findings suggest that yoga may reduce expressive suppression and may improve PTSD symptoms by increasing psychological flexibility. More research is needed to replicate and extend these findings.
BACKGROUND: Studies using yoga have demonstrated initial efficacy for treating symptoms across anxiety disorders, including posttraumatic stress disorder. OBJECTIVE: Understanding how interventions influence participants' physical activity and what determinants affect continued physical activity behavior change is important because maintenance of the behavior may be critical to continued mental health gains and symptom reduction. METHODS: This study investigated change in physical activity and possible psychological mechanisms of physical activity behavior change, including self-efficacy and regulatory motivation, in a randomized controlled trial of yoga for women with post-traumatic stress disorder symptoms (n=38). RESULTS: Growth curve modeling results showed no significant changes in physical activity or self-efficacy for either group, whereas external motivation decreased significantly in the yoga group but not in the control group. CONCLUSIONS: Investigators of future yoga interventions may want to focus on increasing self-efficacy and internal regulatory motivation, so that physical activity and resultant symptom relief can be maintained.
BACKGROUND: Studies using yoga have demonstrated initial efficacy for treating symptoms across anxiety disorders, including posttraumatic stress disorder. OBJECTIVE: Understanding how interventions influence participants' physical activity and what determinants affect continued physical activity behavior change is important because maintenance of the behavior may be critical to continued mental health gains and symptom reduction. METHODS: This study investigated change in physical activity and possible psychological mechanisms of physical activity behavior change, including self-efficacy and regulatory motivation, in a randomized controlled trial of yoga for women with post-traumatic stress disorder symptoms (n=38). RESULTS: Growth curve modeling results showed no significant changes in physical activity or self-efficacy for either group, whereas external motivation decreased significantly in the yoga group but not in the control group. CONCLUSIONS: Investigators of future yoga interventions may want to focus on increasing self-efficacy and internal regulatory motivation, so that physical activity and resultant symptom relief can be maintained.
BACKGROUND: Studies using yoga have demonstrated initial efficacy for treating symptoms across anxiety disorders, including posttraumatic stress disorder. OBJECTIVE: Understanding how interventions influence participants' physical activity and what determinants affect continued physical activity behavior change is important because maintenance of the behavior may be critical to continued mental health gains and symptom reduction. METHODS: This study investigated change in physical activity and possible psychological mechanisms of physical activity behavior change, including self-efficacy and regulatory motivation, in a randomized controlled trial of yoga for women with post-traumatic stress disorder symptoms (n=38). RESULTS: Growth curve modeling results showed no significant changes in physical activity or self-efficacy for either group, whereas external motivation decreased significantly in the yoga group but not in the control group. CONCLUSIONS: Investigators of future yoga interventions may want to focus on increasing self-efficacy and internal regulatory motivation, so that physical activity and resultant symptom relief can be maintained.
OBJECTIVE: Eating-disordered behavior is prevalent among college women. Few interventions have successfully reduced risk factors for these behaviors, however. The most promising interventions are both selective and interactive. This study compared two newer types of interventions that meet these criteria: cognitive dissonance and yoga programs. METHOD: This study advertised programs for women who were dissatisfied with their bodies. Participants (N = 93) were randomly assigned to dissonance, yoga, or control groups. RESULTS: Hierarchical regression analyses revealed that there were no significant post-intervention differences between the yoga and control groups. Dissonance group participants had significantly lower scores than the scores of both other groups on measures of disordered eating, drive for thinness, body dissatisfaction, alexithymia, and anxiety. CONCLUSION: These findings have important implications for interventions on college campuses. In particular, dissonance interventions appear to be an efficient and inexpensive approach to reducing eating disorder risk factors. Additional research regarding the value of yoga interventions is needed.