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Background and objectives Up to 50% of patients undergoing hemodialysis suffer from symptoms of depression and/or anxiety. Access to traditional pharmacotherapies and psychotherapies for depression or anxiety in this patient population has been inadequate. The objective of this study was to investigate the feasibility and effectiveness of brief mindfulness meditation intervention for patients on hemodialysis with depression and anxiety symptoms.Design, setting, participants, & measurements This study was a randomized, controlled, assessor-blinded trial conducted in an urban hemodialysis unit. Forty-one patients were randomly assigned to intervention (n=21) and treatment-as-usual (n=20) groups. The intervention group received an 8-week individual chairside meditation intervention lasting 10–15 minutes, three times a week during hemodialysis. Feasibility outcomes were primarily assessed: enrollment rates, intervention completion rates, and intervention tolerability. Symptoms of depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7).
Results Of those deemed eligible for the study, 67% enrolled (41 of 61). Of the participants randomized to the intervention group, 71% completed the study, with meditation being well tolerated (median rating of 8 of 10 in a Likert scale; interquartile range=10–5 of 10). Barriers to intervention delivery included frequent hemodialysis shift changes, interruptions by staff or alarms, space constraints, fluctuating participant medical status, and participant fatigue. Meditation was associated with subjective benefits but no statistically significant effect on depression scores (change in PHQ-9, −3.0±3.9 in the intervention group versus −2.0±4.7 in controls; P=0.45) or anxiety scores (change in GAD-7, −0.9±4.6 versus −0.8±4.8; P=0.91).
Conclusions On the basis of the results of this study, mindfulness meditation appears to be feasible and well tolerated in patients on hemodialysis with anxiety and depression symptoms. The study did not reveal significant effects of the interventions on depression and anxiety scores.
<p><em>Buddhism and Western Psychology</em> represents one of the early volumes to contain reflections on the interface between Buddhism and psychology from a diverse and expert group of Western Buddhist scholars, psychologists, and Asian Buddhists. Fourteen essays are organized according to four major Buddhist traditions: (1) Pāli Buddhism; (2) Japanese Buddhism; (3) Sanskrit (Mahāyāna) Buddhism; and (4) Tibetan Buddhism. Areas of Western influence come from psychoanalysis, Jungian psychology, German phenomenology and the related field of existential psychology or "daseinanalyse." (Zach Rowinski 2005-03-10)</p>
This chapter elaborates the psychophysiological basis of a forensic assessment that helps in eliciting truth from a person during a forensic assessment interview (FAINT). The FAINT is set up as a scientific experiment where the only stimulus presented is the interviewer's question, and all extraneous stimuli are controlled. A FAINT utilizes relevant questions dealing with the crime, to pose the greatest threat to the guilty suspect because he will be forced to either confess to or lie about the matter at hand. Comparison questions designed to deal with earlier transgressions or peccadilloes are utilized to threaten the innocent suspect. Under these circumstances, when a suspect lies, emotional changes occur because of conditioning, conflict, or psychological set. This emotional imbalance causes subsequent physiological changes resulting in observable behaviors, the degree of which may be affected by various factors. These factors include the interviewee's perception of the interviewer's ability to detect deception, the interviewee's past experiences at deception, and the interviewee's perception of the seriousness of being caught. Through the use of relevant and comparison questions, and given the ability to observe and detect changes associated with sympathetic arousal, the trained interviewer can monitor the suspect's psychological set and solve the puzzle of truth or deception.
The authors constructed a measure of spiritual meaning, defined as the extent to which an individual believes that life or some force of which life is a function has a purpose, will, or way in which individuals participate, to supplement measures of personal meaning (mindfulness to a framework or philosophy of life) and implicit meaning (engaging in activities and valuing attitudes that people typically report as comprising an ideally meaningful life). Using a sample of 465 undergraduates, the authors selected 14 Likert-format items that exhibited desirable psychometric characteristics to constitute the Spiritual Meaning Scale (SMS). Along with measures of personal meaning, implicit meaning, and the Big Five personality dimensions, the SMS was analyzed in relationship to mental health measures (hope, depression, anxiety, and antisocial features) that had also been administered to the aforementioned sample. Hierarchical regression analyses indicated that each of the meaning variables explained variance in hope and depression beyond the variance explained by the Big Five personality factors.
Mindfulness training involves the cultivation of nonjudgemental attention to unwanted thoughts, feelings and bodily experiences via meditation and may help ameliorate both psychological and physical symptoms of chronic disease. Clinical trials have shown that mindfulness training improves the psychological well-being of people with rheumatoid arthritis(RA). However, there is limited evidence for its efficacy on disease activity outcomes in RA. Given evidence linking increased mindfulness to improved immune markers, mindfulness training may reduce disease activity in patients with RA by enhancing their immune function. The aim of this randomised controlled trial was to examine the effects of a standardised mindfulness-based stress reduction (MBSR) intervention on RA disease activity.
Mindfulness‐based stress reduction (MBSR) has grown in popularity over the last two decades, showing efficacy for a variety of health issues. In the current study, we examined the effects of an MBSR intervention on pain, positive states of mind, stress, and mindfulness self‐efficacy. These measures were collected before and following an 8‐week intervention. Post‐intervention levels of stress were significantly lower than pre‐intervention levels, while mindfulness self‐efficacy and positive states of mind were at significantly higher levels. The findings underscore the potential for stress management, awareness and attention training, and positive states of mind using MBSR.
<p>We recently reported the presence of reliable asymmetries in frontal-brain electrical activity in infants that distinguished between certain positive- and negative-affect elicitors. In order to explore the degree to which these asymmetries in brain activity are associated with individual differences in affective response, 35 ten-month-old female infants were presented with a stranger-approach, mother-approach, and maternal-separation experience while an electroencephalogram (EEG) from the left- and right-frontal and left- and right-parietal scalp regions was recorded and facial and other behavioral responses were videotaped. Changes in frontal-EEG asymmetry reflected behavioral changes between conditions. In addition, individual differences in affective response to separation were related to differences in frontal-brain asymmetries. These findings indicate that lawful changes exist in asymmetries of frontal-brain activation during the expression of certain emotions in the first year of life and that individual differences in emotional responsivity are related to these measures of brain activity.</p>
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<p>The article looks at <em>Dorjé tekpé tsawa dang yenlak gi tungwé shakpa</em> (rdo rje theg pa'i rtsa ba dang yan lag gi ltung ba'i bshags pa), written by Indrabhūti, as a traditional Tantric confession of errors. The article attempts to arrive at a clearer idea of this practice of confessing errors by looking at comparable structures in Theravā̄da and Mahāyāna traditions. (Mark Premo-Hopkins 2004-04-14)</p>
Mindfulness training has been proposed as a potentially important new approach for the treatment of generalized anxiety disorder (GAD). However, to date only a few studies have investigated mindfulness training for GAD. The aim of this study was to further investigate symptom change and recovery in pathological worry after mindfulness-based cognitive therapy (MBCT) using an uncontrolled pre-post design. Twenty-three adults with a primary diagnosis of GAD participated in the study. The MBCT program involved 9 weekly 2-hour group sessions, a post-treatment assessment session, and 6-week and 3-month follow-up sessions. Intent-to-treat analysis revealed significant improvements in pathological worry, stress, quality of life, and a number of other symptoms at post-treatment, which were maintained at follow-up. Attrition was also low, and MBCT was perceived as a credible and acceptable intervention. However, when applying standardized recovery criteria to pathological worry scores, the rate of recovery at post-treatment was very small, although improved at follow-up. Overall, the findings suggest MBCT is definitely worthy of further investigation as a treatment option for GAD, but falls well short of outcomes achieved by past research. Possible reasons for the poor rate of recovery, implications, and limitations are briefly outlined.
Geriatric depression and anxiety are very common but difficult to treat pharmacologically; patients are more sensitive to adverse effects and respond relatively less well to medication.(1) Mindfulness-based cognitive therapy (MBCT) is a psychological therapy that has been highly effective in the treatment of psychiatric disorders, particularly in preventing relapse of depression.(2) However, there has only been one previous exploratory study examining its effectiveness in treating older adults.(3) We hypothesized that MBCT group psychotherapy will improve acute anxiety and depression in late life.We examined a retrospective case series of six geriatric outpatients (aged ≥ 60) with major depression and/or anxiety disorders who underwent an eight-week group MBCT course (2 hours per week) delivered by a psychiatrist (SR) in Fall 2014. Patients with normal cognition or mild cognitive impairment were included, while patients with dementia, acute psychosis, or acute suicidal ideation were excluded. Psychotropic medications were not adjusted during the treatment period. Ethics approval was obtained at Sunnybrook Health Sciences Centre in Toronto, Canada. We compared patients’ self-report scores on the Beck Anxiety Inventory (BAI), Beck Depression Inventory 2 (BDI-2), and Montreal Cognitive Assessment (MoCA) pre- and post-MBCT.
Our patients were aged 66 to 82 (mean 74.5 ± 6.2), 66.7% were females, with an average of 4.8 (± 3.4) medical comorbidities and 6.3 (± 2.9) medications, including 1.0 (± 0.9) psychiatric medications. At baseline, patients (n = 6) had a mean BAI score of 24.5 (± 15.6), a BDI of 17.8 (± 12.8), and a MoCA of 27.0 (± 1.4). All patients completed the MBCT course and all self-reported enjoying the groups, with three patients attending all sessions and three patients missing only one session.
Following MBCT, in patients with baseline anxiety (BAI > 7) (n = 5), the BAI score was significantly decreased by a mean of 37.7% (± 13.7) (range 26.1% to 57.1%) reduced from 28.0 (± 14.5) to 18.6 (± 11.8) (t = 6.7, p = .003). Considering patients with baseline depression (BDI > 7) (n = 4), the BDI score decreased by 33.3% (± 38.2) (range from 8.7% to 77.8%), reduced from 26 (± 2.1) to 17 (± 9.1), although likely due to our limited sample size, this result was non-significant (t = 1.78, p = .17). Patients’ cognition (n = 6) did not change meaningfully (mean +0.2 points increase in MoCA ± 1.8). At the end of the MBCT course, patients reported practicing formal mindfulness on their own an average of 3.6 times per week for 13.3 minutes/day.
We observed strong effect sizes in both anxiety and depression for MBCT (Cohen’s d of 0.71 and 1.4, respectively), comparable to first-line antidepressants and individual cognitive behavioral therapy after generally longer treatment periods (e.g., a Cohen’s d of 0.4–1.3 after 15 weeks, with important placebo effects).(4,5)
Our findings suggest that group MBCT could be an effective, well-tolerated, and health resource-efficient alternative and adjunct to current treatments in older adults. This appeared to be the case in our small sample of patients with an average symptom severity in the moderate-to-severe range. Future randomized controlled trials should further assess the effectiveness of MBCT in late-life anxiety and depression.
Examined were electroencephalogram (EEG) asymmetries during the presence of discrete facial signs of emotion among 10-month-old infants who were tested in a standard stranger- and mother-approach paradigm that included a brief separation from mother. Data underscore the usefulness of EEG measures of hemispheric activation in differentiating among certain emotional states. (RH)
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BackgroundMen are at greater risk than women of dying by suicide. One in eight will experience depression – a leading contributor to suicide – in their lifetime and men often delay seeking treatment. Previous research has focused on men’s use of unhelpful coping strategies, with little emphasis on men’s productive responses. The present study examines the positive strategies men use to prevent and manage depression.
Method
A national online survey investigated Australian men’s use of positive strategies, including 26 strategies specifically nominated by men in a previous qualitative study. Data were collected regarding frequency of use or openness to using untried strategies, depression risk, depression symptoms, demographic factors, and other strategies suggested by men. Multivariate regression analyses explored relationships between regular use of strategies and other variables.
Results
In total, 465 men aged between 18 and 74 years participated. The mean number of strategies used was 16.8 (SD 4.1) for preventing depression and 15.1 (SD 5.1) for management. The top five prevention strategies used regularly were eating healthily (54.2 %), keeping busy (50.1 %), exercising (44.9 %), humour (41.1 %) and helping others (35.7 %). The top five strategies used for management were taking time out (35.7 %), rewarding myself (35.1 %), keeping busy (35.1 %), exercising (33.3 %) and spending time with a pet (32.7 %). With untried strategies, a majority (58 %) were open to maintaining a relationship with a mentor, and nearly half were open to using meditation, mindfulness or gratitude exercises, seeing a health professional, or setting goals. In multivariate analyses, lower depression risk as measured by the Male Depression Risk Scale was associated with regular use of self-care, achievement-based and cognitive strategies, while lower scores on the Patient Health Questionnaire-9 was associated with regular use of cognitive strategies.
Conclusions
The results demonstrate that the men in the study currently use, and are open to using, a broad range of practical, social, emotional, cognitive and problem-solving strategies to maintain their mental health. This is significant for men in the community who may not be in contact with professional health services and would benefit from health messages promoting positive strategies as effective tools in the prevention and management of depression.
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