ObjectiveMindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects.
Method
In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor + Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age = 32 years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test.
Results
As predicted, Monitor + Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress.
Conclusions
This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.
CONTEXT:Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.
OBJECTIVE:
To compare rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care.
DESIGN:
Patients who met remission criteria after 8 months of algorithm-informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months.
SETTING:
Outpatient clinics at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and St Joseph's Healthcare, Hamilton, Ontario.
PARTICIPANTS:
One hundred sixty patients aged 18 to 65 years meeting DSM-IV criteria for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to 1 of the 3 study conditions.
INTERVENTIONS:
Patients in remission discontinued their antidepressants and attended 8 weekly group sessions of MBCT, continued taking their therapeutic dose of antidepressant medication, or discontinued active medication and were switched to placebo.
MAIN OUTCOME MEASURE:
Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on module A of the Structured Clinical Interview for DSM-IV.
RESULTS:
Intention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P = .03). Among unstable remitters (1 or more Hamilton Rating Scale for Depression score >7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo (P = .03), whereas for stable remitters (all Hamilton Rating Scale for Depression scores ≤7 during remission) there were no group differences in survival.
CONCLUSIONS:
For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.
In this article we examine the role of appeasement in human emotion, social practice, and personality. We first present an analysis of human appeasement. Appeasement begins when the conditions of social relations lead one individual to anticipate aggression from others, is expressed in submissive, inhibited behavior, which in turn evokes inferences and emotions in others that bring about social reconciliation. Our empirical review focuses on two classes of human appeasement: reactive forms of appeasement, including embarrassment and shame, which placate others after social transgressions; and anticipatory forms of appeasement, including polite modesty and shyness, which reduce the likelihood of social conflict and aggression. Our review of the empirical evidence indicates that embarrassment, shame, modesty, and shyness share the eliciting conditions, submissive behavior, and social consequences of appeasement. We conclude by discussing social processes that allow humans to appease one another, such as teasing, and those that prevent appeasement, such as legal and negotiation practices, to the benefit and detriment of human relations. Aggr. Behav. 23:359–374, 1997. © 1997 Wiley-Liss, Inc.
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Importance Concerns exist about the current quality of undergraduate medical education and its effect on students’ well-being.Objective To identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students.
Data Sources Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and ERIC from database inception dates to October 2016. Studies examined any intervention designed to promote medical students’ emotional well-being in the setting of a US academic medical school, with an outcome defined as students’ reports of well-being as assessed by surveys, semistructured interviews, or other quantitative methods.
Data Extraction and Synthesis Two investigators independently reviewed abstracts and full-text articles. Data were extracted into tables to summarize results. Study quality was assessed by the Medical Education Research Study Quality Instrument (MERQSI), which has a possible range of 5 to 18; higher scores indicate higher design and methods quality and a score of 14 or higher indicates a high-quality study.
Findings Twenty-eight articles including at least 8224 participants met eligibility criteria. Study designs included single-group cross-sectional or posttest only (n = 10), single-group pretest/posttest (n = 2), nonrandomized 2-group (n = 13), and randomized clinical trial (n = 3); 89.2% were conducted at a single site, and the mean MERSQI score for all studies was 10.3 (SD, 2.11; range, 5-13). Studies encompassed a variety of interventions, including those focused on pass/fail grading systems (n = 3; mean MERSQI score, 12.0), mental health programs (n = 4; mean MERSQI score, 11.9), mind-body skills programs (n = 7; mean MERSQI score, 11.3), curriculum structure (n = 3; mean MERSQI score, 9.5), multicomponent program reform (n = 5; mean MERSQI score, 9.4), wellness programs (n = 4; mean MERSQI score, 9.0), and advising/mentoring programs (n = 3; mean MERSQI score, 8.2).
Conclusions and Relevance In this systematic review, limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research.
<p>This essay emanates from a 44-year career in the classroom and in a variety of administrative andfaculty roles throughout the academy.6 It notes my journey of becoming a white footsoldier for multicultural issues in higher education, in alliance with others whose racial identities were diverse, e.g., black, Latina/o, Asian, white, and multiracial. We worked to make our university less racist, less monolithically White, less White-male, and more multiculturally inclusive and equitable in curriculum, pedagogy, policies, and programs. As gender identities, socioeconomic status, sexual orientations, and religious affiliations came increasingly into focus, these intersectionalities were added to our understandings and advocacy. My primary emphasis has been on race.</p>
The main purpose of the study was to ascertain the benefits of employing a hybrid evaluation approach to assessing a teacher education programme's objectives or intended outcomes. The benefits of employing the hybrid evaluation approach enacted through its evaluation survey component was seen in the fact that it acts as a guide for participants' thinking, facilitates the acquisition of a broad overview of their thoughts and could provide stakeholders with statistical data, if needed. The benefit of employing the hybrid evaluation approach enacted through its reflective journaling component, was seen in the fact that journaling helped participants to carry out in-depth "thinking about", and formulating written perceptions of various aspects of the programme. The strength of the hybrid evaluation approach rests in the combined and simultaneous use of both components in a single process of programme evaluation.
Note: This book includes a spoken-word audio CD, which is not available with the digital ebook edition.The newest treatment for pain is one of the oldest, most effective strategies for pain-free living: meditation. With Break Through Pain, meditation expert Shinzen Young teaches you how to retrain your relationship to pain through traditional meditation practices. Drawing from 30 years of results in the field, this widely respected teacher offers the essential techniques that have proven successful at pain management centers around the country.Break Through Pain adapts the core principles of mindfulness training to a practical process that can treat even extreme, chronic pain effectively, possibly reducing the need for drugs or surgery. You will learn that, by observing and opening to pain, you can stop resisting it and step outside physical suffering. Step-by-step techniques taught in plain language show how to overcome internal resistance the key to transforming physical pain into a flow of pure energy. With regular practice, you can tap into your mind's own power to overcome physical pain.
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Brain Respiration (BR)-training is a unique form of breathing exercise that develops potential ability by facilitating brain function. It is recognized as an effective method of improving the scholastic aptitude and emotional stability of children. The present study was designed to investigate the characteristics of the EEG during this training. Spectral analysis was used to examine the relative power in the EEG of 12 children while they practiced BR-training, and these were compared to those of 12 matched controls. BR-trainees showed a lower θ rhythm than the controls before the training session began and lower β[sub 2] power before, during and after the session. In contrast, the BR subjects showed greater relative α[sub 1] power than the controls in the left frontal region during BR-training, which persisted throughout the BR-training schedule. There is evidence that decreased θ and β waves may be correlated with emotional maturation, whilst increased α waves are associated with educational achievement. These findings enhance our understanding of the neurophysiological basis of the effects of BR-training upon emotion and maturation.
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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.
This bestselling, classic work offers a definitive presentation of the theory and practice of cognitive therapy for depression. Aaron T. Beck and his associates set forth their seminal argument that depression arises from a "cognitive triad" of errors and from the idiosyncratic way that one infers, recollects, and generalizes. From the initial interview to termination, many helpful case examples demonstrate how cognitive-behavioral interventions can loosen the grip of "depressogenic" thoughts and assumptions. Guidance is provided for working with individuals and groups to address the full range of problems that patients face, including suicidal ideation and possible relapse.
Deepening global crises surround us. We are beset by climate change, fracking, tar sands extraction, GMOs, and mass extinctions of species, to say nothing of nuclear weapons proliferation and Fukushima, the worst nuclear disaster in history. Many of us fall prey to despair even as we feel called to respond to these threats to life on our planet.Authors Joanna Macy and Molly Brown address the anguish experienced by those who would confront the harsh realities of our time. In this fully updated edition of Coming Back to Life, they show how grief, anger and fear are healthy responses to threats to life, and when honored can free us from paralysis or panic, through the revolutionary practice of the Work that Reconnects. New chapters address engaging communities of color, children and teens in the Work.
The Work that Reconnects has spread around the world, inspiring hundreds of thousands to work toward a life-sustaining human culture. Coming Back to Life introduces the Work's theoretical foundations, illuminating the angst of our era with extraordinary insight. Pointing the way forward out of apathy, it offers personal counsel as well as easy-to-use methods for group work that profoundly affect peoples' outlook and ability to act in the world.
A comprehensive guide to what's what and what works in complementary medicine, this expert guide cuts through the jargon and gives you the facts about the alternatives.
As a results of reviews of database for effects of complementary therapies for improvement of Quality of Life on cancer patients, there were 8 mind-body therapies, 2 manual based therapies, 17 biologic based therapies(3 vitamin or minerals, 6 health nutrient products, 8 herbs). There were relative much more proportional studies of mind-body therapies and manual based therapies for quality of life of cancer. It were reported much more positive results in cognitive behavioral therapy, meditation, art therapy, music therapy, yoga included to mind-body therapies also it were reported much more positive result in massage & acupressure included to manual based therapies. And then these findings can be considered to us clinical application of these therapies by additional studies. On the other hand, the amount of study for quality of life of cancer in biologic based therapies was relatively more smaller than mind-body therapies and the results were contrary to each other. The mistletoe, one of the biological therapeutic products, can be considered to relatively useful material as a results of this review and its seems like to have positive value for further study, materials such as honey, ginseng or heat-treated ginseng, AHCCR, selenium. The others of biologic based therapies were inconclusive due to relatively small amounts of studies or revealed negative conclusion or negative tendency by their studies. The high usual rate of complementary therapy in cancer patients in Korea is applying the screw to us study for complementary medicine and is producing needs of complementary closed co-works or cooperation between the citizens, the government, medical doctors for high quality study.
BACKGROUND:Mindfulness-based cognitive therapy (MBCT) has been widely used to treat patients with depressive disorder to prevent relapse. The objective of this study was to examine the effectiveness of newly developed MBCT program as an adjuvant to pharmacotherapy in the treatment of patients with panic disorder or generalized anxiety disorder.
METHODS:
Forty-six patients with panic disorder or generalized anxiety disorder were assigned to either MBCT or an anxiety disorder education (ADE) program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Symptom Checklist-90-Revised (SCL-90-R) were used to assess the patients at 0 week and after the two programs had been running for 2, 4, and 8 weeks.
RESULTS:
The MBCT group demonstrated significantly more improvement than the ADE group according to all anxiety (HAM-A, p<0.01; BAI, p<0.01; anxiety subscale of SCL-90-R, p=0.01) and depression (HAM-D, p<0.01; BDI, p<0.01; depression subscale of SCL-90-R, p<0.01) scale scores. The obsessive-compulsive and phobic subscales of the SCL-90-R also showed significantly more improvement in the MBCT group. However, no significant improvement was observed in the MBCT group versus the ADE group in terms of the somatization, interpersonal sensitivity, paranoid ideation, or psychoticism subscale scores of the SCL-90-R.
CONCLUSIONS:
MBCT may be effective at relieving anxiety and depressive symptoms in patients with panic disorder or generalized anxiety disorder. However, well-designed, randomized controlled trials are needed.
Mindfulness-based cognitive therapy (MBCT) has been studied to treat patients with depressive or anxiety disorders. The aim of this study was to examine whether MBCT is effective as an adjunct to pharmacotherapy in the treatment of patients with panic disorder. Twenty-three patients with panic disorder were included in a MBCT program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), and Panic Disorder Severity Scale (PDSS) were used to assess the patients during the MBCT program. Both HAM-A and PDSS scores were significantly decreased at the 2nd, 4th and 8th weeks compared to baseline in the patients with panic disorder (HAM-A, p<0.01; PDSS, p<0.01). Also, BAI, APPQ and ASI-R were improved significantly after MBCT program (BAI, p<0.01; APPQ, p<0.01; ASI-R, p<0.01). In addition, all subscale scores of ASI-R decreased significantly. MBCT could be effective as an adjunct to pharmacotherapy in patients with panic disorder. However, randomized controlled trials are needed.
This study examined the effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. A nonequivalent, control group, pre-posttest design was used. A convenience sample of 41 nursing students were randomly assigned to experimental (n=21) and control groups (n=20). Stress was measured with the PWI-SF (5-point) developed by Chang. Anxiety was measured with Spieberger's state anxiety inventory. Depression was measured with the Beck depression inventory. The experimental group attended 90-min sessions for eight weeks. No intervention was administered to the control group. Nine participants were excluded from the analysis because they did not complete the study due to personal circumstances, resulting in 16 participants in each group for the final analysis. Results for the two groups showed (1) a significant difference in stress scores (F=6.145, p=0.020), (2) a significant difference in anxiety scores (F=6.985, p=0.013), and (3) no significant difference in depression scores (t=1.986, p=0.056). A stress coping program based on mindfulness meditation was an effective intervention for nursing students to decrease their stress and anxiety, and could be used to manage stress in student nurses. In the future, long-term studies should be pursued to standardize and detail the program, with particular emphasis on studies to confirm the effects of the program in patients with diseases, such as cancer.
ObjectiveIn this study, the Mindfulness Based Stress Reduction (MBSR) program was applied to patients presenting with depression and anxiety after surgery from spontaneous subarachnoid hemorrhage (SAH) and the effects were assessed.
Methods
The subjects were patients admitted for cerebral aneurysm rupture and treated by means of surgery from March to December, 2007. More than 6 months had passed after surgery, without any special lesions showing up on computed tomography (CT), and the Glasgow outcome scale (GOS) was 5 points. Among patients with anxiety and depression symptoms, 11 patients completed the program. The MBSR program was conducted once a week, 2.5 hours each, for 8 weeks. The evaluation criteria were : 1) the Beck Depression Inventory (BDI): it measures the type and level of depression, 2) the State-Trait Anxiety Inventory : the anxiety state of normal adults without mental disorder, and 3) Heart Rate Variability (HRV) : the influence of the autonomous nervous system on the sinoarterial node varies continuously in response to the change of the internal/external environment.
Results
The BDI value was decreased from 18.5 ± 10.9 to 9.5 ± 7.1 (p = 0.013) : it was statistically significant, and the depression level of patients was lowered. The state anxiety was decreased from 51.3 ± 13.9 to 42.3 ± 15.2; the trait anxiety was reduced from 50.9 ± 12.3 to 41.3 ± 12.8, and a borderline significant difference was shown (p = 0.091, p = 0.056). In other words, after the treatment, although it was not statistically significant, a decreased tendency in anxiety was shown. In the HRV measurement, standard deviation normal to normal (SDNN), square root of the square root of the mean sum of squared differences between adjacent normal to normal intervals (RMSSD), and total power (TP) showed significant increase, Physical Stress Index (PSI) showed a significant reduction, and thus an improvement in the homeostatic control mechanism of the autonomic nervous system was ween.
Conclusion
The MBSR program was applied to the patients showing anxiety and depression reaction after SAH treatment, and a reduction in depression symptoms and physiological reactions were observed. The application of the MBSR program may be considered as a new tool in improving the quality of life for patients after surgery.
BACKGROUND: Meeting projected needs for ethnically diverse nurses depends on a strong pipeline of diverse students within nursing programs. Colleges assume students readily navigate the university; however, this may not be the reality especially among ethnic minority students.PURPOSE: The purpose was to explore the concept of mindfulness among ethnic minority nursing students. Exploring mindfulness, and a lack thereof, may provide strategies for overcoming challenges ethnic minority students experience in prelicensure nursing programs.
METHODS: A qualitative study using thematic analysis of semistructured in-depth interviews was conducted with 20 ethnic minority undergraduate nursing students.
RESULTS: Themes that emerged reveal positive associations of mindfulness and negative implications when there is a lack of mindfulness.
CONCLUSION: Based on the findings from this study, using consistent mindfulness techniques could positively influence coping skills for dealing with the stressors of college, resulting in overall success and retention of ethnic minority and first-generation students in a nursing program.
PurposeAlthough the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for panic disorder (PD) has been studied previously, data on the predictors of treatment outcomes in MBCT for PD are scarce.
Materials and Methods
Eighty patients with PD were screened to analyze treatment outcomes such as MBCT completion, treatment response, and remission after undergoing MBCT for PD. Sociodemographic characteristics, comorbid personality disorders, and baseline medication doses were examined. The study administered the Panic Disorder Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale and Anxiety Sensitivity Inventory-Revised to patients at baseline and at eight weeks.
Results
Sixty-five participants were enrolled in the present study. Comorbid personality disorder was significantly associated with MBCT non-completion. We found that anxiety sensitivity (AS) improvement after an eight week MBCT program was a statistically significant factor associated with treatment response. Using logistic regression analysis, AS improvement after MBCT showed significant association with PD remission after MBCT.
Conclusion
Comorbid personality disorders of participants could be a potential predictor of MBCT non-completion. Furthermore, AS improvement after MBCT may predict treatment response and remission after MBCT for PD. However, better designed studies with a larger number of patients are needed to confirm our findings.
What could help do the work of medication, meditation, and community police officers? The answer’s in your backyard.
Whether you’re looking for an introduction to psychosynthesis or sweeping guidance for navigating the emerging ups and downs, get this book, open it up, and hang on. In addition to imparting revealing theory, important landmarks, and startling insights from masters around the world, Molly leads you in ready-to-use meditations and exercises that will have you rubbing elbows with powerful parts of your being, discovering your next horizon, and linking with the leader in yourself.
Using data for 25,780 species categorized on the International Union for Conservation of Nature Red List, we present an assessment of the status of the world’s vertebrates. One-fifth of species are classified as Threatened, and we show that this figure is increasing: On average, 52 species of mammals, birds, and amphibians move one category closer to extinction each year. However, this overall pattern conceals the impact of conservation successes, and we show that the rate of deterioration would have been at least one-fifth again as much in the absence of these. Nonetheless, current conservation efforts remain insufficient to offset the main drivers of biodiversity loss in these groups: agricultural expansion, logging, overexploitation, and invasive alien species.Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Recent psychological and neuropsychological research suggests that executive functions — the cognitive control processes that regulate thought and action — are multifaceted and that different types of executive functions are correlated but separable. The present multivariate twin study of three executive functions (inhibiting dominant responses, updating working memory representations, and shifting between task sets), measured as latent variables, examined why people vary in these executive control abilities and why these abilities are correlated but separable from a behavioral genetic perspective. Results indicated that executive functions are correlated because they are influenced by a highly heritable (99%) common factor that goes beyond general intelligence or perceptual speed, and they are separable because of additional genetic influences unique to particular executive functions. This combination of general and specific genetic influences places executive functions among the most heritable psychological traits. These results highlight the potential of genetic approaches for uncovering the biological underpinnings of executive functions and suggest a need for examining multiple types of executive functions to distinguish different levels of genetic influences.
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