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Nejadghaderi SA, Mousavi SE, Fazlollahi A, Motlagh Asghari K, Garfin DR. Efficacy of yoga for posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2024; 340:116098. [PMID: 39191128 DOI: 10.1016/j.psychres.2024.116098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/24/2024] [Accepted: 07/21/2024] [Indexed: 08/29/2024]
Abstract
Yoga is an increasingly popular complementary intervention to reduce posttraumatic stress disorder (PTSD) symptoms and related comorbidities, but its safety and treatment efficacy are not firmly established. We conducted a systematic review and meta-analysis of existing randomized control trials (RCTs) of yoga interventions for PTSD and related secondary outcomes (e.g., depression). Initial search results found over 668 potential papers. Twenty met inclusion criteria (e.g., RCTs on adult participants with PTSD that evaluated safety or efficacy outcomes). Meta-analysis indicated that, compared to control interventions, participation in yoga interventions significantly improved self-report PTSD (standardized mean difference [SMD]: -0.51; 95 % confidence interval [CI]: -0.68, -0.35) and immediate (SMD: -0.39; 95 % CI: -0.56, -0.22) and long-term (SMD: -0.44; 95 % CI: -0.74, -0.13) depression symptoms. However, using clinician-reported assessments, yoga interventions were not associated with improved PTSD symptoms. Type of yoga differentially predicted outcomes. Sensitivity analysis showed consistent effect sizes when omitting each study from main analyses. Six studies reported whether any serious adverse events occurred. None were indicated. No publication bias was found, although individual intervention studies tended to be high in bias. Results suggest yoga is likely a safe and effective complementary intervention for reducing PTSD and depressive symptoms in individuals with PTSD. More rigorous RCTs are warranted.
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Affiliation(s)
- Seyed Aria Nejadghaderi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Systematic Review and Meta‑analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asra Fazlollahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kimia Motlagh Asghari
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dana Rose Garfin
- Community Health Sciences, Fielding School of Public Health, University of California, 560 Charles E Young Drive South, Box 951772, Los Angeles, CA 90095, USA.
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Dunn N, Esplin JA, Fitzgerald M. Moving out of your mind and into your body: Yoga buffers the effects of childhood maltreatment on PTSD symptoms. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1050-1056. [PMID: 35549992 DOI: 10.1080/07448481.2022.2066956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/15/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
Objective: Childhood maltreatment has been consistently linked to posttraumatic stress disorder (PTSD) symptoms among college students and yoga may buffer the effects. The current study examined the frequency of college student's yoga practice over the past year as a moderator of childhood maltreatment and PTSD symptoms in the past 30 days. Participants: A sample of 177 college students from a southern university. Methods: Participants competed an online survey in exchange for extra credit or entry into a gift card raffle. Results: Moderation analysis indicated that a more frequent yoga practice buffered the relationship between maltreatment and PTSD symptoms. Conclusion: Clinicians working with college students with a history of maltreatment are encouraged to make referrals to yoga classes. Universities are encouraged to adopt trauma-sensitive yoga programs.
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Affiliation(s)
- Nadia Dunn
- School of Child and Family Sciences, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Jacob A Esplin
- School of Child and Family Sciences, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Michael Fitzgerald
- School of Child and Family Sciences, University of Southern Mississippi, Hattiesburg, Mississippi, USA
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Coates Quezada CA, Armstrong L, Kilmer R, Quinlan M, Reeve C. Trauma of the Shared Environment: A Qualitative Analysis of the Experiences of Survivors of College Campus Sexual Assault. Violence Against Women 2024; 30:1538-1563. [PMID: 36942422 DOI: 10.1177/10778012231163573] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Survivors of campus sexual assault are often tasked with healing while sharing an environment with their perpetrators. However, little is known about the effects of a shared environment on survivor well-being. A qualitative thematic analysis design was employed to address this gap. We conducted semi-structured interviews with nine female survivors who identified their perpetrators as fellow students at a large state university in the southeastern U.S. The five themes that emerged are situated within an ecological framework, which is also used to guide our recommendations for supporting survivors' well-being within higher education.
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Affiliation(s)
- C Austin Coates Quezada
- Department of Psychological Science, University of North Carolina Charlotte, Charlotte, NC, USA
| | - Laura Armstrong
- Department of Psychological Science, University of North Carolina Charlotte, Charlotte, NC, USA
| | - Ryan Kilmer
- Department of Psychological Science, University of North Carolina Charlotte, Charlotte, NC, USA
| | - Margaret Quinlan
- Department of Psychological Science, University of North Carolina Charlotte, Charlotte, NC, USA
| | - Charlie Reeve
- Department of Psychological Science, University of North Carolina Charlotte, Charlotte, NC, USA
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Moosivand M, Kulemarzi MJB, Shirazi MS, Zaremohzzabieh Z. Flexibility and inflexibility in an Iranian sample: psychometric properties of MPFI based on the Hexaflex model. BMC Psychol 2024; 12:34. [PMID: 38238867 PMCID: PMC10797814 DOI: 10.1186/s40359-024-01531-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVES Acceptance and Commitment Therapy (ACT) emphasizes the importance of psychological flexibility in promoting emotional, psychological, and social well-being, while also acknowledging rigidity as a precursor to psychological disorders. Analyzing the psychometric qualities based on the multidimensional Hexaflex model is critical for determining the efficiency of therapeutic interventions. Thus, the purpose of this study is to investigate the psychometric features of the Multidimensional Psychological Flexibility Inventory (MPFI) within the context of the Hexaflex model in a group of Iranian university students. METHODS Exploratory and confirmatory factor analyses were used in this study to evaluate the psychometric features of the flexibility/inflexibility scale (MPFI) in a sample of Iranian university students. FINDINGS In the exploratory factor analysis involving a sample of 300 students, six factors were identified for flexibility and six for inflexibility (56.3% males and 43.7% females). In the confirmatory factor analysis with a sample of 388 participants, the results validated 60 items across a total of six flexibility and inflexibility factors. This outcome can serve as a robust estimate for flexibility, inflexibility, the second-order model, and the final model. Cronbach's alpha values for various components, including acceptance, present-moment awareness (or contact with the present moment), self as context, cognitive defusing, values, committed action, total flexibility, experiential avoidance, lack of present-moment awareness, self as content, fusion, lack of contact with values, inaction, and total inflexibility, were reported as follows: 0.818, 0.869, 0.862, 0.904, 0.935, 0.935, 0.942, 0.895, 0.839, 0.883, 0.904, 0.912, 0.941, and 0.941, respectively. CONCLUSIONS The Farsi version of the MPFI for university students has great psychometric qualities, making it a reliable assessment instrument for the ACT.
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Affiliation(s)
- Mahboobeh Moosivand
- Department of Social Science and Development Studies, Women Research Center, Alzahra University, Tehran, Iran
| | | | - Maryam Sayad Shirazi
- Department of Psychology, Women Research Center, Alzahra University, Tehran, Iran
| | - Zeinab Zaremohzzabieh
- Institute for Social Science Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Trethewey E, McIver S, Evans S, O'Brien J, O'Shea M. Yoga as an adjunct treatment for the eating disorders: A qualitive enquiry of clinician perspectives. Complement Ther Clin Pract 2023; 53:101796. [PMID: 37741064 DOI: 10.1016/j.ctcp.2023.101796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/04/2023] [Accepted: 08/27/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Yoga has been recognised as a beneficial adjunct for eating disorder (ED) treatment due to demonstrating positive effects on ED symptomology. Despite this, research exploring the perspectives of clinicians regarding the use of yoga for the spectrum of the EDs is limited. Consequently, this study utilised qualitative enquiry to explore the experiences and perspectives of clinicians regarding the implementation of yoga as an adjunct for ED treatment. This research examines how yoga may be safely applied for the EDs, to enhance ED treatment approaches and recovery. METHODS This study employed semi-structured interviews with 12-clincians with up to 20-years of experience working therapeutically with people with EDs. Participants were asked their perspectives on the benefits, risks, and adaptations for delivering safe and suitable yoga programs for the spectrum of EDs. Template thematic analysis was used. RESULTS Four distinct themes were identified. They included the (1) benefits of yoga, (2) risks associated with the practice, (3) recommendations for adapting yoga for this cohort, and (4) implementing yoga alongside current psychological treatment. CONCLUSIONS Clinicians viewed yoga as a safe and suitable transdiagnostic treatment, with the potential to support individuals with a more holistic and sustained recovery model. Clinicians raised concerns that might arise with the use of yoga for this cohort, however, they also emphasised the ability for these to be mitigated with a series of key adaptations. Importantly, clinicians recommended that yoga is implemented and monitored alongside ED treatment to ensure its suitability and safety. Key barriers for implementing yoga as an adjunct treatment and future research directions are discussed. Recent research has explored the benefits of yoga for individuals with eating disorders (EDs). However, researchers have not yet interviewed clinicians who work with those with EDs regarding their views on using yoga for their clients. This study therefore interviewed 12 clinicians working with individuals with EDs, to obtain their views for using yoga as a therapeutic treatment for this group. Overall, clinicians viewed yoga as a safe and beneficial treatment for EDs. While some concerns were raised regarding the safety of yoga for this group, clinicians emphasised that these could be relieved by a series of key adaptations. This study offers unique insights into how yoga may be safely applied into the care for ED clients, to enhance their treatment approaches and recovery.
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Affiliation(s)
| | - Shane McIver
- School of Health and Social Development, Deakin University, Australia.
| | | | - Jennifer O'Brien
- School of Allied Health, Australian Catholic University, Australia.
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Ali M, Oble MJP, Sonia SN, George S, Shahi SR, Ali Z, Abaza A, Jamil A, Gutlapalli SD, Khan S. A Systematic Review of Quantitative and Qualitative Results of Randomized Controlled Trials Assessing the Effect of Yoga in Adult Women With Post-traumatic Stress Disorder: What Is Known So Far. Cureus 2023; 15:e47765. [PMID: 38021711 PMCID: PMC10676296 DOI: 10.7759/cureus.47765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Yoga has been increasingly practiced in recent years, with many of its practitioners being female. Adults may seek a complementary and alternative medicine (CAM) modality, such as yoga, to attempt to alleviate symptoms related to mental health conditions such as post-traumatic stress disorder (PTSD). Our goal for this systematic review was to collect and analyze all available data from quantitative and qualitative reports of randomized controlled trials (RCTs) conducted over the past 10 years on the impact of yoga on women diagnosed with PTSD. We included RCTs with the adult female population in which yoga was practiced for more than one week. We searched the databases PubMed, PubMed Central (PMC), and MEDLINE on June 11, 2022, Embase on June 12, 2022, and Science Direct on June 13, 2022, to find relevant articles. With the Cochrane RoB2 tool and Critical Appraisal Skills Programme (CASP) criteria, we checked for their quality, after which we selected 13 high-quality reports comprising seven original study designs and a total of 496 women. Of the 13 reports, nine evaluated effectiveness, four assessed feasibility, three explored acceptability, and four identified qualitative themes. We compared the results based on the assessed themes. Our results found yoga effective, feasible, acceptable, and a viable interoceptive pathway for emotional and personal growth. Limitations in our study include insufficient papers with large sample sizes and not including papers other than RCTs. With our research, we hope to present healthcare providers with research-based data on the effects of yoga so that they may better navigate its role in therapy as the trend of seeing more patients taking an interest in such alternative approaches rises.
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Affiliation(s)
- Marya Ali
- Psychiatry Clinical Research, Nishtar Medical University, Multan, PAK
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mrinal J P Oble
- Medicine, Kempegowda institute of Medical Sciences and Research Centre, Bengaluru, IND
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shamsun Nahar Sonia
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Srushti R Shahi
- Medicine, St. Martinus University Faculty of Medicine (SMUFOM), Willemstad, CUW
| | - Zahra Ali
- Medicine, Bolan University of Medical and Health Sciences, Quetta, PAK
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Abdelrahman Abaza
- Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aneeque Jamil
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sai Dheeraj Gutlapalli
- Internal Medicine, Richmond University Medical Center Affiliated With Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
- Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Laplaud N, Perrochon A, Gallou-Guyot M, Moens M, Goudman L, David R, Rigoard P, Billot M. Management of post-traumatic stress disorder symptoms by yoga: an overview. BMC Complement Med Ther 2023; 23:258. [PMID: 37480017 PMCID: PMC10360332 DOI: 10.1186/s12906-023-04074-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/07/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) can occur after trauma. While PTSD management strategies include first-line pharmacotherapy and psychotherapy, mind-body therapies, such as yoga, are applied in the PTSD population. This overview aimed to summarize the effectiveness of yoga interventions on PTSD symptoms in adults in a systematic review (SR) including randomized controlled trials (RCTs). METHOD We searched for SR with or without meta-analysis of RCTs involving adults with PTSD diagnosis or trauma history. The search was conducted until April 2022, through six databases (Cochrane Database, MEDLINE (Pubmed), Scopus, Embase, CINHAL and PEDro). The primary outcome was the evolution of PTSD symptoms throughout the intervention. Secondary outcomes included follow-up, safety, adherence, and cost of the intervention. Two authors independently performed the selection, data extraction and risk of bias assessment with the AMSTAR 2 tool and overlap calculation. This overview is a qualitative summary of the results obtained in the selected studies. RESULTS Eleven SRs were analyzed, of which 8 included meta-analyses. The overlap between studies was considered very high (corrected covered area of 21%). Fifty-nine RCTs involving 4434 participants were included. Yoga had a significant small-to-moderate effect-size on PTSD symptom decrease in 7 SRs and non-significant effects in 1 SR with meta-analysis. All SR without meta-analysis found beneficial effects of yoga on PTSD. Secondary outcomes were not sufficiently assessed to provide clear evidence. Results should be interpreted with caution as 1 SR was rated as at moderate risk of bias, 3 as low and 7 as critically low. CONCLUSIONS While yoga therapy seems promising for decreasing PTSD symptoms, future research should standardize yoga therapy duration/frequency/type and consider long-term efficacy to better delineate yoga therapy efficacy in PTSD patients.
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Affiliation(s)
- Nina Laplaud
- ILFOMER (Institut Limousin de FOrmation Aux Métiers de La Réadaptation), Université de Limoges, Limoges, France
| | - Anaïck Perrochon
- ILFOMER (Institut Limousin de FOrmation Aux Métiers de La Réadaptation), Université de Limoges, Limoges, France
- Laboratoire HAVAE, Université de Limoges, 20217, Limoges, UR, France
| | | | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- STIMULUS Research Consortium (Research and TeachIng Neuromodulation Uz Brussel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Department of Physiotherapy, Pain in Motion (PAIN) Research Group, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- STIMULUS Research Consortium (Research and TeachIng Neuromodulation Uz Brussel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Department of Physiotherapy, Pain in Motion (PAIN) Research Group, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Research Foundation-Flanders (FWO), 1090, Brussels, Belgium
| | - Romain David
- Department of Physical and Rehabilitation Medicine, Poitiers University Hospital, University of Poitiers, 86000, Poitiers, France
- PRISMATICS (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), University Hospital of Poitiers, Poitiers, France
| | - Philippe Rigoard
- PRISMATICS (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), University Hospital of Poitiers, Poitiers, France
- Department of Spine Neurosurgery & Neuromodulation, Poitiers University Hospital, 86000, Poitiers, France
- ISAE-ENSMA, Pprime Institute UPR 3346, CNRS, University of Poitiers, 86000, Poitiers, France
| | - Maxime Billot
- PRISMATICS (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), University Hospital of Poitiers, Poitiers, France.
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Byun S, Jeon L. Preschool teachers' psychological wellbeing, emotion regulation, and emotional responsiveness: a US-Korea comparison. Front Psychol 2023; 14:1152557. [PMID: 37404591 PMCID: PMC10316284 DOI: 10.3389/fpsyg.2023.1152557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/18/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction Psychological wellbeing is an essential indicator of early care and education (ECE) teachers' positive practices across countries. Moreover, previous studies suggest that teachers' wellbeing and practice may be indirectly associated via emotion regulation. However, teachers in various contexts demonstrate different patterns of psychological wellbeing, emotion regulation, and emotional responsiveness, and the ways these factors associate with each other also vary. Methods The current study investigates whether the indirect associations between ECE teachers' psychological wellbeing (i.e., emotional exhaustion, job-related competence, and personal stress) and their responsiveness toward children's emotions via emotion regulation (i.e., reappraisal and suppression) appear differently in two national contexts, the United States (US) and South Korea (SK). Multi-group path analysis was conducted to compare the mediation models between US teachers (n = 1,129) and SK teachers (n = 322). Results We found significant indirect associations among wellbeing, emotion regulation, and responsiveness in both countries. However, significant associations were more prominent among SK teachers, and the patterns of indirect associations had substantial cross-country differences. Furthermore, the roles of reappraisal and suppression emotion regulation found to be different among ECE teachers in SK and US. Discussion The cross-country variations in the associations among wellbeing, emotion regulation, and responsiveness suggest that differential policy efforts and intervention strategies are needed for ECE teachers in the US and SK.
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Affiliation(s)
- Sooyeon Byun
- School of Education, Johns Hopkins University, Baltimore, MD, United States
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Lieny Jeon
- School of Education, Johns Hopkins University, Baltimore, MD, United States
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
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Chiesi F, Tagliaferro C, Marunic G, Lau C. Prioritize positivity in Italians: a validation and measurement invariance study of an italian version of the prioritizing positivity scale. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Patel AR, Kovacevic M, Hinton D, Newman E. "I put a stone on my heart and kept going": An explanatory model of how distress is generated and regulated among Indian women from slums reporting gender-based violence. Transcult Psychiatry 2022; 59:522-538. [PMID: 34860626 DOI: 10.1177/13634615211055003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinical variation in the expression of panic disorder, depression and anxiety, and posttraumatic stress disorder (PTSD) has have been documented across cultures. However, local (emic) cultural models that explain how people make sense of their illness experiences remain relatively understudied in India among trauma-exposed populations. Further, the integration of emic findings into clinical care is limited, underscoring the need for emic perspectives following trauma to improve the development or adaptation of trauma-focused treatments in India. This study describes an emic explanatory model of distress, which includes idioms of distress, perceived causes of distress, and coping/help-seeking behaviors among Indian women from slums reporting gender-based violence. This explanatory model can be used as a culturally grounded way to develop clinical case conceptualizations to adapt and deliver psychological treatments for this under-served population.
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Affiliation(s)
| | | | - Devon Hinton
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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O'Shea M, Capon H, Skvarc D, Evans S, McIver S, Harris J, Houston E, Berk M. A pragmatic preference trial of therapeutic yoga as an adjunct to group cognitive behaviour therapy versus group CBT alone for depression and anxiety. J Affect Disord 2022; 307:1-10. [PMID: 35301041 DOI: 10.1016/j.jad.2022.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/13/2022] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Yoga has several mechanisms that make it a promising treatment for depression and anxiety, including physical activity, behavioural activation, and mindfulness. Following positive outcomes from adapted CBT interventions incorporating mindfulness-based practices, this study explored the effects of a therapeutic yoga program as an adjunct to group-based CBT for depression or anxiety. METHODS This was a pragmatic preference trial involving adults diagnosed with depression or anxiety in a regional primary mental healthcare service (n = 59), comparing transdiagnostic group CBT (n = 27) with transdiagnostic group CBT combined with an adjunct therapeutic yoga program (n = 32). A preference recruitment design allowed eligible participants (n = 35) to self-select into the adjunct program. The Depression Anxiety Stress Scale-21 (DASS) was assessed at baseline, post-intervention, and three-months follow up. RESULTS CBT + Yoga was an acceptable alternative to CBT alone. Significant reductions were observed in total DASS scores and the 3 subscales of the DASS for both groups, however CBT + Yoga showed significantly lower depressive and anxiety symptoms post-intervention, compared to CBT alone. CBT + Yoga also showed sustained reductions in depressive symptoms over three-months, and more rapid reductions in depressive symptoms, compared to CBT alone. LIMITATIONS These findings should be considered preliminary due to the moderate sample size, with a rigorous randomised control trial necessary to definitively support the integration of yoga within mental health care to augment the benefits and uptake of transdiagnostic CBT for depression and anxiety. CONCLUSIONS Complementing other mindfulness-based practices, therapeutic yoga shows promise as an adjunct to transdiagnostic CBT.
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Affiliation(s)
| | - Hannah Capon
- School of Psychology, Deakin University, Australia
| | - David Skvarc
- School of Psychology, Deakin University, Australia
| | | | - Shane McIver
- School of Health and Social Development, Deakin University, Australia
| | - Jill Harris
- Kyo Yoga and Healing, Ocean Grove, Australia
| | - Emma Houston
- School of Psychology, Deakin University, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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12
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Self-compassion and cognitive flexibility in trauma-exposed individuals with and without PTSD. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00732-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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O'Shea M, Capon H, Evans S, Agrawal J, Melvin G, O'Brien J, McIver S. Integration of hatha yoga and evidence-based psychological treatments for common mental disorders: An evidence map. J Clin Psychol 2022; 78:1671-1711. [PMID: 35315071 PMCID: PMC9546402 DOI: 10.1002/jclp.23338] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/19/2021] [Accepted: 02/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking. MATERIALS AND METHODS This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence-based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders. RESULTS Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi-experimental research designs. DISCUSSION Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD. CONCLUSIONS Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence-based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice.
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Affiliation(s)
- Melissa O'Shea
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Hannah Capon
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Subhadra Evans
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Jyotsna Agrawal
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Glenn Melvin
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Jennifer O'Brien
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Shane McIver
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Australia
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Zhu L, Li L, Li XZ, Wang L. Mind–Body Exercises for PTSD Symptoms, Depression, and Anxiety in Patients With PTSD: A Systematic Review and Meta-Analysis. Front Psychol 2022; 12:738211. [PMID: 35153889 PMCID: PMC8833099 DOI: 10.3389/fpsyg.2021.738211] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aims to systematically analyze the effects of mind–body exercises on post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in patients with PTSD. Furthermore, it intends to provide scientific evidence-based exercise prescriptions. Methods Chinese (i.e., China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, and Wanfang) and English (i.e., Web of Science, PubMed, the Cochrane Library, and EMBASE) databases were used as data sources to search for studies on the effects of mind–body exercises on symptoms associated with patients with PTSD from January 1980 to November 2020. After a rigorous screening, 16 eligible randomized controlled trials (RCTs) were included in the meta-analysis. Results Mind–body exercises exerted a significant effect on PTSD symptoms [standard mean difference (SMD) = −0.41, 95% confidence interval (CI) −0.64 to −0.19, p < 0.001], depression (SMD = −0.35, 95% CI: −0.55 to −0.15, p < 0.001), and anxiety (SMD = −0.31, 95% CI: −0.74 to −0.12, p < 0.001) among patients with PTSD. Subgroup analysis demonstrated that 60–150 min per session for 8–16 weeks of mindfulness was more effective in improving symptoms in patients with PTSD under 45 years of age compared with other subgroups. For depression, 150–180 min of yoga exercises once per week was effective. For anxiety, the frequency, timing, duration, and type of mind–body exercises that are most effective in relieving anxiety in patients with PTSD cannot be determined at this time due to the limited number of eligible RCTs. Conclusions Mind–body exercises were found to be significantly effective in improving PTSD symptoms, depression, and anxiety in patients with PTSD. Therefore, they can be used as an adjunct to intervention for symptoms of patients with PTSD. However, this conclusion requires further confirmation through additional scientific and objective RCTs. Systematic Review Registration: Unique Identifier: INPLASY2020120072.
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Affiliation(s)
- Lin Zhu
- School of Wushu and Art, Nanjing Sport Institute, Nanjing, China
| | - Long Li
- School of Wushu and Art, Nanjing Sport Institute, Nanjing, China
- *Correspondence: Long Li
| | - Xiao-zhi Li
- Department of Physical Education, Southeast University, Nanjing, China
| | - Lin Wang
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
- Lin Wang
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15
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Tibbitts DC, Aicher SA, Sugg J, Handloser K, Eisman L, Booth LD, Bradley RD. Program evaluation of trauma-informed yoga for vulnerable populations. EVALUATION AND PROGRAM PLANNING 2021; 88:101946. [PMID: 33901773 PMCID: PMC8325936 DOI: 10.1016/j.evalprogplan.2021.101946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND Trauma is highly prevalent among vulnerable populations, including those who are incarcerated, in treatment for substance use, or seeking mental health services. Trauma-informed yoga seeks to create a safer yoga practice for individuals with a trauma history and may improve emotional and physical wellbeing. Thus, we conducted an evaluation of a trauma-informed yoga program to gain insight into participant experiences. METHODS Trauma-informed yoga classes were led by trained volunteers and held in three sectors that work with vulnerable populations: corrections and reentry, substance use treatment and recovery, and community and mental health. Data were collected via anonymous survey using a retrospective pre-post design. The survey instrument captured reasons for student participation and perceived effects of yoga on emotional and physical wellbeing. RESULTS Students were motivated to participate in yoga classes by expectations of physical, mental, and spiritual benefit. Students reported perceived improvements in emotional and physical wellbeing and greater use of self-regulation skills after starting yoga. CONCLUSION Our findings suggest trauma-informed yoga is perceived as beneficial by vulnerable individuals, especially those in the correctional system or recovering from substance use. Our results support the value of offering trauma-informed yoga in institutionalized and community settings. Improvements in emotional and physical wellbeing warrant formal study.
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Affiliation(s)
- Deanne C Tibbitts
- Helfgott Research Institute, National University of Natural Medicine, 049 SW Porter Street, Portland, OR, 97201, USA.
| | - Sue A Aicher
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA; Living Yoga (Board of Directors: SAA, JS, Staff: LE, LDB, Volunteer: KH), 5100 SW Macadam Ave., Suite 360, Portland, OR, 97239, USA.
| | - Judith Sugg
- Living Yoga (Board of Directors: SAA, JS, Staff: LE, LDB, Volunteer: KH), 5100 SW Macadam Ave., Suite 360, Portland, OR, 97239, USA.
| | - Kimberlee Handloser
- Living Yoga (Board of Directors: SAA, JS, Staff: LE, LDB, Volunteer: KH), 5100 SW Macadam Ave., Suite 360, Portland, OR, 97239, USA.
| | - Liz Eisman
- Living Yoga (Board of Directors: SAA, JS, Staff: LE, LDB, Volunteer: KH), 5100 SW Macadam Ave., Suite 360, Portland, OR, 97239, USA.
| | - Lauren D Booth
- Living Yoga (Board of Directors: SAA, JS, Staff: LE, LDB, Volunteer: KH), 5100 SW Macadam Ave., Suite 360, Portland, OR, 97239, USA.
| | - Ryan D Bradley
- Helfgott Research Institute, National University of Natural Medicine, 049 SW Porter Street, Portland, OR, 97201, USA.
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16
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Vallejo MA, Vallejo-Slocker L, Offenbaecher M, Hirsch JK, Toussaint LL, Kohls N, Sirois F, Rivera J. Psychological Flexibility Is Key for Reducing the Severity and Impact of Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7300. [PMID: 34299758 PMCID: PMC8307804 DOI: 10.3390/ijerph18147300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 12/27/2022]
Abstract
Fibromyalgia has a significant impact on the lives of patients; symptoms are influenced by psychological factors, such as psychological flexibility and catastrophizing. The objective of this study was to determine the importance of these variables in moderating the association between the severity and impact of fibromyalgia symptoms. A total of 187 patients from a general hospital population were evaluated using the Combined Index of Severity of Fibromyalgia (ICAF), the Fibromyalgia Impact Questionnaire (FIQ), the Acceptance and Action Questionnaire-II (AAQ-II), and the Pain Catastrophizing Scale (PCS). A series of multiple regression analyses were carried out using the PROCESS macro and decision tree analysis. The results show that psychological flexibility modulates the relation between severity and the impact of fibromyalgia symptoms. Catastrophism has residual importance and depends on the interaction with psychological flexibility. Interaction occurs if the severity of the disease is in transition from a mild to a moderate level and accounts for 40.1% of the variance in the sample. These aspects should be considered for evaluation and early intervention in fibromyalgia patients.
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Affiliation(s)
- Miguel A. Vallejo
- Psychology Faculty, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain;
| | - Laura Vallejo-Slocker
- Psychology Faculty, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain;
| | - Martin Offenbaecher
- Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377 Munich, Germany;
| | - Jameson K. Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, TN 37614, USA;
| | | | - Niko Kohls
- Division of Integrative Health Promotion, University of Applied Science and Arts, 96450 Coburg, Germany;
| | - Fuschia Sirois
- Department of Psychology, University of Sheffield, Sheffield S1 2LT, UK;
| | - Javier Rivera
- Rehumatology Unit, Instituto Provincial de Rehabilitación, Hospital General Universitario “Gregorio Marañón”, 28028 Madrid, Spain;
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17
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Ong I. Treating Complex Trauma Survivors: A Trauma-Sensitive Yoga (TSY)-Informed Psychotherapeutic Approach. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2020.1761498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Isabelle Ong
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
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18
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Lang AJ, Malaktaris A, Maluf KS, Kangas J, Sindel S, Herbert M, Bomyea J, Simmons AN, Weaver J, Velez D, Liu L. A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery. Contemp Clin Trials Commun 2021; 21:100719. [PMID: 33604485 PMCID: PMC7875811 DOI: 10.1016/j.conctc.2021.100719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/07/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Posttraumatic stress disorder (PTSD) is a chronic, disabling, and prevalent mental health disorder among Veterans. Despite the availability of empirically supported psychotherapies, many Veterans remain symptomatic after treatment and/or prefer to seek complementary and integrative health approaches, including yoga, to manage PTSD. The randomized controlled trial (RCT) described herein will evaluate the efficacy of a manualized yoga program as compared to nonaerobic exercise in reducing PTSD severity among Veterans. A secondary aim of this study is to better understand the mechanisms of change. METHODS Veterans (N = 192) with PTSD will be randomized to hatha yoga or nonaerobic physical activity control; both groups consist of 12 weekly, 60-min group or online training sessions with 15-20 min of daily at-home practice. Outcome measures will be administered at baseline, mid-treatment, posttreatment, and 12-week follow-up. PROJECTED OUTCOMES This study will evaluate changes in PTSD severity (primary outcome) as well as depression, anxiety, anger, sleep problems, and psychosocial disability (secondary outcomes). We will also use multiple mediation to examine two potential models of the mechanisms of clinical effect: the Attention Model (i.e., yoga increases attentional control, which reduces PTSD symptoms), the Coping Model (i.e., yoga increases distress tolerance, which improves coping, which reduces PTSD symptoms), and the combination of these models. This aspect of the study is innovative and important given the absence of an existing, comprehensive model for understanding yoga's impact on PTSD. Ultimately, we hope to develop guidelines for application of yoga to PTSD recovery.
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Affiliation(s)
- Ariel J. Lang
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Departments of Psychiatry and Family Medicine and Public Health, 3350 La Jolla Village Dr. (MC 111N1), San Diego, CA, 92161, USA
| | - Anne Malaktaris
- VA San Diego Healthcare System/Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA
| | - Katrina S. Maluf
- San Diego State University, School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Julie Kangas
- VA San Diego Healthcare System, UCSD Department of Psychiatry, 8810 Rio San Diego Dr., San Diego, CA, 92108, USA
| | - Selin Sindel
- University of California San Diego, Department of Cognitive Science, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Matthew Herbert
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Jessica Bomyea
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Alan N. Simmons
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Judy Weaver
- Connected Warriors, 4950 Communication Ave, Ste 115, Boca Raton, FL, 33431, USA
| | - Deborah Velez
- Veteran's Medical Research Foundation, 3350 La Jolla Village Dr, San Diego, CA, 92037, USA
| | - Lin Liu
- VA San Diego Healthcare System, UCSD Department of Preventive Medicine and Public Health, 9500 Gilman Dr., MC0725, La Jolla, CA, 92093-0725, USA
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19
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Mindful attention awareness and cognitive defusion are indirectly associated with less PTSD-like symptoms via reduced maladaptive posttraumatic cognitions and avoidance coping. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01521-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractRecently, the effects of mindfulness-based interventions for posttraumatic stress disorder (PTSD) have been studied. However, we lack knowledge of the processes or mechanisms through which mindfulness influences resilience or promotes recovery following exposure to trauma. In this study, we examine the process by which mindfulness and cognitive-behavioral factors such as posttraumatic negative cognition and avoidance behaviors are associated with reduced PTSD-like symptoms. A questionnaire survey was conducted with 885 university students, using the Trauma Experience Questionnaire, Mindful Attention Awareness Scale, Cognitive Fusion Questionnaire, Post-Traumatic Stress Disorder Checklist, revised Ways of Coping Checklist, and a brief version of the Posttraumatic Cognitions Inventory. Data from 254 participants who experienced trauma with PTSD-like symptoms were analyzed. The final model using SEM indicated no direct association of mindful attention awareness on PTSD-like symptoms, a small direct association of cognitive defusion on PTSD-like symptoms, and a large indirect association mediated by posttraumatic negative cognitions and avoidance coping. Owing to the study’s cross-sectional design, strong conclusions cannot be drawn regarding the causal relationship of mindfulness and cognitive-behavioral factors or generalizations. However, our findings suggest that it would be worthwhile to continue to clarify the mechanism of mindfulness and to investigate its use in the treatment of PTSD. In the future, a highly accurate study design will hopefully be used to examine the mechanisms of several different factors associated with improvement in posttraumatic stress symptoms, preferably including them in the same model.
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20
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Park CL, Finkelstein-Fox L, Sacco SJ, Braun TD, Lazar S. How does yoga reduce stress? A clinical trial testing psychological mechanisms. Stress Health 2021; 37:116-126. [PMID: 32797683 PMCID: PMC10159010 DOI: 10.1002/smi.2977] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
Yoga interventions can reduce stress, but the mechanisms underlying that stress reduction remain largely unidentified. Understanding how yoga works is essential to optimizing interventions. The present study tested five potential psychosocial mechanisms (increased mindfulness, interoceptive awareness, spiritual well-being, self-compassion and self-control) that have been proposed to explain yoga's impact on stress. Forty-two participants (62% female; 64% White) in a yoga program for stress reduction completed surveys at baseline (T1), mid-intervention (T2) and post-intervention (12 weeks; T3). We measured two aspects of stress, perceived stress and stress reactivity. Changes were assessed with paired t-tests; associations between changes in mechanisms were tested in residual change models. Only stress reactivity decreased, on average, from T1 to T3. Except for self-compassion, all psychosocial mechanisms increased from T1 to T3, with minimal changes from T2 to T3. Except for self-control, increases in each mechanism were strongly associated with decreases in both measures of stress between T1 and T2 and decreases in perceived stress from T1 to T3 (all p's < 0.05). Increased psychosocial resources are associated with stress reduction. Yoga interventions targeting these resources may show stronger stress reduction effects. Future research should test these linkages more rigorously using active comparison groups and larger samples.
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Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Shane J Sacco
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Tosca D Braun
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sara Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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21
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Mullen RA, Protti T, Block-Lerner J, Marks DR, Sandoz EK, Ricardo P. Curriculum-based yoga and acceptance and commitment training intervention for undergraduate students: A mixed-methods investigation. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Uğur E, Kaya Ç, Tanhan A. Psychological inflexibility mediates the relationship between fear of negative evaluation and psychological vulnerability. CURRENT PSYCHOLOGY 2020; 40:4265-4277. [PMID: 32982124 PMCID: PMC7509823 DOI: 10.1007/s12144-020-01074-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
College students worldwide and in Turkey face many biopsychosocial spiritual and economic issues, in part due to developmental and contextual factors. Understanding these issues and their relationship with psychological inflexibility, which is the central concept to the Acceptance and Commitment Therapy (ACT), is an unexplored gap in the literature. Therefore, the aim of the present study is to examine the mediating and moderating roles of Psychological Inflexibility (PI) in the relationship between Fear of Negative Evaluation (FNE) and Psychological Vulnerability (PV), and to set an empirical ground for developing evidence-based research and practices based on ACT. The study group consisted of 389 undergraduate students studying in various departments of a mid-sized urban state university. Regression-based mediation and moderation testing procedures revealed that PI partially mediates the relationship between FNE and PV. Moderating role of PI on the same relationship was not verified. The present findings are deemed to be useful for understanding the relationships of these constructs and developing future mental health research and interventions to address biopsychosocial spiritual issues and enhance wellbeing especially from an ACT perspective.
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Affiliation(s)
- Erol Uğur
- Psychological Counseling and Guidance at the Department of Educational Sciences, Sakarya University, Hendek Campus, 54300 Sakarya, Turkey
| | - Çınar Kaya
- Psychological Counseling and Guidance at the Faculty of Education, Kütahya Dumlupınar University, 43100 Kütahya, Turkey
| | - Ahmet Tanhan
- Economic and Social Research Center - ESAM, Ankara, Turkey.,Department of Counseling, The University of North Carolina at Greensboro, Greensboro, NC USA.,Department of Counseling, Adiyaman University, Adiyaman, Turkey.,Institute for Muslim Mental Health, Belleville, MI USA
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23
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Darroch FE, Roett C, Varcoe C, Oliffe JL, Gonzalez Montaner G. Trauma-informed approaches to physical activity: A scoping study. Complement Ther Clin Pract 2020; 41:101224. [PMID: 32819867 DOI: 10.1016/j.ctcp.2020.101224] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- F E Darroch
- Carleton University, Department of Health Sciences, 1125 Colonel By Drive, Ottawa, ON, K1S5B6, Canada.
| | - C Roett
- UBC School of Nursing, Vancouver, BC, V6T 2B5, Canada.
| | - C Varcoe
- UBC School of Nursing, Vancouver, BC, V6T 2B5, Canada.
| | - J L Oliffe
- UBC School of Nursing, Vancouver, BC, V6T 2B5, Canada.
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Huberty J, Sullivan M, Green J, Kurka J, Leiferman J, Gold K, Cacciatore J. Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial. BMC Complement Med Ther 2020; 20:173. [PMID: 32503517 PMCID: PMC7275350 DOI: 10.1186/s12906-020-02926-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/14/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a "stretch and tone" control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health. METHODS Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable. RESULTS Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control). CONCLUSIONS This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov. NCT02925481. Registered 10-04-16.
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Coronavirus Stress, Optimism-Pessimism, Psychological Inflexibility, and Psychological Health: Psychometric Properties of the Coronavirus Stress Measure. Int J Ment Health Addict 2020; 19:2423-2439. [PMID: 32837425 PMCID: PMC7272108 DOI: 10.1007/s11469-020-00337-6] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The coronavirus (COVID-19) pandemic is currently a global health threat attributed to negatively affecting the mental health and well-being of people globally. The purpose of the present study is to examine the mediating role of optimism-pessimism and psychological inflexibility in the relationship of coronavirus stress with psychological problems among Turkish adults. The sample of the study included 451 adults (55% women). Participants mainly consisted of young adults with a mean age of 23.30 years, ranging from 18 to 65 years (SD = 6.97). A mediation model indicated that coronavirus stress had a significant predictive effect on optimism-pessimism, psychological inflexibility, and psychological problems. Further, optimism-pessimism and psychological inflexibility mediated the effect of coronavirus stress on psychological problems in adults. Lastly, optimism-pessimism predicted the psychological problems of adults through psychological inflexibility. These results elucidate our understanding of the role of mediators in coronavirus stress and psychological health problems. The findings are useful in terms of providing evidence for tailoring interventions and implementing preventative approaches to mitigate the psychopathological consequences of COVID-19. Based on the present findings, the potential utility of acceptance and commitment therapy is discussed within the context of COVID-19.
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26
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Park CL, Finkelstein-Fox L, Groessl EJ, Elwy AR, Lee SY. Exploring how different types of yoga change psychological resources and emotional well-being across a single session. Complement Ther Med 2020; 49:102354. [PMID: 32147083 DOI: 10.1016/j.ctim.2020.102354] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Yoga demonstrates beneficial effects in many populations, yet our understanding of how yoga brings about these effects is quite limited. Among the proposed mechanisms of yoga are increasing psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) that may bring about salutary effects on emotional wellbeing. Further, yoga is a complex practice comprising meditation, active and restorative postures, and breathwork; however little is known about how different components may affect mechanisms. We aimed to determine how an acute session of yoga (and its specific components) related to pre- to post- session changes in proposed mechanisms (psychological resources) and whether those changes were associated with positive changes in emotions. DESIGN 144 regular yoga practitioners completed measures of mindfulness, body consciousness, self-transcendence, social connectedness, spiritual peace, and exercise-induced emotions (positive engagement, revitalization, tranquility, exhaustion) immediately before and after a yoga session (N = 11 sessions, each a different type of yoga). Perceived properties of each yoga session, exercise exertion and engagement with the yoga teacher were assessed immediately following the session. RESULTS Pre-to post- yoga, levels of positive emotions (engagement, tranquility and revitalization) increased while exhaustion decreased. Further, all psychological resources increased and closely tracked improved emotions. Additionally, aspects of the yoga session correlated with changes in psychological resources (mechanisms) and emotions. CONCLUSIONS Yoga may influence multiple psychological mechanisms that influence emotional well-being. Further, different types of yoga may affect different mechanisms. Results can inform yoga interventions aiming to optimize effects through specific mechanisms such as mindfulness or spirituality.
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Affiliation(s)
| | | | | | | | - Sharon Y Lee
- University of Connecticut, USA; University of California, San Diego, USA; Brown University, USA
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Szkody E, Mckinney C. Social Support Versus Emotion Regulation: Mediators of Attachment and Psychological Problems After Social Exclusion. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.10.882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: Secure parental attachment improves the perception of available social support and the socialization of emotion regulation strategies. Research has suggested that both perceived social support and emotion regulation help individuals reappraise stressful situations as less stressful. Individuals under stress are at an increased risk for psychological problems. Method: The current study examined whether social support, emotion regulation, and psychological inflexibility mediated the relation between parental attachment and psychological problems after a social exclusion task. Results: Results indicated that secure parental attachment was associated with an increased ability to up-regulate emotions and with an increase in the perception of available social support. Secure attachment to either parent was indirectly associated with psychological problems reported after social exclusion. Discussion: Indirect effects were found only for pathways from attachment through emotion regulation strategies, which suggests that emotion regulation may be a driving factor between attachment to parental figures and stress induced psychological problems. Further results, limitations, and implications were discussed.
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González-Valero G, Zurita-Ortega F, Ubago-Jiménez JL, Puertas-Molero P. Use of Meditation and Cognitive Behavioral Therapies for the Treatment of Stress, Depression and Anxiety in Students. A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4394. [PMID: 31717682 PMCID: PMC6888319 DOI: 10.3390/ijerph16224394] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 12/28/2022]
Abstract
The prevalence of mental health problems within students due to high academic demands and learning difficulties is a current challenge the field of education. The aim of this study is to review the scientific literature in order to analyze the effect produced by cognitive-behavioral programs and meditation strategies on stress, anxiety, and depression in students. A further aim is to identify the determinants of treatment success. The bibliographic search was carried out using Web of Science, specifically in the categories of "Education and Educational Research" and "Psychology", obtaining a sample of 122 articles published between 2007 and 2018. Studies were included which had a pre-experimental or quasi-experimental design and included pre-test and post-test phases. Following application of inclusion criteria, 34 articles were selected for inclusion in a meta-analysis of the random effects of each variable. This obtained an average effect size of -0.41 for stress, -0.37 for anxiety, and -0.30 for depression. Three moderating variables were analyzed, with significant correlations being found for the type of treatment relating to stress (Q = 11.01, df = 2, p = 0.004, R2 = 0.294) and depression (Q = 6.14, df = 2, p = 0.048; R2 = 0.436). The stage of education of the individuals was also found to impact upon anxiety intervention success (Q = 13.093 df = 2, p = 0.0009, R2 = 0.196). Interventions mainly addressed the importance of meditation strategies, mindfulness programs, and cognitive-behavioral therapy to reduce stress, anxiety, and depression in students. This supports the need to increase research at an early age, considering the treatment of mental health as a key factor influencing academic performance and quality of life.
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Affiliation(s)
| | | | | | - Pilar Puertas-Molero
- Department of Didactics of Musical, Artistic and Corporal Expression, University of Granada, 18071 Granada, Spain; (G.G.-V.); (F.Z.-O.); (J.L.U.-J.)
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Capon H, O'Shea M, McIver S. Yoga and mental health: A synthesis of qualitative findings. Complement Ther Clin Pract 2019; 37:122-132. [DOI: 10.1016/j.ctcp.2019.101063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 12/14/2022]
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Experiences of trauma-sensitive yoga among inner city youth: A mixed-methods feasibility study. Complement Ther Clin Pract 2019; 35:62-71. [DOI: 10.1016/j.ctcp.2019.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/16/2018] [Accepted: 01/22/2019] [Indexed: 11/20/2022]
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31
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Blanchard BE, Stevens A, Cann AT, Littlefield AK. Regulate yourself: Emotion regulation and protective behavioral strategies in substance use behaviors. Addict Behav 2019; 92:95-101. [PMID: 30597337 DOI: 10.1016/j.addbeh.2018.12.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/14/2018] [Accepted: 12/16/2018] [Indexed: 10/27/2022]
Abstract
Although research suggests links between emotion regulation strategies and substance use outcomes, little work has examined the relationship between specific strategies (i.e., reappraisal and suppression) and outcomes (i.e., alcohol and cannabis consumption and related problems). To date, no research has examined the association between emotion regulation strategies and protective behavioral strategies used while engaging in substance use. Thus, the current study examined these relations for females and males. Undergraduates (N = 643) completed an online battery of self-report measures. Using structural equation modeling, results indicated improved Emotion Regulation Questionnaire model fit after one item was removed. Reappraisal was negatively associated with alcohol binge frequency and related problems for females, though suppression was negatively related to these outcomes for males. Reappraisal was also negatively associated with cannabis-related problems for males only. Reappraisal was positively associated with all types of protective behavioral strategies use for females, whereas only alcohol-specific serious harm reduction and cannabis protective behavioral strategies were significant for males. Latent variable interactions between reappraisal and protective behavioral strategies were significant for past-month cannabis use and related problems for males and indicated protective behavioral strategies use was more protective against past-month use and cannabis-related problems for those high in reappraisal. Although replication is necessary, these preliminary findings suggest the link between emotion regulation strategies and substance use outcomes among college students is complex and future work may benefit from examining these relations from an emotion regulation flexibility perspective.
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Ong I, Cashwell CS, Downs HA. Trauma-Sensitive Yoga: A Collective Case Study of Women’s Trauma Recovery from Intimate Partner Violence. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21501378.2018.1521698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Isabelle Ong
- National Institute of Education, Nanyang Technological University, Singapore
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Åkerblom S, Perrin S, Rivano Fischer M, McCracken LM. The Relationship Between Posttraumatic Stress Disorder and Chronic Pain in People Seeking Treatment for Chronic Pain. Clin J Pain 2018; 34:487-496. [DOI: 10.1097/ajp.0000000000000561] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Kobylińska D, Lewczuk K, Marchlewska M, Pietraszek A. For Body and Mind: Practicing Yoga and Emotion Regulation. SOCIAL PSYCHOLOGICAL BULLETIN 2018. [DOI: 10.5964/spb.v13i1.25502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The purpose of the present study was to examine if the length of yoga training may influence the use of cognitive reappraisal and expressive suppression (as emotion regulation strategies) and whether this relationship may be moderated by personality traits. Based on previous studies, we hypothesized that the link between the length of yoga practice and emotion regulation can rely most heavily on participants’ conscientiousness and extraversion levels. Ninety women in two groups participated in the study: those who have been practicing yoga for over a year and those who have been practicing for a shorter period of time. An Emotion Regulation Questionnaire was applied to measure the use the strategies of cognitive reappraisal and expressive suppression. Moreover, personality traits, based on the Big Five model were assessed. The results of the study provided support for our prediction: participants who engaged in yoga practice for a longer period of time (as compared to participants who practiced yoga for a shorter duration), reported using cognitive reappraisal more often. Furthermore, longer yoga practice was more beneficial than shorter practice especially for individuals with low levels of conscientiousness and extraversion. Thus, extraversion and conscientiousness seem to facilitate the process of drawing benefits from practicing yoga.
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Avery T, Blasey C, Rosen C, Bayley P. Psychological Flexibility and Set-Shifting Among Veterans Participating in a Yoga Program: A Pilot Study. Mil Med 2018; 183:e359-e363. [DOI: 10.1093/milmed/usy045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Timothy Avery
- War Related Illness and Injury Study Center, VA Palo Alto Heath Care System, U.S. Department of Veterans Affairs, 3801 Miranda Avenue, Palo Alto, CA
- Stanford University, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA
| | - Christine Blasey
- Stanford University, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA
| | - Craig Rosen
- Stanford University, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA
- National Center for PTSD, U.S. Department of Veterans Affairs, 795 Willow Road, Menlo Park, CA
| | - Peter Bayley
- War Related Illness and Injury Study Center, VA Palo Alto Heath Care System, U.S. Department of Veterans Affairs, 3801 Miranda Avenue, Palo Alto, CA
- Stanford University, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA
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Powell PA. Individual differences in emotion regulation moderate the associations between empathy and affective distress. MOTIVATION AND EMOTION 2018; 42:602-613. [PMID: 29899583 PMCID: PMC5982456 DOI: 10.1007/s11031-018-9684-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Individual differences in empathy can have positive and negative psychological outcomes. Yet, individual differences in the processing and regulation of empathy-induced emotion have not been fully explored within this dynamic. This study was designed to explore whether individual differences in emotion regulation strategies moderated the effects of empathy on common forms of affective distress. Eight hundred and forty four participants completed survey measures of trait empathy, emotion regulation strategies, and symptoms of depression, anxiety, and stress. Affective empathy typically predicted greater affective distress, but the effects on depression and anxiety were offset when people were effective at reappraising their emotions. Cognitive empathy predicted lower distress on average, but this beneficial effect on anxiety and stress was absent in those who typically suppressed their emotions. Finally, suppression unexpectedly reduced the depression and stress reported for people high in affective empathy. Individual differences in emotion regulation are an important moderator between empathy and psychological health, and thus a useful target for intervention.
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Affiliation(s)
- Philip A Powell
- 1Department of Economics, Institute for Economic Analysis of Decision-making (InstEAD), University of Sheffield, 9 Mappin Street, South Yorkshire, S1 4DT UK.,2Present Address: School of Health and Related Research (ScHARR), University of Sheffield, South Yorkshire, S1 4DA UK
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Sciarrino NA, DeLucia C, O'Brien K, McAdams K. Assessing the Effectiveness of Yoga as a Complementary and Alternative Treatment for Post-Traumatic Stress Disorder: A Review and Synthesis. J Altern Complement Med 2017; 23:747-755. [DOI: 10.1089/acm.2017.0036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Christian DeLucia
- College of Psychology, Nova Southeastern University, Fort Lauderdale, FL
| | - Kaitlin O'Brien
- College of Psychology, Nova Southeastern University, Fort Lauderdale, FL
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38
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Group interventions to reduce emotional distress and fatigue in breast cancer patients: a 9-month follow-up pragmatic trial. Br J Cancer 2017; 117:1442-1449. [PMID: 28926526 PMCID: PMC5680472 DOI: 10.1038/bjc.2017.326] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 01/22/2023] Open
Abstract
Background: Long-term effects of psychosocial interventions to reduce emotional distress, sleep difficulties, and fatigue of breast cancer patients are rarely examined. We aim to assess the effectiveness of three group interventions, based on cognitive behavioural therapy (CBT), yoga, and self-hypnosis, in comparison to a control group at a 9-month follow-up. Methods: A total of 123 patients chose to participate in one of the interventions. A control group was set up for those who agreed not to participate. Emotional distress, fatigue, and sleep quality were assessed before (T0) and after interventions (T1), and at 3-month (T2) and 9-month follow-ups (T3). Results: Nine months after interventions, there was a decrease of anxiety (P=0.000), depression (P=0.000), and fatigue (P=0.002) in the hypnosis group, and a decrease of anxiety (P=0.024) in the yoga group. There were no significant improvements for all the investigated variables in the CBT and control groups. Conclusions: Our results showed that mind–body interventions seem to be an interesting psychological approach to improve the well-being of breast cancer patients. Further research is needed to improve the understanding of the mechanisms of action of such interventions and their long-term effects on quality of life.
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Reinhardt KM, Noggle Taylor JJ, Johnston J, Zameer A, Cheema S, Khalsa SBS. Kripalu Yoga for Military Veterans With PTSD: A Randomized Trial. J Clin Psychol 2017; 74:93-108. [DOI: 10.1002/jclp.22483] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 02/24/2017] [Accepted: 03/13/2017] [Indexed: 12/21/2022]
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40
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Curtis K, Hitzig SL, Bechsgaard G, Stoliker C, Alton C, Saunders N, Leong N, Katz J. Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial. J Pain Res 2017; 10:999-1017. [PMID: 28496356 PMCID: PMC5422575 DOI: 10.2147/jpr.s130530] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objectives The purpose of this randomized controlled trial was to evaluate the effects of a specialized yoga program for individuals with a spinal cord injury (SCI) on pain, psychological, and mindfulness variables. Materials and methods Participants with SCI (n=23) were outpatients or community members affiliated with a rehabilitation hospital. Participants were randomized to an Iyengar yoga (IY; n=11) group or to a 6-week wait-list control (WLC; n=12) group. The IY group participated in a twice-weekly 6-week seated IY program; the WLC group participated in the same yoga program, after the IY group’s yoga program had ended. Pain, psychological, and mindfulness measures were collected at two time points for both groups (within 1–2 weeks before and after program 1 and at a third time point for the WLC group (within 1 week after program 2). Results Linear mixed-effect growth models were conducted to evaluate the main effects of group at T2 (postintervention), controlling for T1 (preintervention) scores. T2 depression scores were lower (F1,18=6.1, P<0.05) and T2 self-compassion scores higher (F1,18=6.57, P< 0.05) in the IY group compared to the WLC group. To increase sample size and power, the two groups were combined and analyzed across time by comparing pre- and postintervention scores. Main effects of time were found for depression scores, (F1,14.83=6.62, P<0.05), self-compassion, (F1,16.6=4.49, P<0.05), mindfulness (F1,16.79=5.42, P<0.05), mindful observing (F1,19.82=5.06, P<0.05), and mindful nonreactivity, (F1,16.53=4.92, P<0.05), all showing improvement after the intervention. Discussion The results indicated that a specialized 6-week yoga intervention reduced depressive symptoms and increased self-compassion in individuals with SCI, and may also have fostered greater mindfulness.
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Affiliation(s)
- Kathryn Curtis
- Department of Psychology, Faculty of Health, York University
| | - Sander L Hitzig
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre.,Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network
| | | | | | - Charlene Alton
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network
| | - Nicole Saunders
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network
| | - Nicole Leong
- Community Care Access Centre, London, ON, Canada
| | - Joel Katz
- Department of Psychology, Faculty of Health, York University
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Riley KE, Park CL, Wilson A, Sabo A, Antoni MH, Braun TD, Harrington J, Reiss J, Pasalis E, Harris A, Cope S. Improving physical and mental health in frontline mental health care providers: Yoga-based stress management versus cognitive behavioral stress management. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2016; 32:26-48. [PMID: 33354168 DOI: 10.1080/15555240.2016.1261254] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The need for brief, low-cost, easily disseminable and effective interventions to promote healthy lifestyles is high. This is especially true for mental health providers. We developed two studies to compare the impacts of Cognitive Behavioral Stress Management (CBSM) and Yoga Based Stress Management (YBSM) interventions for healthcare professionals. Study 1 offered an 8-week YBSM intervention to 37 mental healthcare participants and collected health data pre and post. Study 2 offered YBSM and CBSM classes to 40 randomly assigned mental healthcare providers and collected mental and physical health data at four time points. In Study 1, using t-tests, the YBSM intervention affected a number of mental and physical wellbeing indices pre to post. In Study 2, using linear mixed modeling, both YBSM and CBSM groups improved significantly (p <.05) in fruit and vegetable intake, heart rate, alcohol consumption, relaxation and awareness, professional quality of life, compassion satisfaction, burnout, depression, and stress levels. There was a group by time effect for coping confidence (CBSM increased more, p<.05, F = 4.34), physical activity (YBSM increased more, p<.05, F = 3.47), overall mental health (YBSM increased more, p<.10, F =5.32), and secondary traumatic stress (YBSM decreased more, p<.10, F = 4.89). YBSM and CBSM appear to be useful for healthcare professionals' mental and physical health. YBSM demonstrates some benefit above and beyond the extremely well-studied and empirically supported CBSM, including increased physical activity, overall mental health, and decreased secondary traumatic stress benefits.
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Affiliation(s)
- K E Riley
- Memorial Sloan Kettering Cancer Center
| | | | - A Wilson
- Kripalu Center for Yoga & Health
| | - A Sabo
- Berkshires Medical Center
| | | | | | | | | | | | - A Harris
- Kripalu Center for Yoga & Health
| | - S Cope
- Kripalu Center for Yoga & Health
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West J, Liang B, Spinazzola J. Trauma Sensitive Yoga as a complementary treatment for posttraumatic stress disorder: A Qualitative Descriptive analysis. INTERNATIONAL JOURNAL OF STRESS MANAGEMENT 2016; 24:173-195. [PMID: 28458503 DOI: 10.1037/str0000040] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research on Posttraumatic Stress Disorder and chronic childhood abuse has revealed that traditional trauma treatments often fail to fully address the complicated symptom presentation, including the somatic complaints, loss of awareness of one's emotional and physical being in the present moment, and overall lack of integration between the self and the body. The mindfulness-based intervention of hatha yoga shows promise as a complementary treatment, and focuses on personal growth in addition to symptom reduction. This qualitative study explored the experiences of thirty-one adult women with PTSD related to chronic childhood trauma who participated in a 10-week Trauma Sensitive Yoga class, specifically examining perceived changes in symptoms and personal growth. Five themes were identified that reflect participants' feelings of Gratitude and compassion, Relatedness, Acceptance, Centeredness, and Empowerment. Results and implications for research and clinical work are presented.
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Scotland-Coogan D, Davis E. Relaxation Techniques for Trauma. JOURNAL OF EVIDENCE-INFORMED SOCIAL WORK 2016; 13:434-41. [PMID: 27119722 DOI: 10.1080/23761407.2016.1166845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Physiological symptoms of posttraumatic stress disorder (PTSD) manifest as increased arousal and reactivity seen as anger outburst, irritability, reckless behavior with no concern for consequences, hypervigilance, sleep disturbance, and problems with focus (American Psychiatric Association, 2013 ). In seeking the most beneficial treatment for PTSD, consideration must be given to the anxiety response. Relaxation techniques are shown to help address the physiological manifestations of prolonged stress. The techniques addressed by the authors in this article include mindfulness, deep breathing, yoga, and meditation. By utilizing these techniques traditional therapies can be complemented. In addition, those who are averse to the traditional evidence-based practices or for those who have tried traditional therapies without success; these alternative interventions may assist in lessening physiological manifestations of PTSD. Future research studies assessing the benefits of these treatment modalities are warranted to provide empirical evidence to support the efficacy of these treatments.
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Affiliation(s)
| | - Erin Davis
- b Behavioral Health, KP Partners for Patriots , Spring Hill, Florida , USA
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44
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Klatte R, Pabst S, Beelmann A, Rosendahl J. The Efficacy of Body-Oriented Yoga in Mental Disorders–A Systematic Review and Meta-Analysis. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 113:195-202. [PMID: 27118717 PMCID: PMC5400032 DOI: 10.3238/arztebl.2016.0195] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND The efficacy of body-oriented yoga in the treatment of mental disorders has been investigated in numerous studies. This article is a systematic review and meta-analysis of the relevant publications. METHODS All studies in which the efficacy of hatha-yoga, i.e., body-oriented yoga with asanas and pranayama, was studied in adult patients suffering from a mental disorder (as diagnosed by ICD or DSM criteria) were included in the analysis. The primary endpoint was disorder-specific symptom severity. The publications were identified by a systematic search in the PubMed, Web of Science, PsycINFO and ProQuest databases, supplemented by a search with the Google Scholar search engine and a manual search in the reference lists of meta-analyses and primary studies, as well as in specialized journals. RESULTS 25 studies with a total of 1339 patients were included in the analysis. A large and significant effect of yoga was seen with respect to the primary endpoint (symptom severity) (Hedges' g = 0.91; 95% confidence interval [0.55; 1.28]; number needed to treat [NNT]: 2.03), with substantial heterogeneity (I2 = 69.8%) compared to untreated control groups. Small but significant effects of yoga were also seen in comparison with attention control (g = 0.39; [0.04; 0.73]; NNT: 4.55) and physical exercise (g = 0.30; [0.01; 0.59]; NNT: 5.75); no difference in efficacy was found between yoga and standard psychotherapy (g = 0.08; [-0.24; 0,40]; NNT: 21.89). In view of the relatively high risk of bias, these findings should be interpreted with caution. CONCLUSION Body-oriented yoga with asanas and pranayama as central components is a promising complementary treatment for mental disorders and should be investigated in further high-quality studies.
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Affiliation(s)
- Rahel Klatte
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Friedrich-Schiller-University Jena
| | - Simon Pabst
- Institute of Psychology, Department of Research Synthesis, Intervention and Evaluation, Friedrich-Schiller-University Jena
- AHG Psychosomatische Klinik Bad Pyrmont
| | - Andreas Beelmann
- Institute of Psychology, Department of Research Synthesis, Intervention and Evaluation, Friedrich-Schiller-University Jena
| | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Friedrich-Schiller-University Jena
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Martin EC, Dick AM, Scioli-Salter ER, Mitchell KS. Impact of a Yoga Intervention on Physical Activity, Self-Efficacy, and Motivation in Women with PTSD Symptoms. J Altern Complement Med 2015; 21:327-32. [PMID: 25973554 PMCID: PMC4486144 DOI: 10.1089/acm.2014.0389] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Emily C. Martin
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Erica R. Scioli-Salter
- Women's Health Sciences Division, National Center for PTSD, Veterans Affairs Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Karen S. Mitchell
- Women's Health Sciences Division, National Center for PTSD, Veterans Affairs Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
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