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Lee A, Thuras P, Baller J, Jiao C, Guo B, Erbes CR, Polusny MA, Liu C, Wu B, Lim KO, Bishop JR. Serotonin Transporter (SLC6A4) and FK506-Binding Protein 5 (FKBP5) Genotype and Methylation Relationships with Response to Meditation in Veterans with PTSD. Mol Neurobiol 2024:10.1007/s12035-024-04096-6. [PMID: 38671329 DOI: 10.1007/s12035-024-04096-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/04/2024] [Indexed: 04/28/2024]
Abstract
Meditation-based interventions are novel and effective non-pharmacologic treatments for veterans with PTSD. We examined relationships between treatment response, early life trauma exposure, DNA polymorphisms, and methylation in the serotonin transporter (SLC6A4) and FK506-binding protein 5 (FKBP5) genes. DNA samples and clinical outcomes were examined in 72 veterans with PTSD who received meditation-based therapy in two separate studies of mindfulness-based stress reduction (MBSR) and Transcendental Meditation (TM). The PTSD Checklist was administered to assess symptoms at baseline and after 9 weeks of meditation intervention. We examined the SLC6A4 promoter (5HTTLPR_L/S insertion/deletion + rs25531_A/G) polymorphisms according to previously defined gene expression groups, and the FKBP5 variant rs1360780 previously associated with PTSD disease risk. Methylation for CpG sites of SLC6A4 (28 sites) and FKBP5 (45 sites) genes was quantified in DNA samples collected before and after treatment. The 5HTTLPR LALA high expression genotype was associated with greater symptom improvement in participants exposed to early life trauma (p = 0.015). Separately, pre to post-treatment change of DNA methylation in a group of nine FKBP5 CpG sites was associated with greater symptom improvement (OR = 2.8, 95% CI 1.1-7.1, p = 0.027). These findings build on a wealth of existing knowledge regarding epigenetic and genetic relationships with PTSD disease risk to highlight the potential importance of SLC6A4 and FKBP5 for treatment mechanisms and as biomarkers of symptom improvement.
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Affiliation(s)
- Adam Lee
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Room 7-115 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55455, USA
| | - Paul Thuras
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - Joshua Baller
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, MN, USA
| | - Chuan Jiao
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, USA
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Krebs, Université Paris Cité, 75014, Paris, France
| | - Bin Guo
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
| | - Christopher R Erbes
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - Melissa A Polusny
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - Chunyu Liu
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Baolin Wu
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California-Irvine, Irvine, CA, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Geriatric Research, Education, and Clinical Center, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Room 7-115 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55455, USA.
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA.
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Sylvia AM, Jastrowski Mano K, Birkley EL, Mano QR. Systematic Review of Dispositional Mindfulness and Posttraumatic Stress Disorder Symptomology: A Targeted Examination of Avoidance. TRAUMA, VIOLENCE & ABUSE 2024:15248380231221278. [PMID: 38523454 DOI: 10.1177/15248380231221278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope.
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Affiliation(s)
- Allison M Sylvia
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Erica L Birkley
- University of Cincinnati College of Medicine, Department of Psychiatry and Behavioral Neuroscience, Cinicinnati, OH, USA
- Birkley Consulting, Cincinnati, OH, USA
| | - Quintino R Mano
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
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Atak I, Artan T. Effects of a mindfulness-based groupwork program on adolescents in a children's home. SOCIAL WORK IN HEALTH CARE 2024; 63:168-187. [PMID: 38217519 DOI: 10.1080/00981389.2024.2302631] [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: 06/26/2022] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
Mindfulness means being in the present, intentionally and without any judgment. Mindfulness helps people cope with challenging experiences such as trauma. Children's Homes in Türkiye are institutions that provide social care to young people with past traumatic experiences. This study aims at evaluating the effects of a mindfulness-based (MB) groupwork program with a group of residents in a Children's Home. An experimental pretest-posttest control group design was used. An eight-session MB training program was implemented with 21 female adolescents. There were 29 female adolescents in the control group. The MB groupwork program significantly increased the mindfulness levels of the group. However, its effect on the other variables could not be determined at a significant level. There were positive correlations between mindfulness, life satisfaction and subjective happiness, and a negative correlation with perceived stress. The results of this study showed that MB interventions increase mindfulness levels of adolescents in a Children's Home setting in Türkiye. Secondly, as mindfulness increased, life satisfaction and subjective happiness also increased while perceived stress decreased. MB interventions are recommended to be used in social work interventions with different groups since it can contribute to subjective well-being.
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Affiliation(s)
- Irmak Atak
- Istanbul Provincial Directorate of Family and Social Services, UNEC Social Work and Social Innovations Research Center, Azerbaijan State University of Economics, Baku, Azerbaijan, Istanbul, Türkiye
| | - Taner Artan
- Faculty of Health Sciences, Department of Social Work, UNEC Social Work and Social Innovations Research Center, Istanbul University-Cerrahpaşa, Baku, Azerbaijan
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Laricchiuta D, Garofalo C, Mazzeschi C. Trauma-related disorders and the bodily self: current perspectives and future directions. Front Psychol 2023; 14:1166127. [PMID: 37275691 PMCID: PMC10235635 DOI: 10.3389/fpsyg.2023.1166127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Trauma-related disorders are debilitating psychiatric conditions that influence people who have directly or indirectly witnessed adversities. Dramatic brain/body transformations and altered person's relationship with self, others, and the world occur when experiencing multiple types of traumas. In turn, these unfortunate modifications may contribute to predisposition to trauma-related vulnerability conditions, such as externalizing (aggression, delinquency, and conduct disorders) problems. This mini-review analyzes the relations between traumatic experiences (encoded as implicit and embodied procedural memories) and bodily self, sense of safety for the own body, and relationship with others, also in the presence of externalizing conducts. Furthermore, an emerging research area is also considered, highlighting principles and techniques of body-oriented and sensorimotor therapies designed to remodel bodily self-aspects in the presence of trauma, discussing their potential application with individuals showing externalizing problems.
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Polizzi CP, Sleight FG, Aksen DE, McDonald CW, Lynn SJ. Mindfulness and COVID-19-Related Stress: Staying Present During Uncertain Times. Mindfulness (N Y) 2023; 14:1135-1147. [PMID: 37304660 PMCID: PMC10150345 DOI: 10.1007/s12671-023-02132-5] [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] [Accepted: 04/14/2023] [Indexed: 06/13/2023]
Abstract
Objectives The SARS-CoV-2 (COVID-19) pandemic is recognized as a mass traumatic event in which COVID-19-related stress (CS) can indicate other trauma- and/or stressor-related disorder. The facets of mindfulness (observing, describing, acting with awareness, nonjudging, and nonreacting) have been linked to reductions in stress-related symptoms and thus may protect against CS. We extended previous research by evaluating mindfulness facets as resilience skills negatively related to CS. Method Undergraduate students (n = 495) completed an online battery of questionnaires. A subsample of students endorsing clinically elevated CS (n = 165) was also evaluated. We utilized hierarchical regression to account statistically for the mindfulness facets in addition to indicators of psychological distress (e.g., negative affect, neuroticism, dissociation) and social desirability. We performed analyses twice, once in the overall sample, and once in the high CS subsample. Results Less observing and greater nonjudging related to reduced CS while other study variables were controlled for in the overall sample. In contrast, acting with awareness and nonjudging negatively related to CS in the subsample, but were not related to CS when we accounted for psychological-distress variables that positively related to CS in the analysis. Conclusions Although variables indicative of psychological distress robustly contribute to CS, observing, acting with awareness, and nonjudging may be mindfulness skills that can be targeted to buffer clinically significant CS. Preregistration This study was not pre-registered.
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Affiliation(s)
- Craig P. Polizzi
- Veterans Affairs Boston Healthcare System, 150 S Huntington Ave, Boston, MA 02130 USA
- Department of Psychiatry, Boston University School of Medicine, Boston, USA
| | - Fiona G. Sleight
- Department of Psychology, Binghamton University (SUNY), Binghamton, USA
| | - Damla E. Aksen
- Department of Psychology, Binghamton University (SUNY), Binghamton, USA
| | | | - Steven Jay Lynn
- Department of Psychology, Binghamton University (SUNY), Binghamton, USA
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Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia. Int J Equity Health 2023; 22:30. [PMID: 36765360 PMCID: PMC9912539 DOI: 10.1186/s12939-023-01842-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Compared to the general population, persons with disabilities are at increased risk of poor mental health. The aim of this study was to determine the rates and correlates of psychological distress and post-traumatic stress disorder (PTSD) among persons with physical disabilities in Cambodia. METHODS From July to December 2021 data were collected as part of a mental health screening programme for persons with physical disabilities who access prosthetic and orthotic services. Psychological distress was measured using the Kessler-10 (K-10) and PTSD using the PC-PTSD-5. Bivariate and multiple linear regression analyses were conducted to identify factors associated with levels of psychological distress and PTSD among this population. RESULTS Our study found a high prevalence of psychological distress and PTSD in this patient cohort. Of the 213 participants, 31.5% were likely to be experiencing mild to moderate psychological distress indicative of a mental health disorder, with 13.6% likely to have a severe mental health disorder. Sixty-five percent of patients reported experiencing PTSD symptoms, with forty-six percent meeting the criteria for probable PTSD. Psychological distress was associated with pathological worry, rumination, and facets of mindfulness. Rumination and pathological worry were found to be significant predictors of psychological distress. PTSD symptoms were associated with pathological worry but not facets of mindfulness or rumination. Facets of mindfulness and pathological worry were found to be significant predictors of PTSD. CONCLUSION Integration of mental health services within the disability sector is required to address psychological distress and PTSD symptoms among people with physical disabilities in Cambodia. Health system interventions, such as screening, referral, and the training of health providers, need to be strengthened. Further studies focussing on the psychosocial determinants of mental health of persons with disabilities in Cambodia are required.
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Haun JN, Alman AC, Jean-Baptiste E, Melillo C, McMahon-Grenz J, Paykel JM. Delivery of Complementary and Integrative Health Using Virtual Health Resources: A Scoping Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:851-861. [PMID: 35819410 PMCID: PMC9700349 DOI: 10.1089/jicm.2021.0458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Complementary and integrative health (CIH) modalities promote overall health and well-being and can be beneficial for individuals with a range of conditions. Traditionally, CIH has been delivered in person. COVID-19 created a need to identify sustainable remote delivery options to assure access to CIH while practicing public health recommendations. This scoping review maps the opportunities and challenges to remotely delivered CIH. Materials and methods: A scoping review was conducted between June 2020 and October 2020 using the following search engines: PubMed, Academic Search Premier, PsycINFO, CINAHL, Cochrane Reviews, and the Cochrane Clinical Trial Collections. Search results investigating remote CIH delivery were restricted to articles written in English, published after 1990. Results: Of the 10,884 articles identified, after review for content and methods, 330 articles were included. Most articles were randomized controlled trials (n = 170), applied mindfulness (n = 203), and targeted mental and behavioral health conditions (n = 182). Interventions were primarily delivered through mobile applications (n = 151) and web-based platforms (n = 86). Most commonly reported barriers were adherence (n = 24), resource requirements (e.g., time and space) (n = 23), and technology-related issues (n = 21). Although most studies did not report facilitators (n = 217), most commonly reported facilitators were social and technologic supports, accessibility, usability, perceptions, and rewards. Participant outcomes measured were broad and included movement (n = 88), stress (n = 68), and pain (n = 54). Intervention characteristic outcomes most often measured were satisfaction and usability (n = 5). Conclusions: This scoping literature review identified many articles addressing remote delivery of CIH, but few reporting on the implementation of remotely delivered CIH. Findings suggest remotely delivered CIH, specifically mindfulness and meditation-based modalities, is a viable treatment option for a diverse range of health conditions. Feasibility studies and larger sample sizes are recommended to strengthen the scientific evidence.
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Affiliation(s)
- Jolie N. Haun
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Amy C. Alman
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Esther Jean-Baptiste
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Christine Melillo
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Julie McMahon-Grenz
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
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Somohano VC, Bowen S. Trauma-Integrated Mindfulness-Based Relapse Prevention for Women with Comorbid Post-Traumatic Stress Disorder and Substance Use Disorder: A Cluster Randomized Controlled Feasibility and Acceptability Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:729-738. [PMID: 35648046 DOI: 10.1089/jicm.2021.0306] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Comorbid post-traumatic stress disorder and substance use disorder (PTSD-SUD) among women receiving substance use treatment are common. Few evidence-based interventions target PTSD-SUD, however, fewer are gender responsive. Mindfulness-based relapse prevention (MBRP) has shown effectiveness for women with SUD, although it does not explicitly target PTSD. Integration of trauma-focused and gender-responsive treatments into MBRP may address the limited availability of PTSD-SUD interventions for women. This study assessed feasibility and acceptability of trauma-integrated MBRP (TI-MBRP). Methods: A single-blind computer-generated cluster-randomized design was employed in which women with PTSD-SUD (N = 83) received either TI-MBRP (k = 5) or MBRP (k = 5). Measures of PTSD symptom severity and craving were administered at pre-, post-, 1-, 3-, 6-, 9-, and 12-month follow-up and assessed at the individual level. Results: TI-MBRP demonstrated acceptability among participants; however, attrition was high (64%) at 12-month follow-up. Reductions in PTSD were greater in the MBRP than in the TI-MBRP group at postcourse and 1-month follow-up, and there were significant reductions in PTSD severity and craving over the 12-month period in both conditions. Conclusions: Integrating trauma- and gender-focused interventions into MBRP was feasible and acceptable. MBRP alone may be effective in reducing both PTSD and SUD symptoms in women with PTSD-SUD; however, confirmatory studies are warranted. Clinical Trial Registration Number: NCT03505749.
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Affiliation(s)
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
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Saban KL, Collins EG, Mathews HL, Bryant FB, Tell D, Gonzalez B, Bhoopalam S, Chroniak CP, Janusek LW. Impact of a Mindfulness-Based Stress Reduction Program on Psychological Well-Being, Cortisol, and Inflammation in Women Veterans. J Gen Intern Med 2022; 37:751-761. [PMID: 36042095 PMCID: PMC9481828 DOI: 10.1007/s11606-022-07584-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 04/01/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Women veterans experience higher levels of stress-related symptoms than their civilian counterparts. Psychological stress is associated with greater inflammation and may increase risk for cardiovascular disease (CVD). Mindfulness-based stress reduction (MBSR) has been found to improve psychological well-being in other populations but no randomized controlled trials (RCT) have been conducted examining the impact of MBSR on well-being and inflammation in women veterans at risk for CVD. OBJECTIVE Determine the effectiveness of MBSR in improving psychological well-being, cortisol, and inflammation associated with CVD in women veterans. DESIGN The design is a RCT comparing MBSR to an active control condition (ACC) consisting of a health education program. PARTICIPANTS Women veterans (N=164) with risk factors for CVD from the Chicagoland area participated in the study. INTERVENTION An 8-week MBSR program with weekly 2.5-h classes was compared to an ACC consisting of an 8-week health promotion education program with weekly 2.5-h classes. MAIN MEASURES The outcomes were psychological well-being [perceived stress, depressive symptoms, loneliness, and post-traumatic stress disorder (PTSD)] symptoms and stress-related markers, including diurnal salivary cortisol and cytokines interleukin-6 (IL-6) and interferon gamma (IFN-γ). Data were collected at baseline, 4 weeks (mid-point of intervention), 8 weeks (completion of intervention), and 6 months after completion of MBSR or ACC. KEY RESULTS Compared to the ACC, women who participated in MBSR reported less perceived stress, loneliness, and symptoms of PTSD. Although there were no significant differences between groups or changes over time in IL-6 or IFN-γ, participants in the MBSR program demonstrated a more rapid decline in diurnal salivary cortisol as compared to those in the ACC. CONCLUSIONS MBSR was found to improve psychological well-being and decrease diurnal salivary cortisol in women veterans at risk for CVD. Health care providers may consider MBSR for women veterans as a means by which to improve their psychological well-being.
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Affiliation(s)
- Karen L Saban
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA, 5000 S. 5th Ave., Hines, IL, 60141, USA. .,Marcella Niehoff School of Nursing, Loyola University Chicago, 2160 S. First Ave, Center for Translational Research and Education, Maywood, IL, 60153, USA.
| | - Eileen G Collins
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA, 5000 S. 5th Ave., Hines, IL, 60141, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, 845 S. Damen Ave. MC 902, Chicago, IL, 60612, USA
| | - Herbert L Mathews
- Stritch School of Medicine, Loyola University Chicago, 2160 S. First Ave, Center for Translational Research and Education, Maywood, IL, 60153, USA
| | - Fred B Bryant
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Coffey Hall Rm. 242, Chicago, IL, 60660, USA
| | - Dina Tell
- Marcella Niehoff School of Nursing, Loyola University Chicago, 2160 S. First Ave, Center for Translational Research and Education, Maywood, IL, 60153, USA
| | - Beverly Gonzalez
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA, 5000 S. 5th Ave., Hines, IL, 60141, USA
| | - Sudha Bhoopalam
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA, 5000 S. 5th Ave., Hines, IL, 60141, USA
| | | | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, 2160 S. First Ave, Center for Translational Research and Education, Maywood, IL, 60153, USA
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Parker SC, Ahrens AH. (Just Thinking of) Uncertainty Increases Intolerance of Uncertainty. JOURNAL OF INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1027/1614-0001/a000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Intolerance of uncertainty is a far-reaching – yet not widely examined – construct with clinical and nonclinical associations. The current study implemented a brief reflection on uncertainty hypothesized to increase tolerance of uncertainty. The group who engaged in the reflection ( n = 50) was compared to an active control condition ( n = 50). Results demonstrated the opposite of the primary hypothesis: simply reflecting on uncertainty significantly increased intolerance of uncertainty (vs. tolerance of uncertainty). Results also demonstrated that those higher in mindfulness were higher in tolerance of uncertainty, with the “nonreactivity” factor of mindfulness contributing unique variance. These findings suggest multiple factors that might contribute to both tolerance and intolerance of uncertainty. This study indicates that investigations of interventions that include training in mindfulness and its component of nonreactivity might be particularly warranted.
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Affiliation(s)
- Suzanne C. Parker
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Department of Psychology, American University, Washington, DC, USA
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Reyes AT, Song H, Bhatta TR, Kearney CA. Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness- and acceptance-based mobile app for posttraumatic stress disorder. Perspect Psychiatr Care 2022; 58:776-784. [PMID: 34018197 DOI: 10.1111/ppc.12848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/23/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study used a mindfulness- and acceptance-based mobile app to examine the relationships between resilience, mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptoms. DESIGN AND METHODS A quasi-experimental pre-posttest, single-group study design was used. A total of 23 college student veterans used the app for 4 weeks. Outcomes of resilience, mindfulness, experiential avoidance, and PTSD were measured at three time-points (baseline, end of Week 2, and end of Week 4). FINDINGS All outcomes significantly improved at postintervention. Improvements in resilience and PTSD significantly correlated with improvement in mindfulness. PRACTICE IMPLICATIONS Mindfulness- and acceptance-based mobile apps can be safely used by individuals with PTSD as a complementary approach to enhance resilient coping with PTSD.
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Affiliation(s)
- Andrew T Reyes
- School of Nursing, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Huaxin Song
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Tirth R Bhatta
- Department of Sociology, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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Donahue ML, Dunne EM, Gathright EC, DeCosta J, Balletto BL, Jamison RN, Carey MP, Scott-Sheldon LAJ. Complementary and integrative health approaches to manage chronic pain in U.S. military populations: Results from a systematic review and meta-analysis, 1985-2019. Psychol Serv 2021; 18:295-309. [PMID: 32134305 PMCID: PMC7483193 DOI: 10.1037/ser0000417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The objective of this study was to examine the efficacy of complementary and integrative health (CIH) approaches for reducing pain intensity (primary outcome) and depressive symptoms (secondary outcome) as well as improving physical functioning (secondary outcome) among U.S. military personnel living with chronic pain. Studies were retrieved from bibliographic databases, databases of funded research, and reference sections of relevant articles. Studies that (a) evaluated a CIH approach to promote chronic pain management among military personnel, (b) used a randomized controlled trial design, and (c) assessed pain intensity were included. Two coders extracted data from each study and calculated effect sizes. Discrepancies between coders were resolved through discussion. Comprehensive searches identified 12 studies (k = 15 interventions) that met inclusion criteria. CIH practices included cognitive-behavioral therapies (k = 5), positive psychology (k = 3), yoga (k = 2), acupuncture (k = 2), mindfulness-based interventions (k = 2), and biofeedback (k = 1). Across these studies, participants who received the intervention reported greater reductions in pain intensity (d+ = 0.44, 95% CI [0.21, 0.67], k = 15) compared to controls. Statistically significant improvements were also observed for physical functioning (d+ = 0.36, 95% CI [0.11, 0.61], k = 11) but not for depressive symptoms (d+ = 0.21, 95% CI [-0.15, 0.57], k = 8). CIH approaches reduced pain intensity and improved physical functioning. These approaches offer a nonpharmacological, nonsurgical intervention for chronic pain management for military personnel. Future studies should optimize interventions to improve depressive symptoms in military populations experiencing chronic pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Marissa L. Donahue
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Eugene M. Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
| | - Emily C. Gathright
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
| | - Julie DeCosta
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Brittany L. Balletto
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Robert N. Jamison
- Pain Management Center, Brigham and Women’s Hospital, Chestnut Hill, MA
- Harvard Medical School, Boston, MA
| | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Lori A. J. Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
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The case for mindfulness interventions for traumatic stress in high violence, low resource settings. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00177-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Sharma N, Dhar RL. From curse to cure of workplace ostracism: A systematic review and future research agenda. HUMAN RESOURCE MANAGEMENT REVIEW 2021. [DOI: 10.1016/j.hrmr.2021.100836] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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15
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Marchand WR, Klinger W, Block K, VerMerris S, Nazarenko E, Curtis H, Newton J, Herrmann TS, Yabko B, Lane J. Mindfulness-based Therapeutic Sailing for Veterans With Psychiatric and Substance Use Disorders. Mil Med 2021; 187:e445-e452. [PMID: 33564887 DOI: 10.1093/milmed/usab030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/05/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Complementary interventions have the potential to enhance treatment engagement and/or response among veterans with psychiatric disorders and/or substance use disorders (SUDs). Mindfulness-based therapeutic sailing (MBTS) is a novel three-session, complementary intervention, which combines nature exposure via recreational sailing and mindfulness training. It was developed specifically to augment both treatment response and engagement among veterans with psychiatric disorders or SUDs. The study reports a follow-up investigation of a version of MBTS modified based upon a previous initial pilot study. MATERIALS AND METHODS This is an institutional review board-approved study of 25 veterans, 23 males and 2 females, who participated in MBTS along with a diagnosis-, gender-, and age-matched control group. All participants had at least one psychiatric disorder or SUD and most (92%) had two or more conditions, with the most common being any SUD (76%) and PTSD (72%). Instruments used to evaluate within-subjects pre- to post-intervention psychological changes were the Acceptance and Action Questionnaire II (AAQII), the Toronto Mindfulness Scale (TMS), and the Five Facet Mindfulness Questionnaire (FFMQ). The Physical Activity Enjoyment Scale (PACES) was administered to evaluate how much the participants enjoyed the intervention. Outcome measures were collected for 1-year pre-intervention and 1-year post-intervention for between-subject analyses. These were numbers of medical and psychiatric hospitalizations, emergency department visits, mental health (MH) and substance abuse treatment visits, and MH and substance abuse treatment failed appointments. Data analysis consisted of using paired, two-tailed t-tests on psychological instrument results, Poisson regression on discrete outcome measures, and chi-square test of independence on demographic factors. RESULTS Within-subjects comparisons revealed significant mean pre- to post-intervention increases in AAQII (P = .04) and TMS scores (P = .009). The FFMQ scores increased but the change was nonsignificant (P = .12). The PACES scores were high for all sessions, indicating enjoyment of the intervention by participants. Although the coefficient was nonsignificant, Poisson regression uncovered reduction in substance abuse treatment visits post-intervention. There were no significant differences for the other variables. For demographic factors, the differences between intervention and control groups were not statistically significant. CONCLUSIONS The MBTS is associated with increases in psychological flexibility (AAQII) and state mindfulness (TMS). The intervention was perceived as pleasurable by participants (PACES) and is potentially associated with decreased utilization of substance use treatment services. These results must be considered as preliminary; however, these finding corroborate results from a previous pilot study and indicate that MBTS holds promise as a complementary intervention that could result in enhanced treatment engagement and/or outcomes for the population studied. A randomized controlled trial of MBTS is warranted. Further, the model of a three-session intervention combining mindfulness training with nature exposure could be adapted for other types of nature exposure, such as hiking or snowshoeing or other complementary interventions including equine-assisted activities and therapies.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA.,School of Medicine Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
| | - William Klinger
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Ken Block
- Park City Sailing Association, Park City, UT 84098, USA
| | | | - Elena Nazarenko
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Heather Curtis
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Julie Newton
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Tracy S Herrmann
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Brandon Yabko
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA.,School of Medicine Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
| | - Jose Lane
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
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Post‐traumatic stress disorder and depressive symptoms following a Herdsmen attack: The role of life meaning in mediating trait mindfulness. Stress Health 2020. [DOI: 10.1002/smi.3012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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17
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Marchand WR, Sandoval K, Lackner R, Parker SC, Herrmann T, Yabko B, Velasquez T, Lewis L, Butler J. Mindfulness-based interventions for military veterans: A systematic review and analysis of the literature. Complement Ther Clin Pract 2020; 42:101274. [PMID: 33276226 DOI: 10.1016/j.ctcp.2020.101274] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/14/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In recent years, mindfulness-based interventions (MBIs) have experienced exponential growth in terms of development, application, and research. However, few studies have examined implementation and efficacy of these interventions in particular populations, such as military Veterans. Such studies are needed as one cannot assume that the literature on MBIs implemented with the general population or other specific populations apply equally well to Veterans. This population is unique regarding professional competencies, military ethos, high degrees of medical comorbidities and barriers to treatment. The aim of this work was to review and summarize the literature over the previous five years (2014-2020) assessing the use of MBIs among military Veterans to guide clinical care and future research. METHODS Systematic literature review. RESULTS A total of 88 articles were found. Screening titles and abstracts resulted in 49 articles being excluded. The remaining 39 articles were read in full, and of these, 12 were excluded due to not fully meeting the inclusion criteria. Thus, the present review included a total of 27 articles, 3 of which used qualitative methods and 24 of which used quantitative methods. CONCLUSIONS MBIs hold promise as complementary adjunctive interventions for Veterans with PTSD and possibly other psychiatric disorders. Currently there are significant gaps in the literature that must be addressed to move the field forward. The main deficiency is, with a few exceptions, the lack of rigorous RCTs. Another major concern is the lack of generalizability to female and non-white Veterans given that the subject samples across all studies reviewed were 85% male and 76% white. At this time, MBSR, PCBMT and MBCT can be recommended as adjunctive complementary interventions for the reduction of PTSD symptoms. Research recommendations to move the field forward are provided.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT, 84108, USA.
| | - Kristin Sandoval
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA
| | - Ryan Lackner
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA
| | - Suzanne C Parker
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA
| | - Tracy Herrmann
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA
| | - Brandon Yabko
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Tania Velasquez
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA; Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA, Salt Lake City Health Care System, Salt Lake City, UT, 84148, USA
| | - Lacey Lewis
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA
| | - Jorie Butler
- VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA
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Herrmann T, Marchand WR, Yabko B, Lackner R, Beckstrom J, Parker A. Veterans' interests, perceptions, and use of mindfulness. SAGE Open Med 2020; 8:2050312120938226. [PMID: 32821386 PMCID: PMC7406919 DOI: 10.1177/2050312120938226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 06/08/2020] [Indexed: 01/01/2023] Open
Abstract
Objective: Mindfulness-based interventions are an evidence-based approach utilized in health care. There is developing evidence for effective use with military Veterans. However, little is known about Veterans’ view of mindfulness. This study aims to understand their interests, perceptions, and use of mindfulness to enhance educational outreach and treatment engagement. Methods: A cross-sectional study was conducted across the Veterans Health Administration in Salt Lake City, UT by administering a questionnaire to military Veterans. The questionnaire included the following themes: (1) demographics and respondents’ mindfulness practice; (2) respondents’ perceptions and beliefs about mindfulness; and (3) respondents’ knowledge and interest in learning about mindfulness. Results: In all, 185 military Veterans were surveyed; 30% practiced mindfulness in the past year, mainly for stress, posttraumatic stress disorder, sleep, and depression. Over 75% who practiced reported perceived benefit. Veterans rarely reported negative beliefs about mindfulness; 56% perceived an understanding of mindfulness and 46% were aware of Veterans Health Administration mindfulness offerings. In all, 55% were interested in learning about mindfulness, 58% were interested in learning how it could help, and 43% were interested in combining mindfulness with a pleasurable activity. Conclusion: Educational engagement approaches should be directed toward the benefits of mindfulness practice with minimal need to address negative beliefs. Outreach including education, with an experiential component, about mindfulness classes, availability of evening and weekend classes, individual sessions, and virtual offerings into Veteran’s homes, may enhance engagement in mindfulness-based interventions. Mindfulness-based interventions that combine mindfulness training with an experiential pleasurable activity may be one mechanism to enhance treatment engagement.
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Affiliation(s)
- Tracy Herrmann
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Department of Nutrition and Integrative Physiology, The University of Utah, Salt Lake City, UT, USA
| | - William R Marchand
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Department of Psychiatry, School of Medicine, The University of Utah, Salt Lake City, UT, USA
| | - Brandon Yabko
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Department of Psychiatry, School of Medicine, The University of Utah, Salt Lake City, UT, USA
| | - Ryan Lackner
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Julie Beckstrom
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Division of Vascular Surgery, School of Medicine, The University of Utah, Salt Lake City, UT, USA
| | - Ashley Parker
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
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Arnaudova I, Amaro H. Acting with awareness and distress tolerance relate to PTSD symptoms among women with substance use disorder. Mindfulness (N Y) 2020; 11:1460-1468. [PMID: 32670430 DOI: 10.1007/s12671-020-01362-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives Women with a history of trauma exposure and substance use disorder (SUD) are more likely to report co-occurring post-traumatic stress disorder (PTSD) symptoms than the general population. However, cognitive factors such as increased distress tolerance and mindfulness disposition might be especially protective against PTSD symptoms for women with SUD. Methods We examined the associations of distress tolerance and mindfulness disposition as potential resilience factors to PTSD symptoms in a sample of women receiving residential treatment for SUD (N = 237, M AGE = 32.34, 56.96% Hispanic). PTSD symptoms were divided into the clusters of Reexperiencing, Avoidance, Dysphoria and Arousal. Results Regression models revealed that distress tolerance and the mindfulness facet of acting with awareness are negatively and incrementally associated with total, dysphoria and arousal PTSD symptom severity, while non-reactivity has a significant negative relationship with avoidance PTSD symptoms. Only distress tolerance emerged to be negatively related to PTSD reexperiencing symptom severity. Conclusions Our findings show that the ability to tolerate distress, as well as specific mindfulness skills, might protect against specific severe PTSD symptoms among women with SUD. Future research should examine whether targeting both of these facets is necessary for achieving favorable clinical outcomes on PTSD in this population.
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Affiliation(s)
- Inna Arnaudova
- Department of Psychiatry, University of California - Los Angeles
| | - Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
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Miller ML, Bagley JM, Normand P, Brennan MB, Van Horn R, Pollack MH, Held P. Increasing Mindfulness Skills of Veterans With PTSD Through Daily Mindfulness Training Incorporated Into an Intensive Treatment Program. Mindfulness (N Y) 2020; 11:964-974. [PMID: 34367355 DOI: 10.1007/s12671-020-01326-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Mindfulness training is frequently included as part of an integrative care approach to treating PTSD in veterans. However, the utility and acceptability of daily group mindfulness training in an intensive treatment program (ITP) for PTSD have not been explored. The study objectives were to determine: (a) whether mindfulness skills significantly increased from pre- to post-treatment and (b) if daily group mindfulness training was acceptable to veterans. Methods Veterans (N = 170 outpatients, age M = 40.7 (SD 9.3), 67.6% male) in this prospective study were consecutively enrolled in a 3-week ITP that included daily mindfulness group sessions. Mindfulness skills were assessed using the Five Facet of Mindfulness Questionnaire (FFMQ) at intake and post-treatment. Acceptability was assessed using an anonymous post-treatment program satisfaction survey. Results Paired t tests demonstrated significant increases in overall mindfulness skills from pre- to post-treatment (t(169) = - 6.33, p < 0.001, d = 0.49). Small to medium effect sizes were observed across subscales: describing, (t(169) = - 5.91, p < 0.001, d = 0.38); acting with awareness, (t(169) = - 3.70, p < 0.001, d = 0.29); nonjudging, (t(169) = - 7.54, p < 0.001, d = 0.58); and nonreactivity, (t(169) = - 4.84, p < 0.001, d = 0.41). Most veterans (n = 125, 74.4%) found daily mindfulness training moderately to very helpful. Conclusions Veterans' mindfulness skills significantly increased over the course of a 3-week ITP, and mindfulness training was found acceptable. Mindfulness training can be delivered daily as part of an ITP for veterans with PTSD, and mindfulness skills can meaningfully increase over the course of 3 weeks. A significant limitation is the lack of control condition.
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Affiliation(s)
- Michelle L Miller
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
| | - Jenna M Bagley
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
| | - Patricia Normand
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
| | - Michael B Brennan
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
| | - Rebecca Van Horn
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
| | - Mark H Pollack
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA
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21
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Chien WT, Chow KM, Chong YY, Bressington D, Choi KC, Chan CWH. The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes. Front Psychiatry 2020; 11:177. [PMID: 32218747 PMCID: PMC7078358 DOI: 10.3389/fpsyt.2020.00177] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 02/25/2020] [Indexed: 01/09/2023] Open
Abstract
Objective: This study aimed to examine how five facets of mindfulness may be associated with the changes in psychotic patients' health outcomes after participating in a mindfulness-based psychoeducation group (MBPEG) program. Methods: Longitudinal follow-up data from two pragmatic randomized controlled trials of MBPEG for psychotic patients were used for this study. A total of 124 patients who completed the MBPEG program were included in this analysis. Patient outcomes (psychotic symptoms, functioning, insight into illness/treatment, subjective recovery) and five facets of mindfulness were assessed at baseline and six, 12 and 24 months post-intervention. Areas under the curve of individual outcomes in repeated-measures were computed using trapezoidal method, rescaled to the original possible range of the underlying variable and used for correlation and regression analyses. Results: All mean scores of the five facets increased across time and were significantly correlated with the improvements in all patient outcomes (p-values ranged from <0.001 to <0.05), except "non-judging" facet and symptom severity. Regression analyses revealed that only "observing" and "acting with awareness" were significantly associated with positive changes across all outcomes (increase in adjusted R 2 ranged from 5.9% to 24.2%, p < 0.001). Conclusions: Two facets of mindfulness, "observing" and "acting with awareness," were related to positive outcomes of psychotic patients after participating in the MBPEG. More efforts in addressing these two facets of mindfulness can be considered to increase the efficacy of mindfulness-based interventions in psychosis.
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Affiliation(s)
- Wai Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yuen Yu Chong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Daniel Bressington
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
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Simons JS, Simons RM, Walters KJ, Keith JA, O'Brien C, Andal K, Stoltenberg SF. Nexus of despair: A network analysis of suicidal ideation among veterans. Arch Suicide Res 2020; 24:314-336. [PMID: 30734645 PMCID: PMC7206527 DOI: 10.1080/13811118.2019.1574689] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The objective of this study was to estimate a network model of risk and resilience factors of suicidal ideation among veterans. Two network models of suicidal ideation among Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn veterans (N = 276) incorporated key disorders, traumatic stress, and resilience constructs to contextualize suicidal ideation. Childhood trauma was positively connected with suicidal ideation and harassment and inversely connected with social support and distress tolerance. This exemplifies long-lasting associations between childhood trauma and re-victimization, emotion regulation, and ability to form supportive social relationships. A subsequent model including lower-order facets indicated that combat trauma was predominantly associated with posttraumatic stress disorder-intrusion symptoms. This study highlights the importance of addressing both risk and resilience to reduce suicide risk among veterans and increases understanding of factors that contribute to suicidal ideation.
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Affiliation(s)
- Jeffrey S Simons
- The University of South Dakota, Vermillion, South Dakota.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota
| | - Raluca M Simons
- The University of South Dakota, Vermillion, South Dakota.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota
| | - Kyle J Walters
- The University of South Dakota, Vermillion, South Dakota
| | | | | | - Kate Andal
- Sioux Falls VA Health Care System, Sioux Falls, South Dakota
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Carpenter JK, Conroy K, Gomez AF, Curren LC, Hofmann SG. The relationship between trait mindfulness and affective symptoms: A meta-analysis of the Five Facet Mindfulness Questionnaire (FFMQ). Clin Psychol Rev 2019; 74:101785. [PMID: 31751877 PMCID: PMC6878205 DOI: 10.1016/j.cpr.2019.101785] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 09/22/2019] [Accepted: 09/25/2019] [Indexed: 11/24/2022]
Abstract
Trait mindfulness appears to be related to lower levels of negative affective symptoms, but it remains uncertain which facets of mindfulness are most important in this relationship. Accordingly, the present meta-analysis examined studies reporting correlations between affective symptoms and trait mindfulness as assessed by the Five Facet Mindfulness Questionnaire. A comprehensive search yielded 148 eligible studies, comprising 157 distinct samples and 44,075 participants. The weighted mean correlation for affective symptoms and overall trait mindfulness was r = -0.53. Among mindfulness facets, Nonjudge (r = -0.48) and Act with Awareness (r = -0.47) demonstrated the largest correlations, followed by Nonreact (r = -0.33) and Describe (r = -0.29). Observe was not significantly correlated with affective symptoms. No significant differences in the strength of correlations were found between anxiety, depression and posttraumatic stress disorder (PTSD) symptoms, though symptoms of generalized anxiety disorder exhibited a weaker negative relationship with the Describe facet compared to PTSD symptoms. Describe also showed a stronger relationship with affective symptoms in Eastern samples compared to Western samples, whereas Western samples had a stronger relationship with Nonjudge. These results provide insight into the nature of the association between trait mindfulness and negative affect.
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Affiliation(s)
- Joseph K Carpenter
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Kristina Conroy
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Angelina F Gomez
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Laura C Curren
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
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Mindfulness Training plus Nature Exposure for Veterans with Psychiatric and Substance Use Disorders: A Model Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234726. [PMID: 31783489 PMCID: PMC6926798 DOI: 10.3390/ijerph16234726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/23/2019] [Accepted: 11/24/2019] [Indexed: 12/27/2022]
Abstract
There is a need to develop novel complementary interventions aimed at enhancing treatment engagement and/or response for veterans with psychiatric and substance use disorders. There is evidence that both mindfulness training and nature exposure (MT/NE) may be beneficial for this population and that combining the two approaches into one intervention might result in synergistic benefit. However, to date, the MT/NE concept has not been tested. This article reports a pilot feasibility and acceptability study of MT/NE which was, in this case, provided via recreational sailing. The primary aim of this project was to develop a model intervention and evaluation process that could be used for future studies of MT/NE interventions using a variety of methods of nature exposure (e.g., hiking, skiing, mountain biking). Results indicate preliminary evidence that it is feasible to utilize MT/NE interventions for the population studied and that the MT/NE model described can serve as a template for future investigations. Further, there were significant pre- to post-intervention decreases in state anxiety, as well as increases in trait mindfulness. Three psychological instruments were identified that might be used in future studies to evaluate MT/NE outcomes. Results from this project provide a model MT/NE intervention template along with evaluation metrics for use in future studies.
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Marchand WR, Yabko B, Herrmann T, Curtis H, Lackner R. Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders. J Altern Complement Med 2019; 25:902-909. [PMID: 31328956 PMCID: PMC6748402 DOI: 10.1089/acm.2018.0511] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: The aim of this study was to evaluate utilization and outcomes of mindfulness-based cognitive therapy (MBCT) provided to veterans with psychiatric disorders. Design: Retrospective chart review. Settings: Veterans Administration Medical Center (VAMC). Subjects: Ninety-eight veterans with psychiatric illness who were enrolled in an MBCT class between May of 2012 and January of 2016. Subjects were predominately white (95%), male (81%), and >50 years old (74%). The most common psychiatric conditions were any mood disorder (82%) and post-traumatic stress disorder (54%). Intervention: Eight-week MBCT class. Outcome measures: Session attendance and pre- to postintervention changes in numbers of emergency department (ED) visits and psychiatric hospitalizations. Results: The average number of sessions attended was 4.87 of 8 and only 16% were present for all sessions. Veteran demographic variables did not predict the number of MBCT sessions attended. However, both greater numbers of pre-MBCT ED visits (p = 0.004) and psychiatric admissions (p = 0.031) were associated with attending fewer sessions. Among patients who experienced at least one pre- or post-treatment psychiatric admission in the 2 years pre- or postintervention (N = 26, 27%), there was a significant reduction in psychiatric admissions from pre to post (p = 0.002). There was no significant change in ED visits (p = 0.535). Conclusions: MBCT may be challenging to implement for veterans with psychiatric illness in, at least some, outpatient VAMC settings due to a high attrition rate. Possible mediation approaches include development of methods to screen for high dropout risk and/or development of shorter mindfulness-based interventions (MBIs) and/or coupling MBIs with pleasurable activities. The finding of a significant decrease in psychiatric hospitalizations from pre- to post-MBCT suggests that prospective studies are warranted utilizing MBCT for veterans at high risk for psychiatric hospitalization.
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Affiliation(s)
- William R. Marchand
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT
- Address correspondence to: William R. Marchand, MD, Whole Health Service, VA Salt Lake City Health Care System, VHASLC 11H, 500 Foothill, Salt Lake City, UT 84148
| | - Brandon Yabko
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT
| | - Tracy Herrmann
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT
| | - Heather Curtis
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT
| | - Ryan Lackner
- Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT
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Haun JN, Ballistrea LM, Melillo C, Standifer M, Kip K, Paykel J, Murphy JL, Fletcher CE, Mitchinson A, Kozak L, Taylor SL, Glynn SM, Bair M. A Mobile and Web-Based Self-Directed Complementary and Integrative Health Program for Veterans and Their Partners (Mission Reconnect): Protocol for a Mixed-Methods Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13666. [PMID: 31094345 PMCID: PMC6535978 DOI: 10.2196/13666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/27/2019] [Accepted: 03/29/2019] [Indexed: 12/13/2022] Open
Abstract
Background Complementary and integrative health (CIH) is a viable solution to PTSD and chronic pain. Many veterans believe CIH can be performed only by licensed professionals in a health care setting. Health information technology can bring effective CIH to veterans and their partners. Objective This paper describes the rationale, design, and methods of the Mission Reconnect protocol to deliver mobile and Web-based complementary and integrative health programs to veterans and their partners (eg, spouse, significant other, caregiver, or family member). Methods This three-site, 4-year mixed-methods randomized controlled trial uses a wait-list control to determine the effects of mobile and Web-based CIH programs for veterans and their partners, or dyads. The study will use two arms (ie, treatment intervention arm and wait-list control arm) in a clinical sample of veterans with comorbid pain and posttraumatic stress disorder, and their partners. The study will evaluate the effectiveness and perceived value of the Mission Reconnect program in relation to physical and psychological symptoms, global health, and social outcomes. Results Funding for the study began in November 2018, and we are currently in the process of recruitment screening and data randomization for the study. Primary data collection will begin in May 2019 and continue through May 2021. Projected participants per site will be 76 partners/dyads, for a total of 456 study participants. Anticipated study results will be published in November 2022. Conclusions This work highlights innovative delivery of CIH to veterans and their partners for treatment of posttraumatic stress disorder and chronic pain. Trial Registration ClinicalTrials.gov NCT03593772; https://clinicaltrials.gov/ct2/show/NCT03593772 (Archived by WebCite at http://www.webcitation.org/77Q2giwtw) International Registered Report Identifier (IRRID) PRR1-10.2196/13666
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Affiliation(s)
- Jolie N Haun
- Rehabilitation Outcomes Research Section, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States
| | - Lisa M Ballistrea
- Rehabilitation Outcomes Research Section, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States
| | - Christine Melillo
- Rehabilitation Outcomes Research Section, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States
| | - Maisha Standifer
- Rehabilitation Outcomes Research Section, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States
| | - Kevin Kip
- Rehabilitation Outcomes Research Section, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States.,College of Public Health, University of South Florida, Tampa, FL, United States
| | - Jacquelyn Paykel
- Whole Health Service, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States
| | - Jennifer L Murphy
- Mental Health and Behavioral Sciences Service, James A Haley Veterans' Hospital and Clinics, Veterans Health Administration, Tampa, FL, United States
| | - Carol E Fletcher
- Veterans Affairs Ann Arbor Healthcare System, Veterans Health Administration, Ann Arbor, MI, United States
| | - Allison Mitchinson
- Veterans Affairs Ann Arbor Healthcare System, Veterans Health Administration, Ann Arbor, MI, United States
| | - Leila Kozak
- Department of Family Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA, United States.,Veterans Affairs Puget Sound Health Care System, Veterans Health Administration, Seattle, WA, United States.,Integrative Health Coordinating Center, Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, United States
| | - Stephanie L Taylor
- Health Services Research and Development, Veterans Health Administration, Los Angeles, CA, United States.,Department of Health Policy and Research, University of California - Los Angeles, Los Angeles, CA, United States
| | - Shirley M Glynn
- Research Service, Veterans Affairs Greater Los Angeles Healthcare System at West Los Angeles, Los Angeles, CA, United States
| | - Matthew Bair
- School of Medicine, Indiana University, Indianapolis, IN, United States.,Regenstrief Institute, Inc, Indianapolis, IN, United States.,Center for Health Information and Communication, Veterans Affairs, Indianapolis, IN, United States
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Trait mindfulness and PTSD symptom clusters: Considering the influence of emotion dysregulation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jasbi M, Sadeghi Bahmani D, Karami G, Omidbeygi M, Peyravi M, Panahi A, Mirzaee J, Holsboer-Trachsler E, Brand S. Influence of adjuvant mindfulness-based cognitive therapy (MBCT) on symptoms of post-traumatic stress disorder (PTSD) in veterans - results from a randomized control study. Cogn Behav Ther 2018; 47:431-446. [PMID: 29893182 DOI: 10.1080/16506073.2018.1445773] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Even 30 or more years after the end of a war, veterans can suffer from post-traumatic stress disorder (PTSD). In the present study, we explored the influence on symptoms of PTSD among Iranian veterans of the Iran-Iraq war of mindfulness-based cognitive therapy (MBCT) as add-on to a standard treatment with citalopram. Forty-eight male veterans with PTSD (mean age: 52.97 years) took part in this eight-week intervention study. Standard treatment for all patients consisted of citalopram (30-50 mg/day at therapeutic dosages). Patients were randomly assigned either to the treatment or to the control condition. Treatment involved MBCT delivered in group sessions once a week. Patients in the control condition met at the hospital with the same frequency and duration for socio-therapeutic events. At baseline and at study completion, patients completed questionnaires covering symptoms of PTSD, depression, anxiety, and stress. At study completion after eight weeks, scores for PTSD (re-experiencing events, avoidance, negative mood and cognition, hyperarousal), depression, anxiety, and stress were lower, but more so in the intervention than the control group. Data suggest that, as adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.
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Affiliation(s)
| | - Dena Sadeghi Bahmani
- b Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS) , University of Basel , Basel , Switzerland.,c Department of Psychiatry, Sleep Disorders Research Center , Kermanshah University of Medical Sciences (KUMS) , Kermanshah , Iran
| | | | | | - Maryam Peyravi
- f Researching Science Unit of Tehran , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Jafar Mirzaee
- h Janbazan Medical and Engineering Research Center (JMERC) , Tehran University of Medical Sciences , Tehran , Iran
| | - Edith Holsboer-Trachsler
- b Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS) , University of Basel , Basel , Switzerland
| | - Serge Brand
- b Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS) , University of Basel , Basel , Switzerland.,c Department of Psychiatry, Sleep Disorders Research Center , Kermanshah University of Medical Sciences (KUMS) , Kermanshah , Iran.,i Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health , University of Basel , Basel , Switzerland
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29
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Schure MB, Simpson TL, Martinez M, Sayre G, Kearney DJ. Mindfulness-Based Processes of Healing for Veterans with Post-Traumatic Stress Disorder. J Altern Complement Med 2018; 24:1063-1068. [PMID: 29733220 DOI: 10.1089/acm.2017.0404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE U.S. veterans are at increased risk of developing post-traumatic stress disorder (PTSD). Prior studies suggest a benefit of mindfulness-based stress reduction (MBSR) for PTSD, but the mechanisms through which MBSR reduces PTSD symptoms and improves functional status have received limited empirical inquiry. This study used a qualitative approach to better understand how training in mindfulness affects veterans with PTSD. DESIGN Qualitative study using semistructured in-depth interviews following participation in an MBSR intervention. SETTING Outpatient. INTERVENTION Eight-week MBSR program. OUTCOME MEASURE Participants' narratives of their experiences from participation in the program. RESULTS Interviews were completed with 15 veterans. Analyses identified six core aspects of participants' MBSR experience related to PTSD: dealing with the past, staying in the present, acceptance of adversity, breathing through stress, relaxation, and openness to self and others. Participants described specific aspects of a holistic mindfulness experience, which appeared to activate introspection and curiosity about their PTSD symptoms. Veterans with PTSD described a number of pathways by which mindfulness practice may help to ameliorate PTSD. CONCLUSIONS MBSR holds promise as a nontrauma-focused approach to help veterans with PTSD.
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Affiliation(s)
- Marc B Schure
- 1 Health and Human Development, Montana State University , Bozeman, MT
| | - Tracy L Simpson
- 2 Center of Excellence in Substance Abuse Treatment and Education , VA Puget Sound Health Care System, Seattle, WA.,3 Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine , Seattle, WA
| | | | - George Sayre
- 5 Health Services Research and Development, VA Puget Sound Health Care System , Seattle, WA.,6 Department of Health Services, University of Washington School of Public Health , Seattle, WA
| | - David J Kearney
- 4 VA Puget Sound Health Care System , Seattle, WA.,7 Department of Medicine, University of Washington School of Medicine , Seattle, WA
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30
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Domingues RB. Modern postural yoga as a mental health promoting tool: A systematic review. Complement Ther Clin Pract 2018; 31:248-255. [PMID: 29705463 DOI: 10.1016/j.ctcp.2018.03.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 03/07/2018] [Indexed: 12/22/2022]
Abstract
Yoga has been gaining popularity as a complementary therapy for mental health conditions, but research on the efficacy of yoga is still in its beginnings. The aim of this systematic review is to investigate the effects of modern postural yoga (strong focus on physical postures) on positive mental health (PMH) indicators in clinical and nonclinical populations. The most common PMH indicators were mindfulness, affect, resilience and well-being, followed by satisfaction with life, self-compassion, empathy and others. Diverse results were found across the 14 studies analysed, including significant positive effects of yoga practice on outcome variables, to no significant effects, both in relation to baseline levels and in relation to control groups. Nonetheless, most studies observed ameliorations in PMH indicators due to yoga practice. Given that yoga interventions pose serious methodological concerns, more research and better experimental designs are needed to properly assess the effects of yoga on PMH indicators.
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Affiliation(s)
- Rita B Domingues
- Centre for Marine and Environmental Research (CIMA), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal; Research Centre for Spatial and Organizational Dynamics (CIEO), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal.
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31
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Meyer EC, Frankfurt SB, Kimbrel NA, DeBeer BB, Gulliver SB, Morrisette SB. The influence of mindfulness, self-compassion, psychological flexibility, and posttraumatic stress disorder on disability and quality of life over time in war veterans. J Clin Psychol 2018; 74:1272-1280. [DOI: 10.1002/jclp.22596] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/06/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Eric C. Meyer
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System
- Texas A&M University Health Science Center; College of Medicine
- Warriors Research Institute at Baylor Scott & White Health
| | - Sheila B. Frankfurt
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System
- Texas A&M University Health Science Center; College of Medicine
| | - Nathan A. Kimbrel
- Durham VA Medical Center
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center
- Duke University Medical Center
| | - Bryann B. DeBeer
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System
- Texas A&M University Health Science Center; College of Medicine
| | - Suzy B. Gulliver
- Texas A&M University Health Science Center; College of Medicine
- Warriors Research Institute at Baylor Scott & White Health
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32
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Boyd JE, Lanius RA, McKinnon MC. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. J Psychiatry Neurosci 2018; 43. [PMID: 29252162 PMCID: PMC5747539 DOI: 10.1503/jpn.170021] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.
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Affiliation(s)
| | | | - Margaret C. McKinnon
- Correspondence to: M.C. McKinnon, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5 Street, Hamilton, ON, Canada;
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33
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Breit S, Kupferberg A, Rogler G, Hasler G. Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Front Psychiatry 2018; 9:44. [PMID: 29593576 PMCID: PMC5859128 DOI: 10.3389/fpsyt.2018.00044] [Citation(s) in RCA: 478] [Impact Index Per Article: 79.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 02/01/2018] [Indexed: 12/13/2022] Open
Abstract
The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. In this review article, we discuss various functions of the vagus nerve which make it an attractive target in treating psychiatric and gastrointestinal disorders. There is preliminary evidence that vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease. Treatments that target the vagus nerve increase the vagal tone and inhibit cytokine production. Both are important mechanism of resiliency. The stimulation of vagal afferent fibers in the gut influences monoaminergic brain systems in the brain stem that play crucial roles in major psychiatric conditions, such as mood and anxiety disorders. In line, there is preliminary evidence for gut bacteria to have beneficial effect on mood and anxiety, partly by affecting the activity of the vagus nerve. Since, the vagal tone is correlated with capacity to regulate stress responses and can be influenced by breathing, its increase through meditation and yoga likely contribute to resilience and the mitigation of mood and anxiety symptoms.
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Affiliation(s)
- Sigrid Breit
- Division of Molecular Psychiatry, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Aleksandra Kupferberg
- Division of Molecular Psychiatry, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Gerhard Rogler
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Gregor Hasler
- Division of Molecular Psychiatry, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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34
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Mehling WE, Chesney MA, Metzler TJ, Goldstein LA, Maguen S, Geronimo C, Agcaoili G, Barnes DE, Hlavin JA, Neylan TC. A 12-week integrative exercise program improves self-reported mindfulness and interoceptive awareness in war veterans with posttraumatic stress symptoms. J Clin Psychol 2017; 74:554-565. [DOI: 10.1002/jclp.22549] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 08/20/2017] [Accepted: 09/01/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Wolf E. Mehling
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Margaret A. Chesney
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Thomas J. Metzler
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Lizabeth A. Goldstein
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Shira Maguen
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | | | | | - Deborah E. Barnes
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | | | - Thomas C. Neylan
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
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35
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Held P, Owens GP, Monroe JR, Chard KM. Increased Mindfulness Skills as Predictors of Reduced Trauma-Related Guilt in Treatment-Seeking Veterans. J Trauma Stress 2017; 30:425-431. [PMID: 28741736 DOI: 10.1002/jts.22209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 04/29/2017] [Accepted: 05/05/2017] [Indexed: 11/12/2022]
Abstract
The present study examined the predictive role of increased self-reported mindfulness skills on reduced trauma-related guilt in a sample of veterans over the course of residential treatment for posttraumatic stress disorder (PTSD; N = 128). The residential treatment consisted of seven weeks of intensive cognitive processing therapy (CPT) for PTSD, as well as additional psychoeducational groups, including seven sessions on mindfulness skills. Increased mindfulness skills describing, acting with awareness, and accepting without judgment were significantly associated with reductions in trauma-related guilt over the course of treatment. Increases in the ability to act with awareness and accept without judgment were significantly associated with reductions in global guilt, R2 = .26, guilt distress, R2 = .23, guilt cognitions, R2 = .23, and lack of justification, R2 = .11. An increase in the ability to accept without judgment was the only self-reported mindfulness skill that was associated with reductions in hindsight bias, β = -.34 and wrongdoing, β = -.44. Increases in self-reported mindfulness skills explained 15.1 to 24.1% of the variance in reductions in trauma-related guilt, suggesting that mindfulness skills may play a key role in reducing the experience of trauma-related guilt during psychotherapy. Our results provide preliminary support for the use of mindfulness groups as an adjunct to traditional evidence-based treatments aimed at reducing trauma-related guilt, though this claim needs to be tested further using experimental designs.
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Affiliation(s)
- Philip Held
- Department of Psychiatry, Rush University Medical Center, Chicago, Illinois, USA
| | - Gina P Owens
- University of Tennessee, Knoxville, Tennessee, USA
| | - J Richard Monroe
- Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio, USA
| | - Kathleen M Chard
- Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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36
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Colgan DD, Wahbeh H, Pleet M, Besler K, Christopher M. A Qualitative Study of Mindfulness Among Veterans With Posttraumatic Stress Disorder: Practices Differentially Affect Symptoms, Aspects of Well-Being, and Potential Mechanisms of Action. J Evid Based Complementary Altern Med 2017; 22:482-493. [PMID: 30208735 PMCID: PMC5871168 DOI: 10.1177/2156587216684999] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/13/2016] [Accepted: 11/21/2016] [Indexed: 11/16/2022] Open
Abstract
This qualitative study explored and compared the subjective experiences of 102 veterans with posttraumatic stress disorder (PTSD) who were randomly assigned to 1 of 4 arms: ( a) body scan, ( b) mindful breathing, ( c) slow breathing, or ( d) sitting quietly. Qualitative data were obtained via semistructured interviews following the intervention and analyzed using conventional content analysis. The percentage of participants within each intervention who endorsed a specific theme was calculated. Two-proportion z tests were then calculated to determine if the differences among themes endorsed in specific groups were statistically significant. Six core themes emerged from analysis of participant responses across the 4 groups: ( a) enhanced present moment awareness, ( b) increased nonreactivity, ( c) increased nonjudgmental acceptance, ( d) decreased physiological arousal and stress reactivity, ( e) increased active coping skills, and ( f) greater relaxation. More participants in the mindfulness intervention groups reported improvement in PTSD symptoms when compared to participants in non-mindfulness groups. Different types of intervention targeted different symptoms and aspects of well-being. Furthermore, type of intervention may have also differentially targeted potential mechanisms of action. This article highlights the importance of employing both quantitative and qualitative research methods when investigating the dynamic process of mindfulness and may inform how practices can be tailored to the needs of the veteran with PTSD.
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Affiliation(s)
| | - Helané Wahbeh
- Oregon Health & Science University, Portland, OR, USA
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37
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Drake DF, Hudak AM, Robbins W. Integrative Medicine in Traumatic Brain Injury. Phys Med Rehabil Clin N Am 2017; 28:363-378. [DOI: 10.1016/j.pmr.2016.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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38
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Bremner JD, Mishra S, Campanella C, Shah M, Kasher N, Evans S, Fani N, Shah AJ, Reiff C, Davis LL, Vaccarino V, Carmody J. A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder. Front Psychiatry 2017; 8:157. [PMID: 28890702 PMCID: PMC5574875 DOI: 10.3389/fpsyt.2017.00157] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 08/09/2017] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Brain imaging studies in patients with post-traumatic stress disorder (PTSD) have implicated a circuitry of brain regions including the medial prefrontal cortex, amygdala, hippocampus, parietal cortex, and insula. Pharmacological treatment studies have shown a reversal of medial prefrontal deficits in response to traumatic reminders. Mindfulness-based stress reduction (MBSR) is a promising non-pharmacologic approach to the treatment of anxiety and pain disorders. The purpose of this study was to assess the effects of MBSR on PTSD symptoms and brain response to traumatic reminders measured with positron-emission tomography (PET) in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans with PTSD. We hypothesized that MBSR would show increased prefrontal response to stress and improved PTSD symptoms in veterans with PTSD. METHOD Twenty-six OEF/OIF combat veterans with PTSD who had recently returned from a combat zone were block randomized to receive eight sessions of MBSR or present-centered group therapy (PCGT). PTSD patients underwent assessment of PTSD symptoms with the Clinician-Administered PTSD Scale (CAPS), mindfulness with the Five Factor Mindfulness Questionnaire (FFMQ) and brain imaging using PET in conjunction with exposure to neutral and Iraq combat-related slides and sound before and after treatment. Nine patients in the MBSR group and 8 in the PCGT group completed all study procedures. RESULTS Post-traumatic stress disorder patients treated with MBSR (but not PCGT) had an improvement in PTSD symptoms measured with the CAPS that persisted for 6 months after treatment. MBSR also resulted in an increase in mindfulness measured with the FFMQ. MBSR-treated patients had increased anterior cingulate and inferior parietal lobule and decreased insula and precuneus function in response to traumatic reminders compared to the PCGT group. CONCLUSION This study shows that MBSR is a safe and effective treatment for PTSD. Furthermore, MBSR treatment is associated with changes in brain regions that have been implicated in PTSD and are involved in extinction of fear responses to traumatic memories as well as regulation of the stress response.
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Affiliation(s)
- James Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Department of Radiology, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States.,Department of Psychiatry, University of Alabama, Birmingham, AL, United States.,The Tuskegee VA Medical Center, Tuskegee, AL, United States
| | - Sanskriti Mishra
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Carolina Campanella
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Majid Shah
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Nicole Kasher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Sarah Evans
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Amit Jasvant Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Collin Reiff
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Lori L Davis
- Atlanta VA Medical Center, Decatur, GA, United States.,Department of Psychiatry, University of Alabama, Birmingham, AL, United States.,The Tuskegee VA Medical Center, Tuskegee, AL, United States
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - James Carmody
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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