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Legrand FD, Chaouloff F, Ginoux C, Ninot G, Polidori G, Beaumont F, Murer S, Jeandet P, Pelissolo A. [Exercise for the promotion of mental health II: Putative mechanisms, recommendations, and scientific challenges]. L'ENCEPHALE 2023; 49:296-303. [PMID: 37105781 DOI: 10.1016/j.encep.2023.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/22/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023]
Abstract
The idea of applying various forms of physical activity for the betterment of physical health and the reduction of chronic medical conditions is ubiquitous. Despite evidence of successful applications of physical activity for improvement of mental health dating back to antiquity, it has until recent years remained unconventional to consider exercise as an intervention strategy for various mental health conditions. The past two decades, however, have seen a relative explosion of interest in understanding and applying various programs and forms of exercise to improve mental health. Here, our purpose is to provide a comprehensive and updated overview of the application of exercise as a strategy for improving mental health. In the present paper we first summarize contemporary research regarding short- and long-term impacts of exercise on mental health. Then an overview of the putative mechanisms and neurobiological bases underpinning the beneficial effects of exercise is provided. Finally, we suggest directions for future research as well as a series of concrete recommendations for clinicians who wish to prescribe physical activity as part of patient mental health management.
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Affiliation(s)
- Fabien D Legrand
- Université de Reims Champagne Ardenne, laboratoire cognition santé société (EA 6291), Reims, France.
| | | | - Clément Ginoux
- Université de Grenoble-Alpes, laboratoire sport en environnement social (SENS), Grenoble-Alpes, France
| | - Gregory Ninot
- Université de Montpellier, institut Debrest d'épidémiologie et de santé publique - Inserm, Montpellier, France
| | | | - Fabien Beaumont
- Université de Reims Champagne Ardenne, laboratoire MATIM, Reims, France
| | - Sébastien Murer
- Université de Reims Champagne Ardenne, laboratoire MATIM, Reims, France
| | - Philippe Jeandet
- Université de Reims Champagne Ardenne, laboratoire résistance induite et bio-protection des plantes (USC INRAE 1488), Reims, France
| | - Antoine Pelissolo
- Service de psychiatrie sectorisée, Assistance Publique-Hôpitaux de Paris, GHU Mondor, université Paris Est Créteil, Créteil, France
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Matko K, Sedlmeier P, Bringmann HC. Embodied Cognition in Meditation, Yoga, and Ethics-An Experimental Single-Case Study on the Differential Effects of Four Mind-Body Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11734. [PMID: 36142006 PMCID: PMC9517053 DOI: 10.3390/ijerph191811734] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 06/01/2023]
Abstract
Yoga is an embodied contemplative practice considered as a path toward long-term well-being, which fosters an integrated processing of bodily and emotional stimuli. However, little is known about how the different components of yoga contribute to these processes. This was the aim of this single-case multiple-baseline study. Herein, we explored how different yoga components affect body awareness, emotion regulation, affectivity, self-compassion, and distress tolerance. Forty-two randomly assigned participants (from initially fifty-seven) completed one of four 8-week treatments: Mantra meditation alone (MA), meditation plus physical yoga (MY), meditation plus ethical education (ME), and meditation plus yoga and ethical education (MYE). Participants had no prior regular yoga or meditation practice. Data were analyzed using visual inspection, effect size estimation, and multilevel modeling. Surprisingly, all four treatments similarly improved body awareness (Tau-UMA = 0.21 to Tau-UMY = 0.49), emotion regulation (Tau-UMYE = -0.43 to Tau-UME = -0.52), self-compassion (η2 = 0.08), and distress tolerance (η2 = 0.13). These effects were maintained until follow-up at 2 and 12 months after the study, even though home practice declined. The MA condition had the least favorable effect on affective experience (Tau-UMA = -0.14 and 0.07), while the ME condition enhanced valence the most (Tau-UME = 0.10) and the MY condition was the most effective in preventing negative affective responses. Although mantra meditation on its own negatively influenced daily affect, it can be assumed as the driving force behind the improvement in the other variables. This points to the central role of meditation in increasing interoception, self-awareness, and embodied processing.
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Affiliation(s)
- Karin Matko
- Institute of Psychology, Chemnitz University of Technology, 09120 Chemnitz, Germany
| | - Peter Sedlmeier
- Institute of Psychology, Chemnitz University of Technology, 09120 Chemnitz, Germany
| | - Holger C Bringmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Psychiatry and Psychotherapy, Krankenhaus Spremberg, 03130 Spremberg, Germany
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A preliminary investigation of yoga as an intervention approach for improving long-term weight loss: A randomized trial. PLoS One 2022; 17:e0263405. [PMID: 35120162 PMCID: PMC8815874 DOI: 10.1371/journal.pone.0263405] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/10/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Yoga targets psychological processes which may be important for long-term weight loss (WL). This study is the first to examine the feasibility, acceptability, and preliminary efficacy of yoga within a weight management program following WL treatment. METHODS 60 women with overweight or obesity (34.3±3.9 kg/m2, 48.1±10.1 years) were randomized to receive a 12-week yoga intervention (2x/week; YOGA) or a structurally equivalent control (cooking/nutrition classes; CON), following a 3-month behavioral WL program. Feasibility (attendance, adherence, retention) and acceptability (program satisfaction ratings) were assessed. Treatment groups were compared on weight change, mindfulness, distress tolerance, stress, affect, and self-compassion at 6 months. Initial WL (3-mo WL) was evaluated as a potential moderator. RESULTS Attendance, retention, and program satisfaction ratings of yoga were high. Treatment groups did not differ on WL or psychological constructs (with exception of one mindfulness subscale) at 6 months. However, among those with high initial WL (≥5%), YOGA lost significantly more weight (-9.0kg vs. -6.7kg) at 6 months and resulted in greater distress tolerance, mindfulness, and self-compassion and lower negative affect, compared to CON. CONCLUSIONS Study findings provide preliminary support for yoga as a potential strategy for improving long-term WL among those losing ≥5% in standard behavioral treatment.
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Vahabi M, Pui-Hing Wong J, Moosapoor M, Akbarian A, Fung K. Effects of Acceptance and Commitment Therapy (ACT) on Mental Health and Resiliency of Migrant Live-in Caregivers in Canada: Pilot Randomized Wait List Controlled Trial. JMIR Form Res 2022; 6:e32136. [PMID: 35084337 PMCID: PMC9090443 DOI: 10.2196/32136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background
Temporary migrant live-in caregivers constitute a vulnerable stream of temporary foreign workers in Canada. This is because the majority are racialized women from the Global South, the gendered nature of caregiving work has historically been undervalued, and their working and living spheres are intertwined which makes application of labor laws and surveillance almost impossible. Their invisible position in the fabric of Canadian society along with their precarious employment and immigration status place their mental health at jeopardy. There is a paucity of research about psychological support for this population.
Objective
Our pilot study Women Empowerment—Caregiver Acceptance and Resilience E-Learning (WE2CARE) aimed to assess the efficacy of a 6-week online delivery of a psychological intervention based on acceptance and commitment therapy (ACT) in reducing psychological distress and promoting resiliency among live-in care givers in the Greater Toronto Area.
Methods
A pilot randomized wait list controlled design was used. Participants were recruited by two community peer champions working with community health organizations serving migrant live-in caregivers. A total of 36 participants were recruited and randomly assigned to the intervention and wait list control groups; 7 dropped out of the study due to competing life priorities. Standardized self-reported surveys were administered online pre-, post-, and 6-week postintervention to assess mental distress (DASS-21), psychological flexibility (AAQ-2), mindfulness (CAMS-R), and Multi-System Model of Resilience (MSMR-I). Independent and dependent t tests were used to compare study outcomes at pre, post, and 6-week follow-up across and within both arms of the study. Linear mixed effects models were created for each outcome of interest from baseline to postintervention among intervention and control participants. Self-reported impact of the WE2CARE intervention was examined using independent t tests across the study arms.
Results
Average age of participants was 38 years. Many were born in the Philippines (23/29, 79%). The data on the impact of the psychological intervention showed a lower level of depression, anxiety, and stress among the intervention group compared with the control. However, the differences were not significant due to small sample size and COVID-19 crisis (6.94 vs 9.50, P=.54; 6.94 vs 10.83, P=.20; 7.76 vs 10.33, P=.44, respectively). There was a significant improvement in mindful qualities and external resilience, particularly in life satisfaction and accessible support among the intervention group (37.18 vs 32.92, t22=2.35, P=.03; 20.29 vs 16.5, t21=2.98, P=.007; 8.47 vs 6.75, t14=2.41, P=.03; 7.59 vs 5.33, t16=.008, respectively).
Conclusions
WE2CARE is among the first studies exploring the efficacy of online delivery of ACT in addressing mental health challenges among live-in caregivers. While there are increased web-based ACT interventions, few use group videoconferencing to promote peer connection and mutual support. WE2CARE showed promising results in reducing psychological distress and promoting mindfulness and resiliency. The intervention highly motivated participants to engage collectively in building social support networks.
International Registered Report Identifier (IRRID)
RR2-10.2196/preprints.31211
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Affiliation(s)
- Mandana Vahabi
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | | | - Masoomeh Moosapoor
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Abdolreza Akbarian
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Kenneth Fung
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Anxiety Sensitivity and Distress Tolerance Predict Changes in Internalizing Symptoms in Individuals Exposed to Interpersonal Trauma. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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6
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Lang AJ, Malaktaris A, Maluf KS, Kangas J, Sindel S, Herbert M, Bomyea J, Simmons AN, Weaver J, Velez D, Liu L. A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery. Contemp Clin Trials Commun 2021; 21:100719. [PMID: 33604485 PMCID: PMC7875811 DOI: 10.1016/j.conctc.2021.100719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/07/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Posttraumatic stress disorder (PTSD) is a chronic, disabling, and prevalent mental health disorder among Veterans. Despite the availability of empirically supported psychotherapies, many Veterans remain symptomatic after treatment and/or prefer to seek complementary and integrative health approaches, including yoga, to manage PTSD. The randomized controlled trial (RCT) described herein will evaluate the efficacy of a manualized yoga program as compared to nonaerobic exercise in reducing PTSD severity among Veterans. A secondary aim of this study is to better understand the mechanisms of change. METHODS Veterans (N = 192) with PTSD will be randomized to hatha yoga or nonaerobic physical activity control; both groups consist of 12 weekly, 60-min group or online training sessions with 15-20 min of daily at-home practice. Outcome measures will be administered at baseline, mid-treatment, posttreatment, and 12-week follow-up. PROJECTED OUTCOMES This study will evaluate changes in PTSD severity (primary outcome) as well as depression, anxiety, anger, sleep problems, and psychosocial disability (secondary outcomes). We will also use multiple mediation to examine two potential models of the mechanisms of clinical effect: the Attention Model (i.e., yoga increases attentional control, which reduces PTSD symptoms), the Coping Model (i.e., yoga increases distress tolerance, which improves coping, which reduces PTSD symptoms), and the combination of these models. This aspect of the study is innovative and important given the absence of an existing, comprehensive model for understanding yoga's impact on PTSD. Ultimately, we hope to develop guidelines for application of yoga to PTSD recovery.
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Affiliation(s)
- Ariel J. Lang
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Departments of Psychiatry and Family Medicine and Public Health, 3350 La Jolla Village Dr. (MC 111N1), San Diego, CA, 92161, USA
| | - Anne Malaktaris
- VA San Diego Healthcare System/Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA
| | - Katrina S. Maluf
- San Diego State University, School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Julie Kangas
- VA San Diego Healthcare System, UCSD Department of Psychiatry, 8810 Rio San Diego Dr., San Diego, CA, 92108, USA
| | - Selin Sindel
- University of California San Diego, Department of Cognitive Science, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Matthew Herbert
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Jessica Bomyea
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Alan N. Simmons
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Judy Weaver
- Connected Warriors, 4950 Communication Ave, Ste 115, Boca Raton, FL, 33431, USA
| | - Deborah Velez
- Veteran's Medical Research Foundation, 3350 La Jolla Village Dr, San Diego, CA, 92037, USA
| | - Lin Liu
- VA San Diego Healthcare System, UCSD Department of Preventive Medicine and Public Health, 9500 Gilman Dr., MC0725, La Jolla, CA, 92093-0725, USA
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7
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Lewis EM, Jeffries ER, Zvolensky MJ, Buckner JD. Anxiety Sensitivity Among Smokers During a Reduction Attempt: The Impact of Hatha Yoga. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Nyer M, Hopkins LB, Farabaugh A, Nauphal M, Parkin S, McKee MM, Miller KK, Streeter C, Uebelacker LA, Fava M, Alpert JE, Pedrelli P, Mischoulon D. Community-Delivered Heated Hatha Yoga as a Treatment for Depressive Symptoms: An Uncontrolled Pilot Study. J Altern Complement Med 2019; 25:814-823. [PMID: 31290694 DOI: 10.1089/acm.2018.0365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objectives: There are no known studies of concurrent exposure to high temperature and yoga for the treatment of depression. This study explored acceptability and feasibility of heated (Bikram) yoga as a treatment for individuals with depressive symptoms. Design: An 8-week, open-label pilot study of heated yoga for depressive symptoms. Subjects: 28 medically healthy adults (71.4% female, mean age 36 [standard deviation 13.57]) with at least mild depressive symptoms (Hamilton Rating Scale for Depression [HRSD-17] score ≥10) who attended at least one yoga class and subsequent assessment visit. Intervention: Participants were asked to attend at least twice weekly community held Bikram Yoga classes. Assessments were performed at screening and weeks 1, 3, 5, and 8. Hypotheses were tested using a modified-intent-to-treat approach, including participants who attended at least one yoga class and subsequent assessment visit (N = 28). Results: Almost half of our subjects completed the 8-week intervention, and close to a third attended three quarters or more of the prescribed 16 classes over 8 weeks. Multilevel modeling revealed significant improvements over time in both clinician-rated HRSD-17 (p = 0.003; dGLMM = 1.43) and self-reported Beck Depression Inventory (BDI; p < 0.001, dGLMM = 1.31) depressive symptoms, as well as the four secondary outcomes: hopelessness (p = 0.024, dGLMM = 0.57), anxiety (p < 0.001, dGLMM = 0.78), cognitive/physical functioning (p < 0.001, dGLMM = 1.34), and quality of life (p = 0.007, dGLMM = 1.29). Of 23 participants with data through week 3 or later, 12 (52.2%) were treatment responders (≥50% reduction in HRSD-17 score), and 13 (56.5%) attained remission (HRSD score ≤7). More frequent attendance was significantly associated with improvement in self-rated depression symptoms, hopelessness, and quality of life. Conclusions: The acceptability and feasibility of heated yoga in this particular sample with this protocol warrants further attention. The heated yoga was associated with reduced depressive symptoms, and other improved related mental health symptoms, including anxiety, hopelessness, and quality of life.
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Affiliation(s)
- Maren Nyer
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA.,2Harvard Medical School, Boston, MA
| | - Lindsey B Hopkins
- 3Department of Psychiatry, University of California, San Francisco, San Francisco, CA.,4Addiction Research Program, San Francisco VA Health Care System, San Francisco, CA
| | - Amy Farabaugh
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA.,2Harvard Medical School, Boston, MA
| | - Maya Nauphal
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Susannah Parkin
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Madison M McKee
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Karen K Miller
- 2Harvard Medical School, Boston, MA.,5Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA
| | - Chris Streeter
- 2Harvard Medical School, Boston, MA.,6Department of Psychiatry and Neurology, Boston University School of Medicine, Boston, MA.,7Department of Psychiatry, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA
| | - Lisa A Uebelacker
- 8Alpert Medical School, Brown University, Providence, RI.,9Butler Hospital, Providence, RI
| | - Maurizio Fava
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA.,2Harvard Medical School, Boston, MA
| | - Jonathan E Alpert
- 10Albert Einstein College of Medicine, Bronx, NY.,11Montefiore Health System, Bronx, NY
| | - Paola Pedrelli
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA.,2Harvard Medical School, Boston, MA
| | - David Mischoulon
- 1Depression Clinical and Research Program (DCRP), Department of Psychiatry, Massachusetts General Hospital, Boston, MA.,2Harvard Medical School, Boston, MA
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9
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Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS. Predictors of and barriers to adherence in a 16-week randomised controlled trial of Bikram yoga in stressed and sedentary adults. Complement Ther Med 2018; 42:374-380. [PMID: 30670270 DOI: 10.1016/j.ctim.2018.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bikram yoga may enhance health outcomes in healthy adults and those at risk for chronic disease, however, challenges remain in achieving optimal adherence to this practice. This study investigated factors influencing adherence to a 16-week Bikram yoga intervention in stressed and sedentary adults. METHODS Experimental group participants (n = 29) were instructed to attend 3-5 Bikram yoga classes weekly for 16 weeks. Baseline demographics, behaviours and health measures were investigated as predictors of adherence. Barriers were assessed via documentation of adverse events, and exit survey responses. RESULTS Participants (38.2 ± 10.1 years) were predominantly overweight-obese (83%), female (79%), and attended 27 ± 18 classes. Higher adherence was associated with older age (p = 0.094), less pain (p = 0.011), fewer physical limitations (p = 0.011), poorer blood lipid profile, and higher heart rate variability (HRV; total power, (p = 0.097)). In multi-variable analysis, three variables: age (β = 0.492, p = 0.006), HRV (β = 0.413, p = 0.021) and pain (β = 0.329, p = 0.048) remained predictors of adherence. Difficulty committing to the trial, lack of enjoyment and adverse events were barriers to adherence. CONCLUSIONS These findings should be considered in the development of future Bikram yoga trials to facilitate higher levels of adherence, which may enhance health outcomes and inform community practice. Future trials should investigate and address additional barriers and facilitators of Bikram yoga practice.
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Affiliation(s)
- Zoe L Hewett
- School of Science and Health, Western Sydney University, Penrith, New South Wales, 2751, Australia.
| | - Kate L Pumpa
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, 2617, Australia.
| | - Caroline A Smith
- National Institute of Complementary Medicine, Western Sydney University, Penrith, New South Wales, 2751, Australia.
| | - Paul P Fahey
- School of Science and Health, Western Sydney University, Penrith, New South Wales, 2751, Australia.
| | - Birinder S Cheema
- School of Science and Health, Western Sydney University, Penrith, New South Wales, 2751, Australia; National Institute of Complementary Medicine, Western Sydney University, Penrith, New South Wales, 2751, Australia.
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Jacquart J, Dutcher CD, Freeman SZ, Stein AT, Dinh M, Carl E, Smits JAJ. The effects of exercise on transdiagnostic treatment targets: A meta-analytic review. Behav Res Ther 2018; 115:19-37. [PMID: 30473437 DOI: 10.1016/j.brat.2018.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The present study meta-analytically reviewed the effects of exercise on four transdiagnostic treatment targets: anxiety sensitivity (AS), distress tolerance (DT), stress reactivity (SR), and general self-efficacy (GSE). METHODS We conducted systematic searches of peer-reviewed studies in bibliographical databases (Cochrane Library, psychINFO, PubMed) before April 1, 2018. Only randomized controlled trials (RCT) evaluating the effect of exercise on AS, DT, SR, or GSE using at least one validated outcome instrument in a sample of adolescents (≥13 years old) or adults were selected. We employed a meta-analysis of effects using random-effects pooling modeling for each treatment target. RESULTS The systematic search yielded 28 RCTs meeting eligibility criteria. Exercise interventions had a large effect on reducing AS (six studies, Hedges's g = 0.72, p = .001), a medium effect on increasing GSE (eight studies, Hedges's g = 0.59, p < .001), and a small effect on reducing SR (ten studies, Hedges's g = 0.32, p < .001). Evidence from four studies suggested that exercise interventions had a small but non-significant effect on increasing DT (Hedges's g = 0.21, p = .26). CONCLUSIONS This meta-analysis provides preliminary evidence exercise can engage certain transdiagnostic targets. Further research is required to optimize exercise intervention parameters to achieve the strongest effects on these important mechanistic variables.
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Affiliation(s)
- Jolene Jacquart
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA.
| | - Christina D Dutcher
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Slaton Z Freeman
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Aliza T Stein
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Mike Dinh
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Emily Carl
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Jasper A J Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
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Otto J, Linden M. Reduction of Distress Intolerance With Salutotherapeutic Interventions: Results From a Randomized Controlled Clinical Trial. CHRONIC STRESS 2018; 2:2470547018800484. [PMID: 32440585 PMCID: PMC7219888 DOI: 10.1177/2470547018800484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/21/2018] [Indexed: 11/17/2022]
Abstract
Background Distress tolerance is the ability to pursue one’s goals in the presence of
(chronic) stressors, hardship, adversities and negative internal states, and
psychological distress. By contrast, distress intolerance is a
transdiagnostic indicator of mental illness and a mediator in coping with
problems in life, work demands, or stress in general. There is a lack of
data regarding intervention strategies. The objective of the present study
is to test the differential effects of two treatment approaches:
“regeneration fostering” versus “resistance training.” Methods Inpatients of a psychosomatic hospital were randomly allocated to either a
resistance training group therapy (n = 65)—that is, active
coping with demands and endurance—or a regeneration fostering group therapy
(n = 62)—that is, recovery, mindful indulgence, and
creative activities. They were compared with a group of patients who
received treatment as usual (n = 43), without special
treatments for distress intolerance, and the outcome was measured with the
“Distress Intolerance Scale.” One-way and repeated measure analyses of
variance and paired t tests were used for the analysis. Results The “regeneration” group showed a significant improvement in distress
intolerance, whereas there was no significant change for the
treatment-as-usual group and in the “resistance” group. Post hoc tests were
conducted with paired sample t tests for pre–post
comparisons for each group. No differences were found for the
treatment-as-usual group (mean difference: 0.03,
SD (mean difference): 0.89;
t(42) = 0.266, p = 0.792,
d = 0.04) and for the resistance group (mean
difference:−0.07, SD (mean difference): 0.73;
t(63) = −0.736, p = 0.464,
d = 0.08). The regeneration group showed a significant
decline in distress intolerance (mean difference: 0.29,
SD (mean difference): 0.72;
t(61) = 3.156, p = 0.002,
d = 0.38). Conclusions In the treatment of distress intolerance, it seems promising to focus on
positive psychology interventions and resources. Limitations of the study
are that it was conducted with psychosomatic inpatients only and that no
follow-up data are available.
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Affiliation(s)
- Josephine Otto
- Research Group Psychosomatic Rehabilitation, Charié University Medicine, Berlin, Germany
| | - Michael Linden
- Research Group Psychosomatic Rehabilitation, Charié University Medicine, Berlin, Germany
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Finkelstein-Fox L, Park CL, Riley KE. Mindfulness and emotion regulation: promoting well-being during the transition to college. ANXIETY STRESS AND COPING 2018; 31:639-653. [PMID: 30189751 DOI: 10.1080/10615806.2018.1518635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Managing stress is very important for first-year college students adjusting to undergraduate life. Aspects of emotion regulation, including mindfulness and the ability to regulate distressing emotion adaptively, often correlate positively with well-being. However, little research has examined overlapping and/or distinct effects of these constructs in predicting changes in adjustment over a stressful transition. Thus, the present study examined the contributions of mindfulness and adaptive emotion regulation abilities in maintaining well-being during the transition to college. We further examined experience with mind-body practices, which may promote mindfulness and positive adjustment. DESIGN Online surveys were administered to 158 undergraduates near the beginning and end of their first semester. METHODS Near semester start and end, students reported levels of mindfulness, adaptive emotion regulation abilities, emotional and spiritual well-being, and experience with mind-body practices. RESULTS Compared to mindfulness, adaptive emotion regulation abilities largely demonstrated stronger cross-sectional and longitudinal associations with well-being. However, mindfulness uniquely protected against changes in depression for students with greater emotion regulation difficulties. Over half of participants reported having tried mind-body practices, but just 1% reported current use. CONCLUSIONS Promoting mindfulness practices and adaptive emotion regulation abilities at the start of college may build resilience in undergraduate students.
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Affiliation(s)
- Lucy Finkelstein-Fox
- a Department of Psychological Sciences , University of Connecticut , Storrs , CT , USA
| | - Crystal L Park
- a Department of Psychological Sciences , University of Connecticut , Storrs , CT , USA
| | - Kristen E Riley
- a Department of Psychological Sciences , University of Connecticut , Storrs , CT , USA.,b Department of Psychiatry and Behavioral Sciences , Memorial Sloan Kettering Cancer Center , New York , NY , USA
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Watts AW, Rydell SA, Eisenberg ME, Laska MN, Neumark-Sztainer D. Yoga's potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study. Int J Behav Nutr Phys Act 2018; 15:42. [PMID: 29720214 PMCID: PMC5932774 DOI: 10.1186/s12966-018-0674-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Background A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults. Methods The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga’s perceived influence on eating and activity behaviors among interview participants. Results Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle. Conclusions Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.
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Affiliation(s)
- Allison W Watts
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA.
| | - Sarah A Rydell
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA
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Nyer M, Nauphal M, Roberg R, Streeter C. Applications of Yoga in Psychiatry: What We Know. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2018; 16:12-18. [PMID: 31975895 PMCID: PMC6519580 DOI: 10.1176/appi.focus.20170055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Yoga has been in use for thousands of years in the East as a healing modality. Western practitioners are now starting to recognize the potential of yoga-based treatments. The purpose of this article is to explore the evidence-base of yoga-based treatments for depression and anxiety with the purpose of furthering the integration of yoga into conventional Western mental health treatment plans.
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Affiliation(s)
- Maren Nyer
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
| | - Maya Nauphal
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
| | - Regina Roberg
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
| | - Chris Streeter
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
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How Is the Practice of Yoga Related to Weight Status? Population-Based Findings From Project EAT-IV. J Phys Act Health 2017; 14:905-912. [PMID: 28682698 DOI: 10.1123/jpah.2016-0608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Yoga may provide a strategy for healthy weight management in young adults. This study examined prevalence and characteristics of young adults' yoga practice and associations with changes in body mass index. METHODS Surveys were completed by 1830 young adults (31.1 ± 1.6 y) participating in Project EAT-IV. Cross-sectional and 5-year longitudinal analyses were conducted stratified by initial weight status. RESULTS Two-thirds (66.5%) of nonoverweight women and 48.9% of overweight women reported ever doing yoga, while 27.2% of nonoverweight women and 16.4% of overweight women practiced regularly (≥30 min/wk). Fewer men practiced yoga. Among young adults practicing regularly (n = 294), differences were identified in intensity, type, and location of yoga practice across weight status. Young adults who were overweight and practiced yoga regularly showed a nonsignificant 5-year decrease in their body mass index (-0.60 kg/m2; P = .49), whereas those not practicing regularly had significant increases in their body mass index (+1.37 kg/m2; P < .01). Frequency of yoga was inversely associated with weight gain among both overweight and nonoverweight young adults practicing yoga regularly. CONCLUSIONS Young adults of different body sizes practice yoga. Yoga was associated with less weight gain over time, particularly in overweight young adults. Practicing yoga on a regular basis may help with weight gain prevention.
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Banducci AN, Connolly KM, Vujanovic AA, Alvarez J, Bonn-Miller MO. The impact of changes in distress tolerance on PTSD symptom severity post-treatment among veterans in residential trauma treatment. J Anxiety Disord 2017; 47:99-105. [PMID: 28109673 DOI: 10.1016/j.janxdis.2017.01.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/17/2016] [Accepted: 01/05/2017] [Indexed: 12/01/2022]
Abstract
Given that rates of PTSD, particularly among military populations, are increasing, it is critical to gain a better understanding of factors associated with treatment response. Low distress tolerance (DT), conceptualized as the perceived or actual inability to tolerate negative emotional states, may impacts veterans' responses to PTSD treatment. Low DT has been associated with more severe PTSD symptoms in clinical and non-clinical samples; however, its impact on PTSD symptomatology across treatment has yet to be assessed. We examined the impact of changes in DT, from intake to discharge, on post-treatment PTSD symptom severity within two samples of veterans recruited from Veterans Affairs residential PTSD treatment facilities in the northwestern and southern United States (Total N=86; 87% male; 46% White, 39% Black, 9% Latino, 6% Other). Veterans completed the Distress Tolerance Scale and PTSD Checklist (PCL) at intake and discharge from residential PTSD treatment. Regression analyses revealed that, within each veteran sample, those with the greatest improvements in DT had the lowest PCL total and subscale scores at discharge after controlling for respective intake PCL scores. This suggests increases in DT across treatment help explain the degree of benefits experienced by veterans following PTSD treatment.
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Affiliation(s)
- Anne N Banducci
- National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (NC-PTSD 324), Menlo Park, CA 94025, United States; Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States; G.V. (Sonny) Montgomery Veterans Affairs Medical Center, 1500 E Woodrow Wilson Ave, Jackson, MS 39216, United States; University of Mississippi Medical Center. 2500 N State St. Jackson, MS 39216, United States.
| | - Kevin M Connolly
- G.V. (Sonny) Montgomery Veterans Affairs Medical Center, 1500 E Woodrow Wilson Ave, Jackson, MS 39216, United States; University of Mississippi Medical Center. 2500 N State St. Jackson, MS 39216, United States
| | - Anka A Vujanovic
- University of Houston, Department of Psychology, 3695 Cullen Bouleva rd, Houston, TX 772014, United States
| | - Jennifer Alvarez
- VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025, United States
| | - Marcel O Bonn-Miller
- National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (NC-PTSD 324), Menlo Park, CA 94025, United States; Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road(152-MPD), Menlo Park, CA 94025, United States; Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3440 Market St, Suite 370, Philadelphia, PA 19104, United States
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Field T. Yoga research review. Complement Ther Clin Pract 2016; 24:145-61. [PMID: 27502816 DOI: 10.1016/j.ctcp.2016.06.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 06/15/2016] [Indexed: 12/12/2022]
Abstract
This paper is a review of empirical studies, review and meta-analysis publications on yoga from the last few years. The review includes demographics/prevalence of yoga as a practice, bibliometric analyses of the yoga publications and the use of yoga for physical fitness and cognitive function. Most of the studies reviewed here involve yoga effects on psychiatric and medical conditions. These include pregnancy, prenatal and postpartum depression; stress, PTSD, anxiety, and obesity; cardiovascular conditions including hypertension; pain syndromes including arthritis, headaches and low back pain; autoimmune conditions including asthma, type II diabetes and multiple sclerosis; immune conditions including HIV and breast cancer; and aging problems including balance, osteoporosis and Parkinson's. The methods and results of those studies are briefly summarized along with their limitations and suggestions for future research. Basically yoga has been more effective than control and waitlist control conditions, although not always more effective than treatment comparison groups such as other forms of exercise. More randomized controlled studies are needed in which yoga is compared to active exercise groups. Having established the physical and mental health benefits of yoga makes it ethically questionable to assign participants to inactive control groups. Shorter sessions should be investigated for cost-effectiveness and for daily practice. Multiple physical and physiological measures need to be added to the self-report research protocols and potential underlying mechanisms need to be further explored. In the interim, the studies reviewed here highlight the therapeutic effects of yoga, a practice that could come to be called yoga therapy.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami, Miller School of Medicine, United States; Fielding Graduate University, United States.
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Powers MB, Asmundson GJG, Smits JAJ. Exercise for Mood and Anxiety Disorders: The State-of-the Science. Cogn Behav Ther 2015; 44:237-9. [PMID: 26057087 PMCID: PMC4545646 DOI: 10.1080/16506073.2015.1047286] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mark B Powers
- a Department of Psychology & Institute for Mental Health Research , The University of Texas at Austin , Austin , TX , USA
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