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Higgins KE, Vinson AE, Petrini L, Kotha R, Black SA. Embracing Failure: Nurturing Learning and Well-Being in Anesthesiology and Perioperative Medicine. Int Anesthesiol Clin 2024; 62:15-25. [PMID: 38785110 DOI: 10.1097/aia.0000000000000444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Failure, ubiquitous in life and medical practice, offers myriad opportunities for learning and growth alongside challenges to overall well-being. In this article, we explore the nature of failure, it's sources and impacts in perioperative medicine, and the specific challenges it brings to trainee well-being. With a deeper understanding of the societal, psychological and cognitive determinants and effects of failure, we propose solutions in order to harness the opportunities inherent in failures to create brave and supportive learning environments conducive to both education and well-being.
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Affiliation(s)
- K Elliott Higgins
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles
| | - Amy E Vinson
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA
| | - Laura Petrini
- Department of Anesthesiology, University of Pennsylvania Perelman, School of Medicine
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia
| | - Rohini Kotha
- Department of Anesthesiology and Oncologic Sciences, Morsani College of Medicine, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida
| | - Stephanie A Black
- Perelman School of Medicine, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Aepfelbacher J, Panny B, Price RB. Experiences of Awe Mediate Ketamine's Antidepressant Effects: Findings From a Randomized Controlled Trial in Treatment-Resistant Depression. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100316. [PMID: 38726038 PMCID: PMC11078768 DOI: 10.1016/j.bpsgos.2024.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/12/2024] [Accepted: 04/01/2024] [Indexed: 05/12/2024] Open
Abstract
Background Ketamine, an NMDA receptor antagonist, provides rapid antidepressant effects. Although much research has focused on neural and molecular mechanisms of action, it is critical to also consider psychological mechanisms that may contribute to its therapeutic efficacy. The construct of an awe-inducing experience, which is a well-validated psychological phenomenon tied to emotional well-being, had not been applied previously in ketamine research. Methods One hundred sixteen participants with depression, 77 of whom received a ketamine infusion (0.5 mg/kg over 40 minutes) and 39 patients who received saline placebo, completed a validated measure of awe (the Awe Experience Scale [AWE-S]) at 40 minutes postinfusion. AWE-S scores were examined as potential mediators of depression outcomes (% improvement in Montgomery-Åsberg Depression Rating Scale score) at 5 postinfusion time points (24 hours and 5, 12, 21, and 30 days). Dissociative effects, measured by Clinician-Administered Dissociative States Scale scores, were tested in parallel mediation models for comparison. Results We found that the psychological experience of awe was strongly reported by participants during ketamine infusion, but not saline infusion, and there were significant associations between total AWE-S scores and Montgomery-Åsberg Depression Rating Scale score improvement (% change) in the ketamine arm at all 5 time points. Furthermore, at all 5 time points, total AWE-S scores statistically mediated the relationship between ketamine and Montgomery-Åsberg Depression Rating Scale scores. By contrast, Clinician-Administered Dissociative States Scale scores did not mediate outcomes at any time point. Conclusions Ketamine infusion strongly induced heightened feelings of awe, and these experiences consistently mediated depression outcomes over a 1- to 30-day period, unlike general dissociative side effects. The specific awe-inspiring properties of ketamine may contribute to its antidepressant effects.
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Affiliation(s)
| | - Benjamin Panny
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rebecca B. Price
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Wiederhold BK. Virtual Awe: Expanding the Horizons of Mental Health Treatment. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024. [PMID: 38916069 DOI: 10.1089/cyber.2024.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
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Chirico A, Borghesi F, Yaden DB, Pizzolante M, Sarcinella ED, Cipresso P, Gaggioli A. Unveiling the underlying structure of awe in virtual reality and in autobiographical recall: an exploratory study. Sci Rep 2024; 14:12474. [PMID: 38816477 PMCID: PMC11139977 DOI: 10.1038/s41598-024-62654-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 05/20/2024] [Indexed: 06/01/2024] Open
Abstract
Over the last two decades, awe has attracted the attention of an increasing number of researchers. The use of virtual reality has been identified as one of the most effective techniques for eliciting awe, in addition to more personalized methods for inducing emotion, such as autobiographical recall. However, previous measures of awe were unable to uncover the hidden structure of this experience. Awe experience scale (AWE-S) has been validated as a comprehensive measure of contingent awe in English, providing new opportunities for analysis. In this two-phases study, we investigated whether the latent structure of the experience of awe evoked by the autobiographical recall technique (Study 1) overlapped with that induced by exposing participants to a validated virtual reality awe-eliciting training (Study 2). The original English AWE-S structure held both in autobiographical recall induction and virtual reality-based elicitation. Despite evidence of overlap between English and Italian structures, low correlations were found between Italian trait measures used to test the concurrent validity of the AWE-S in the Italian sample and AWE-S state dimensions. This study highlights cultural differences in awe experience, trait, and state variations, and provides new insights into the standardized induction of this emotion through simulated environments.
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Affiliation(s)
- Alice Chirico
- Department of Psychology, Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesca Borghesi
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy.
| | - David B Yaden
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marta Pizzolante
- Department of Psychology, Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Eleonora Diletta Sarcinella
- Department of Psychology, Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Pietro Cipresso
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Andrea Gaggioli
- Department of Psychology, Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Istituto Auxologico Italiano, Milan, Italy
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Berkowitz DE, Sherrer DM, Vetter TR. Recognizing the Awe in Anesthesia. Anesth Analg 2024:00000539-990000000-00818. [PMID: 38728225 DOI: 10.1213/ane.0000000000007050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Dan E Berkowitz
- From the Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - D Matthew Sherrer
- From the Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Thomas R Vetter
- From the Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama Birmingham, Birmingham, Alabama
- Department of Surgery and Perioperative Care, Dell Medical School at The University of Texas at Austin, Austin, Texas
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Edwards ME, Helm PJ, Pratscher S, Bettencourt BA, Arndt J. The Impact of Awe on Existential Isolation: Evidence for Contrasting Pathways. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2024; 50:715-732. [PMID: 36631933 DOI: 10.1177/01461672221144597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
We propose that awe has multifaceted relations with existential isolation, a feeling of separation between the self and others or the world. Three studies examined the relation between awe and existential isolation via feelings of small self (vastness, self-size, self-perspectives) and a sense of connectedness. Awe (vs. a control topic) was induced either using virtual reality (Study 1) or a recall task (Studies 2 and 3) and was indirectly associated with higher and lower levels of existential isolation through differing pathways. Awe was associated with lower feelings of existential isolation via an increased sense of vastness, which in turn predicted greater connectedness; whereas awe was associated with higher feelings of existential isolation via increased sense of feeling small, which in turn predicted lower connectedness. This work advances understanding of the complex nature of awe-revealing its competing effects on the self and the social connectedness pathways through which awe can influence existential isolation.
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Lowe MX, Kettner H, Jolly DRP, Carhart-Harris RL, Jackson H. Long-term benefits to psychological health and well-being after ceremonial use of Ayahuasca in Middle Eastern and North African immigrants and refugees. Front Psychiatry 2024; 15:1279887. [PMID: 38666090 PMCID: PMC11044680 DOI: 10.3389/fpsyt.2024.1279887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
Background Refugees and immigrants can experience complex stressors from the process of immigration that can have lasting and severe long-term mental health consequences. Experiences after ayahuasca ingestion are shown to produce positive effects on psychological wellbeing and mental health, including anecdotal reports of improved symptoms of trauma and related disorders. However, data on the longitudinal health impact of naturalistic ayahuasca use in Middle Eastern and North African (MENA) immigrant and refugee populations is limited. Aims The current longitudinal online survey study was conducted to gather prospective data on ceremonial ayahuasca use in a group (N = 15) of primarily female MENA immigrants and refugees and to provide further insight into the patterns and outcomes surrounding that use. The study sought to assess self-reported changes in physical and mental health, well-being, and psychological functioning, examine relationships between aspects of individual mindset (e.g., psychedelic preparedness) prior to ayahuasca use and observed outcomes during (e.g., subjective drug effects) and afterwards (i.e., persisting effects), characterize risks and negative experiences, and describe trauma exposure and personal history. Results/Outcomes Our findings revealed ceremonial use of ayahuasca is associated with significant improvements in mental health, well-being, and psychological functioning, including reductions in depression, anxiety, and shame, and increases in cognitive reappraisal and self-compassion. Most participants reported no lasting adverse effects and experienced notable positive behavioral changes persisting months after ingestion. Conclusion/Interpretation While preliminary, results suggest naturalistic ayahuasca use might hold therapeutic potential for MENA populations exposed to trauma prior to and during the process of migration.
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Affiliation(s)
| | - Hannes Kettner
- Psychedelics Division, Neuroscape, University of California, San Francisco, San Francisco, CA, United States
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | | | - Robin L. Carhart-Harris
- Psychedelics Division, Neuroscape, University of California, San Francisco, San Francisco, CA, United States
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
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Pham TP, Sanocki T. Human Attention Restoration, Flow, and Creativity: A Conceptual Integration. J Imaging 2024; 10:83. [PMID: 38667981 PMCID: PMC11050943 DOI: 10.3390/jimaging10040083] [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: 02/07/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
In today's fast paced, attention-demanding society, executive functions and attentional resources are often taxed. Individuals need ways to sustain and restore these resources. We first review the concepts of attention and restoration, as instantiated in Attention Restoration Theory (ART). ART emphasizes the role of nature in restoring attention. We then discuss the essentials of experiments on the causal influences of nature. Next, we expand the concept of ART to include modern, designed environments. We outline a wider perspective termed attentional ecology, in which attention behavior is viewed within a larger system involving the human and their interactions with environmental demands over time. When the ecology is optimal, mental functioning can be a positive "flow" that is productive, sustainable for the individual, and sometimes creative.
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Affiliation(s)
- Teresa P. Pham
- Department of Psychology, University of South Florida, St. Petersburg, FL 33701, USA;
| | - Thomas Sanocki
- Department of Psychology, University of South Florida, Tampa, FL 33620, USA
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Bhatia A. Surfing stress: A practical and paradigm changing approach to improving personal resilience. Future Healthc J 2024; 11:100022. [PMID: 38646056 PMCID: PMC11025055 DOI: 10.1016/j.fhj.2024.100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Affiliation(s)
- Ashish Bhatia
- Three Shires Medical Centre, Bristol, UK
- University of Bristol, Bristol, UK
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Ramakrishnan P, Brod TM, Lowder T, Padala PR. Psychiatrists' Illustration of Awe in Empathic Listening Assessments: A Pilot Study. Cureus 2024; 16:e55684. [PMID: 38586691 PMCID: PMC10997879 DOI: 10.7759/cureus.55684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Background "Awe" is typically an inspiring emotional response to perceptually vast stimuli signifying the transcendence beyond all cognitive frames of reference when we encounter the unexpected. Physicians' experience of awe in clinical care interactions has not been studied in an empirical, evidence-based way. We aim to present a focused study of awe in a psychiatrist's empathic listening (EL) assessments and propose an evidence-based framework to study it. Methodology This is an exploratory case series of a psychiatrist's EL interactions (mean duration/x̄ of 46.17 minutes) with six patients (two males and four females) aged 32-72 years (x̄ =54.67, σ = 16.64). Using the method of autoethnography, the verbal and nonverbal aspects of the EL assessments were analyzed and open-coded to generate qualitative data. Results The study revealed that the data in all the case studies could be classed into two thematic groups, namely, mindfulness and transpersonal mindfulness. The emotions of "awe" and "non-agency" were ubiquitous in all six case studies both for the psychiatrist and patients. Conclusions Recognizing the awe and non-agency in EL interaction is essential in conceptualizing the "mindfulness-to-transcendence" framework and the first step toward the evidence-based study of transcendence/metaphysics in phenomenological psychiatry.
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Affiliation(s)
- Parameshwaran Ramakrishnan
- Psychiatry, Baptist Health-University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Theology, Ethics, and Natural Sciences, Graduate Theological Union-University of California at Berkeley, Berkeley, USA
| | - Thomas M Brod
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Thomas Lowder
- Graduate Medical Education, Baptist Health-University of Arkansas for Medical Sciences, Little Rock, USA
| | - Prasad R Padala
- Psychiatry, Baptist Health-University of Arkansas for Medical Sciences, Little Rock, USA
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Gramling R, Bennett E, Curtis K, Richards W, Rizzo DM, Arnoldy F, Hegg L, Porter J, Honstein H, Pratt S, Tarbi E, Reblin M, Thambi P, Agrawal M. Developing a Direct Observation Measure of Therapeutic Connection in Psilocybin-Assisted Therapy: A Feasibility Study. J Palliat Med 2023; 26:1702-1708. [PMID: 37590474 DOI: 10.1089/jpm.2023.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Context: Measuring therapeutic connection during psilocybin-assisted therapy is essential to understand underlying mechanisms, inform training, and guide quality improvement. Purpose: To evaluate the feasibility of directly observing indicators of therapeutic connection during psilocybin administration encounters. Methods: We evaluated audio and video data from a recent clinical trial for observable expressions of therapeutic connection as defined in proposed best-practice competencies (i.e., empathic abiding presence and interpersonal grounding). We selected the first four 8-hour encounters involving unique participants, therapists, and gender pairs. Each video was independently coded by three members of an interprofessional six-person team. Using a structured checklist, coders recorded start-stop times, the audible (i.e., speech prosody or words) and visible (i.e., body movements, eye gaze, and touch) cues marking the event, and the qualities of the interaction (e.g., expression of awe, trust, distress, and calmness). We assessed feasibility by observing the frequency, distribution, and overlap of cues and qualities coders used to identify and define moments of therapeutic connection. Results: Among the 2074 minutes of video, coders recorded 372 moments of therapeutic connection. Eighty-three percent were identified by at least two coders and 41% by all three. Coders used a combination of audible and visual cues to identify therapeutic connection in 51% of observed events (190/372). Both the cues and qualities of therapeutic connection expressions varied over the course of psilocybin temporal effects on states of consciousness. Conclusion: Direct observation of therapeutic human connection is feasible, sensitive to changes in states of consciousness and requires evaluation of audible and visual data.
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Affiliation(s)
- Robert Gramling
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Emily Bennett
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Keith Curtis
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
- Department of Emergency Medicine, University of Vermont, Burlington, Vermont, USA
| | - William Richards
- Sunstone Therapies, Rockville, Maryland, USA
- Center for Psychedelic and Consciousness Research, John's Hopkins University, Baltimore, Maryland, USA
| | - Donna M Rizzo
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
- Department of Civil and Environmental Engineering, University of Vermont, Burlington, Vermont, USA
| | - Francesca Arnoldy
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
| | - Logan Hegg
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
- Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Jon Porter
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
- Osher Center for Integrative Health, University of Vermont, Burlington, Vermont, USA
| | | | - Susanna Pratt
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Elise Tarbi
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
- Department of Nursing, University of Vermont, Burlington, Vermont, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
- Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, Vermont, USA
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Paul Thambi
- Sunstone Therapies, Rockville, Maryland, USA
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Rimé B, Páez D. Why We Gather: A New Look, Empirically Documented, at Émile Durkheim's Theory of Collective Assemblies and Collective Effervescence. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1306-1330. [PMID: 36753611 DOI: 10.1177/17456916221146388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
For Durkheim, individuals' survival and well-being rest on cultural resources and social belonging that must be revived periodically in collective assemblies. Durkheim's concern was to clarify how these assemblies achieve this revitalization. An intensive examination of primitive religions led him to identify successive levels of engagement experienced by participants and to develop explanatory principles relevant to all types of collective gatherings. Durkheim's conception is widely referred to nowadays. However, the question of its empirical status remains open. We extracted from his text his main statements and translated them into research questions. We then examined each question in relation to current theories and findings. In particular, we relied on the plethora of recent cognitive and social-psychology studies that document conditions of reduced self-other differentiation. Abundant data support that each successive moment of collective assemblies contributes to blurring this differentiation. Ample support also exists that because shared emotions are increasingly amplified in collective context, they can fuel high-intensity experiences. Moreover, recent studies of self-transcendent emotions can account for the self-transformative effects described by Durkheim at the climax of collective assemblies. In conclusion, this century-old model is remarkably supported by recent results, mostly collected in experimental settings.
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Affiliation(s)
- Bernard Rimé
- Institut de Recherches en Sciences Psychologiques, Université catholique de Louvain
| | - Dario Páez
- Department of Social Psychology, University of the Basque Country
- Faculty of Education and Social Sciences, Universidad Andrés Bello, Chile
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Urrutia J, Anderson BT, Belouin SJ, Berger A, Griffiths RR, Grob CS, Henningfield JE, Labate BC, Maier LJ, Maternowska MC, Weichold F, Yaden DB, Magar V. Psychedelic Science, Contemplative Practices, and Indigenous and Other Traditional Knowledge Systems: Towards Integrative Community-Based Approaches in Global Health. J Psychoactive Drugs 2023; 55:523-538. [PMID: 37747281 DOI: 10.1080/02791072.2023.2258367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/09/2023] [Indexed: 09/26/2023]
Abstract
As individuals and communities around the world confront mounting physical, psychological, and social threats, three complimentary mind-body-spirit pathways toward health, wellbeing, and human flourishing remain underappreciated within conventional practice among the biomedical, public health, and policy communities. This paper reviews literature on psychedelic science, contemplative practices, and Indigenous and other traditional knowledge systems to make the case that combining them in integrative models of care delivered through community-based approaches backed by strong and accountable health systems could prove transformative for global health. Both contemplative practices and certain psychedelic substances reliably induce self-transcendent experiences that can generate positive effects on health, well-being, and prosocial behavior, and combining them appears to have synergistic effects. Traditional knowledge systems can be rich sources of ethnobotanical expertise and repertoires of time-tested practices. A decolonized agenda for psychedelic research and practice involves engaging with the stewards of such traditional knowledges in collaborative ways to codevelop evidence-based models of integrative care accessible to the members of these very same communities. Going forward, health systems could consider Indigenous and other traditional healers or spiritual guides as stakeholders in the design, implementation, and evaluation of community-based approaches for safely scaling up access to effective psychedelic treatments.
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Affiliation(s)
- Julian Urrutia
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Prisons Group Legal Clinic, Universidad de los Andes Medical School, Bogotá, Colombia
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Sean J Belouin
- United States Public Health Service, Department of Health and Human Services (DHHS), Rockville, MD, USA
- Substance Abuse and Mental Health Services Administration (SAMHSA), DHHS, Rockville, MD, USA
- Office of Science and Medicine, DHHS, Washington, DC, USA
- Office of the Assistant Secretary, DHHS, Washington, DC, USA
- Pain and Palliative Care, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Ann Berger
- Pain and Palliative Care, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles S Grob
- David Geffen School of Medicine, University of California (UCLA), Los Angeles, CA, USA
- Division of Child and Adolescent Psychiatry, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Research, Health Policy and Abuse Liability, Pinney Associates, Bethesda, MD, USA
| | | | | | - M Catherine Maternowska
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Frank Weichold
- Office of the Chief Scientist, Office of the Commissioner, US Food and Drug Administration, Silver Spring, MD, USA
| | - David B Yaden
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Veronica Magar
- (formerly) Office of the Director General, World Health Organization, Geneva, Switzerland
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Takano R, Matsuo A, Kawano K. Development of a Japanese version of the Awe Experience Scale (AWE-S): A structural topic modeling approach. F1000Res 2023; 12:515. [PMID: 37900197 PMCID: PMC10611950 DOI: 10.12688/f1000research.134275.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Awe, a complex emotion, arises in response to perceptually and conceptually vast stimuli that transcend one's current frames of reference, which is associated with subjective psychological phenomena, such as a sense of self and consciousness. This study aimed to develop a Japanese version of the Awe Experience Scale (AWE-S), a widely used questionnaire that robustly measured the state of awe, and simultaneously investigated how the multiple facets of awe related to the narrative representations of awe experiences. METHODS The Japanese AWE-S was created via back-translation and its factor structure and validity was investigated through an online survey in Japan. RESULTS The results revealed that the Japanese AWE-S consisted of the same six factors as the original (i.e., time, self-loss, connectedness, vastness, physiological, and accommodation) and had sufficient internal consistency, test-retest reliability, construct validity, and also Japan-specific characteristics. The structured topic modeling generated seven potential topics of the descriptions of awe experiences, which were differently associated with each factor of the Japanese AWE-S. CONCLUSIONS Our findings contribute to a deeper understanding of awe and reveal the constructs of awe in Japan through cross-cultural comparisons. Furthermore, this study provides conceptual and methodological implications regarding studies on awe.
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Affiliation(s)
- Ryota Takano
- Kojimachi Business Center Building, Japan Society for the Promotion of Science, Tokyo, 102-0083, Japan
- Department of Social Psychology, Graduate School of Humanities and Sociology, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Akiko Matsuo
- Research Center for Advanced Science and Technology, The University of Tokyo, Meguro-Ku, Tokyo, 153-8904, Japan
| | - Kazuaki Kawano
- Department of Psychology, Tokai Gakuen University, Nagoya, Aichi, 468-8514, Japan
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Veldheer S, Whitehead-Zimmers M, Bordner C, Weinstein O, Choi H, Spreenberg-Bronsoms K, Davis J, Conroy DE, Schmitz KH, Sciamanna C. Growing Healthy Hearts: a single-arm feasibility study of a digitally delivered gardening, cooking, and nutrition intervention for adults with risk factors for cardiovascular disease. Pilot Feasibility Stud 2023; 9:152. [PMID: 37653532 PMCID: PMC10470136 DOI: 10.1186/s40814-023-01380-5] [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: 02/01/2023] [Accepted: 07/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Food gardening may positively influence cardiovascular disease (CVD) risk-related behaviors. However, the vast majority of existing gardening interventions have used an in-person delivery model which has limitations for scalability. It is not known whether a digitally delivered gardening intervention would be feasible or acceptable to participants. The purpose of this pilot study was to assess the feasibility of a digitally delivered gardening intervention in three domains: participant acceptability, demand, and practicality. METHODS A single-arm, pre-post-study design was used. Participants (n = 30) were aged 20 + with no plans to garden in the coming season and had at least 1 CVD risk factor. The intervention included ten 1-h video-conferencing sessions, written materials, and access to a study website. Content focused on gardening skills, cooking skills, and the Dietary Approaches to Stop Hypertension (DASH) diet. Feasibility outcomes included acceptability (post-program ratings), demand (session attendance rate), and practicality (ability to start a garden and grow F&V). The study was considered feasible if the following criteria were met: ≥ 70% rated the intervention as good or excellent, overall session attendance rate was ≥ 70%, and > 70% were able to start a garden and grow F&V. We also assessed pre-post-program changes in behavioral mediators (gardening confidence, gardening enjoyment, cooking confidence, and nutrition knowledge). Descriptive statistics were calculated. Pre-post differences were evaluated with means and 95% confidence intervals (95% CI). Effect sizes were calculated (Cohen's d). RESULTS All feasibility criteria were met. A total of 93.3% of participants rated the intervention as good or excellent, 96% started a garden and grew F&V, and the overall session attendance rate was 81%. The largest mean pre-post changes were in gardening confidence (pre 7.1 [95% CI: 6.4, 7.9], post 9.0 [95% CI: 8.6, 9.5], Cohen's d = 1.15), gardening enjoyment (pre: 6.3 [95% CI: 5.9, 6.7], post: 7.5 [95% CI: 7.1, 7.9], Cohen's d = 1.69), and cooking self-efficacy (pre: 4.7 [95% CI: 4.3, 5.1], post: 7.7 [95% CI: 7.3, 8.0], Cohen's d = 3.0). CONCLUSION A digitally delivered gardening intervention was feasible, acceptable to participants, and they had meaningful changes in behavioral mediators. The next step is to evaluate the impact of the intervention in a future randomized controlled trial.
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Affiliation(s)
- Susan Veldheer
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA.
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | | | - Candace Bordner
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | | | - Hena Choi
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA
| | | | - Jason Davis
- Department of Early, Middle, and Exceptional Education, Millersville University, Millersville, PA, USA
| | - David E Conroy
- Department of Kinesiology, Penn State University, State College, PA, USA
| | | | - Christopher Sciamanna
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
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16
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Ge BH, Yang F. Transcending the self to transcend suffering. Front Psychol 2023; 14:1113965. [PMID: 37484086 PMCID: PMC10361767 DOI: 10.3389/fpsyg.2023.1113965] [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: 12/01/2022] [Accepted: 03/02/2023] [Indexed: 07/25/2023] Open
Abstract
Suffering is inevitable in human life. Our perspective paper theorizes on precise mechanisms for how self-transcendence-the state in which an individual looks beyond the self and adopts a larger perspective including concern for others and the world-may help people endure the experience of suffering. From an examination of empirical literature ranging from social psychology to clinical research, we propose that self-transcendence may aid the endurance of suffering along three psychological levels: (1) On the level of affect, the unique profundity and positivity of self-transcendent experiences (e.g., awe, flow, compassion) may supersede and reduce the salience of negative affect arising from suffering (e.g., fear, despair, depressive mood). (2) On the level of cognition, the larger frame of reference provided by self-transcendent thinking may contextualize one's suffering as something comprehendible, thereby helping to resolve the challenges of making meaning from suffering (e.g., that one's existing meaning systems are unable to explain the suffering event). (3) On the level of motivation, the drive to fulfill one's need for self-transcendence may counterbalance the more hedonically-oriented motivations that can promote negative coping strategies in response to suffering (e.g., avoidance, substance abuse). All three mechanisms may also provoke downstream prosocial behaviors that help embed the individual into networks of social support. Altogether, by synthesizing specific mechanisms from affective, cognitive, and motivational self-transcendent processes, our paper establishes a theoretical framework for how self-transcendence may help people endure and transcend suffering, thereby elevating the conditions and experiences of our existence.
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17
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Abstract
Wilderness medicine (WM) and lifestyle medicine (LM) both aim to use creative methods to promote health. The purpose of this review is to elucidate the effects of wilderness environments on health and elaborate on the intersections of WM and LM. The three theories describing potential mechanisms of health promotion in the wilderness environment-biophilia theory, stress reduction theory (SRT), and attention restoration theory (ART)-are presented. Activity in the wilderness environment is associated with improved cardiovascular fitness and cognitive performance, better sleep/wake cycles when not at altitude or extremely cold weather, better stress management, positive social interactions, and avoidance of risky substances. Wilderness is medicine and may be used as such to promote vigor and vitality in our patients.
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Affiliation(s)
- Michael S. Moore
- Medical Laboratory Sciences, Weber State University, Ogden, UT, USA (MSM)
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18
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Monroy M, Uğurlu Ö, Zerwas F, Corona R, Keltner D, Eagle J, Amster M. The influences of daily experiences of awe on stress, somatic health, and well-being: a longitudinal study during COVID-19. Sci Rep 2023; 13:9336. [PMID: 37291138 PMCID: PMC10248986 DOI: 10.1038/s41598-023-35200-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/14/2023] [Indexed: 06/10/2023] Open
Abstract
In the present work, we used daily diary methodology to investigate the influence of awe on stress, somatic health (e.g., pain symptoms), and well-being during the COVID-19 pandemic in 2020. We recruited a sample of community adults (N = 269) and a sample of healthcare professionals (N = 145) in the United States. Across both samples, we found that awe and well-being increased, and stress and somatic health symptoms decreased over the 22-day diary period. In daily level analyses, we found that the more daily awe people experienced, the less stress, less somatic health symptoms, and greater well-being they felt. Daily experiences of awe can benefit individuals during times of acute and chronic stress-such as the COVID-19 pandemic.
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Affiliation(s)
- María Monroy
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, MC #5050, Berkeley, CA, 94720-5050, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA.
| | - Özge Uğurlu
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, MC #5050, Berkeley, CA, 94720-5050, USA
| | - Felicia Zerwas
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, MC #5050, Berkeley, CA, 94720-5050, USA
| | - Rebecca Corona
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, MC #5050, Berkeley, CA, 94720-5050, USA
| | - Dacher Keltner
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, MC #5050, Berkeley, CA, 94720-5050, USA
| | - Jake Eagle
- Independent Scientist, Hawi, Hawaii, USA
| | - Michael Amster
- College of Osteopathic Medicine, Touro University California, Vallejo, USA
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Joschko L, Pálsdóttir AM, Grahn P, Hinse M. Nature-Based Therapy in Individuals with Mental Health Disorders, with a Focus on Mental Well-Being and Connectedness to Nature-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2167. [PMID: 36767534 PMCID: PMC9914984 DOI: 10.3390/ijerph20032167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
In times of social and ecological crises, such as COVID-19 with lockdowns and implementing the impact of climate change, mental health degrades. Being outdoors in nature can be health-promoting, can decrease depression, and increase mental well-being. This pilot study investigated the relationships between nature-based therapy, mental health, and individuals' connectedness to nature. We hypothesize that nature-based therapy has a positive impact on individual mental health and connectedness to nature. A mixed-method approach was used to evaluate the effectiveness of nature-based therapy for young psychosomatic patients. The results demonstrated improvements in mental well-being and connectedness to nature through therapy. Additionally, depression scores decreased. Patients reported the importance of the therapist setting the space, the supportive environment, the poems that fostered the nature connection, improvement at the soul level, and overall doing something meaningful. Every patient experienced nature-based therapy as effective. To conclude, the study gives a first insight into the processes of nature-based therapy in the German population at work and the effectiveness of nature-based therapy. Further questions, e.g., season effects, longitudinal effects, and whether patients with low connectedness to nature gain more out of the intervention remain unanswered.
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Affiliation(s)
- Lilly Joschko
- Department of People and Society, The Swedish University of Agricultural Sciences, 234 22 Lomma, Sweden
| | - Anna María Pálsdóttir
- Department of People and Society, The Swedish University of Agricultural Sciences, 234 22 Lomma, Sweden
| | - Patrik Grahn
- Department of People and Society, The Swedish University of Agricultural Sciences, 234 22 Lomma, Sweden
| | - Maximilian Hinse
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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