Mind-body health: research, clinical, and policy applications

Psychophysiologic Self-Awareness Training: Integration of Scientific and Humanistic Principles

The U.S. medical and scientific communities are undergoing dramatic change, including a reevaluation of positivistic values and assumptions. The integration of scientific and humanistic principles is one objective of humanistic psychology. Development of conscious awareness of normally unconscious mind-body reactivity patterns can allow access to profound existential insights. A humanistic approach to psychophysiologic self-regulation integrates values of humanistic psychology with tools and methodologies of the mechanistically oriented scientific community. Through collaborative clinical, educational, and research efforts, humanistic psychologists and applied psychophysiologists are developing a model system of crossdisciplinary resource sharing that embraces the strengths of the humanistic and the materialistic scientific communities. A single case descriptive analysis with journal entries, imagery reports, and physiologic records is included. It is through such collaborative efforts that humanistic psychology can best contribute to the ongoing reconceptualization of scientific values and assumptions.

Anxiety and Depression in Patients with Lower Back Pain

This study investigated the anxiety and depression for a group of 112 patients with Lower Back Pain. 56 patients with Lower Back Pain (21 women, 35 men) were seeking treatment in two clinics. Also, 56 subjects (20 females, 36 males) who had no Lower Back Pain agreed to participate as a control group. Psychological aspects were evaluated on the Symptoms Checklist-90-Revised. Demographic characteristics and information on pain was collected by an author who constructed the questionnaire. The patients reported a higher mean on Anxiety and Depression subscales of SCL-90-R. t tests for means on the SCL-90-R scales between groups indicated statistically significant differences on the anxiety and depression scales.

Comparison of the frequency of psychiatric disorders among patients with chronic low back pain and control group

BACKGROUND

Low back pain (LBP) is one of the most common complaints of patients referred to the clinics. Studies indicated that psychosocial factors have great impact on the patients' complaints and disability. The aim of this study was to evaluate a broad range of psychiatric disorders in patients with chronic LBP (CLBP) and compare them with those of the control group.

PATIENTS AND METHODS

We applied Symptom Checklist 90-R to compare 50 CLBP patients in the case group with 100 participants without it in the control group. The questionnaire measured somatization, obsessive-compulsive disorder, depression, anxiety, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism.

RESULTS

Average "global severity index" was 1.10 in the case and 0.5 in the control group. Average "positive symptom total" was 45.26 in the case and 27.41 in the control group. Average "positive symptom distress index" was 2.50 in the case and 1.50 in the control group. Average scores for all test dimensions were significantly different between the two groups (P = 0.00).

CONCLUSIONS

All dimensions were significantly more common in CLBP patients. Therefore, early diagnosis and treatment of these disorders may improve the outcome of CLBP.

Regulating emotion to improve physical health through the amygdala

The opinion of mind-body interaction has been increasingly acknowledged in recent years, as exemplified by accumulating evidence indicating that physical health (body) is associated with emotion and emotion regulation (mind). Yet, the neural basis linking emotion regulation with physical health remains largely uninvestigated. Here we used magnetic resonance imaging to investigate the neural basis of this pathway in a large population of healthy young adults. With a systematic study revealing the association of self-reported physical health and emotion traits of personality and general affective experiences, we further demonstrated that, for better physical health, individuals needed to regulate their emotion more effectively. Importantly, individuals who had larger gray matter (GM) volume in the amygdala reported not only a higher ability of emotion regulation but also better physical health. Further, GM volume in the amygdala mediated the correlation between emotion regulation ability and physical health. Our findings suggest that the amygdala plays a critical role in the neural circuit through which emotion regulation may influence physical health. Therefore, our study takes the first step toward exploring the neuroanatomical basis for body-mind interaction and may inform interventions aimed at promoting physical health by augmenting skills of emotion regulation.

Effects of Guided imagery on Stress and Anxiety of Women Receiving in Vitro Fertilization

PURPOSE

The purpose of this study was to identify effects of guided imagery on stress including cognitive, affective, marital and social, and anxiety among women receiving in vitro fertilization (IVF).

METHODS

Data were collected between April, 21 and June, 17, 2008. The participants in this study were 57 women (26 for the experimental group, 31 for the control group) receiving IVF for primary or secondary infertility in one of the outpatient infertility centers in Seoul. The guided imagery (Suk, 2001) was provided through audio CD to the experimental group by themselves 8 minutes per day for 2 weeks. Data were analyzed by SPSS 12.0 windows program.

RESULTS

After guided imagery, the experimental group showed significantly lower affective stress and total stress scores. Anxiety scores increased significantly in the control group, but not in the experimental group after treatment.

CONCLUSION

The findings suggest that guided imagery is an effective nursing intervention for reducing stress especially affective stress and anxiety among infertile women receiving IVF in outpatient infertility center.

Somatization and symptom reduction through a behavioral medicine intervention in a mind/body medicine clinic

The authors assessed data from 1,148 outpatients in a 10-week medical symptom reduction program to determine the effectiveness of a behavioral medicine intervention among somatizing patients. The program included instruction in the relaxation response, cognitive restructuring, nutrition, and exercise. Before and after the intervention, the patients were evaluated on the Symptom Checklist-90 Revised (SCL-90R), the Medical Symptom Checklist, and the Stress Perception Scale. They were divided into high- and low-somatizing groups on the basis of the pretreatment SCL-90R somatization scale. At the end of the program, physical and psychological symptoms on the Medical Symptom Checklist and the SCL-90R were significantly reduced in both groups, with the reductions greater in the high-somatizing group. Improvements in stress perception were about the same in both groups, but the absence of an untreated control group precluded estimates of how much the improvements resulted from the behavioral medicine intervention and how much from natural healing over time.

Community assessment: a church community and the parish nurse

In central Massachusetts a large urban parish asked the University of Massachusetts, Amherst School of Nursing to conduct a community assessment for the church and newly employed parish nurse. The aims of the assessment were: to determine the health status of parishioners, identify their perceived health needs and perceived barriers in meeting those needs, and to assist the church and parish nurse in developing a health program for their faith community. Findings of the assessment are based on questionnaire and focus group data. Four hundred and twenty-one questionnaires were completed, and six focus groups were held to validate the data. Results showed most parishioners felt they were in good health (93%), believed faith and spiritual beliefs were important in maintaining health and well-being (91%), and thought that the church should play a role in helping parishioners meet their health needs (70%). In addition, focus group discussions revealed a need for respite care for primary caretakers of the ill and elderly, and health education programs for their teen and elderly populations. In conclusion, parishioners were positive and articulated support of the parish nurse and activities designed to address the physical, emotional, and spiritual needs of their community.

Effects of body-mind training and relaxation stretching on persons with chronic toxic encephalopathy

The purpose of this project was to investigate the psychological and physical effects of training of body awareness and slow stretching on persons with chronic toxic encephalopathy (CTE). In the present study, a method of self-regulation, a body-mind training, is presented. The body-mind training used was a guided relaxation technique combined with meditative stretching. The techniques are introduced and the psychological and physiological effects of the training is presented. Eight subjects with CTE, 48.5 years, were trained for 8 weeks. Outcome measures were percentage alpha brain waves (alpha%), electromyography (EMG) on the frontalis muscle, state-trait anxiety (STAI), creativity (RAT), and mood measured as anxiousness, humour and mental fatigue. The mean alpha% increased 52% during the training period (P < 0.01), and the EMG decreased 31% (P < 0.001. State anxiety decreased 22% during the training period (P < 0.01), but no changes were observed in trait anxiety and in the creativity score. The level of anxiousness and fatigue before a training session decreased during the training period. In conclusion, the body-mind training resulted in an improved ability for physical and mental relaxation as indicated from the lower EMG, the higher alpha% and the decrease in state anxiety.

Guided Imagery. A psychoneuroimmunological intervention in holistic nursing practice

Guided imagery is an independent nursing intervention that uses psychoneuroimmunology (PNI) principles to assist an individual in the management of distressing symptoms. The purpose of this article is to discuss the use of guided imagery in holistic nursing practice. The concepts of PNI are described and the basic steps of guided imagery are presented. PNI research and nursing research on guided imagery as an intervention are reviewed. The principles of guided imagery and PNI are applied to holistic nursing practice. Suggestions for future research methodologies, including psychological, neuroendocrine, and immunological measurements to evaluate the effectiveness of guided imagery, are offered. Rationale for using human immunodeficiency virus infection as a disease model to study the effectiveness of guided imagery is provided.

Psychoneuroimmunology: an emerging framework for nursing research

Psychoneuroimmunology (PNI) is concerned with the mechanisms of bidirectional communication between the neuroendocrine and immune systems. Investigators in other disciplines have used this framework to guide the examination of possible relationships between behavioural factors and the progression of immunologically mediated illnesses and to evaluate the role of immune products in central nervous system disturbances. Nurse scientists have an opportunity to make unique contributions to the growing field of PNI. Unlike basic science research, which has as its goal the generation of fundamental knowledge concerning biological or behavioural processes, nursing research is driven by the need to promote excellence in nursing science as a guide for nursing practice. Although a few nurse scientists have conducted PNI research to date, additional studies are needed to generate new knowledge concerning mind-body interactions in health and illness and to develop strategies that promote mental and physical well-being in persons at risk for immune dysfunction. This paper highlights the few recently conducted nursing studies grounded in a PNI framework to illustrate the utility of PNI in advancing nursing science.

Stress management techniques: are they all equivalent, or do they have specific effects?

This article evaluates the hypothesis that various stress management techniques have specific effects. Studies comparing various techniques are reviewed, as well as previous literature reviews evaluating the effects of individual techniques. There is evidence that cognitively oriented methods have specific cognitive effects, that specific autonomic effects result from autonomically oriented methods, and that specific muscular effects are produced by muscularly oriented methods. Muscle relaxation and/or EMG biofeedback have greater muscular effects and smaller autonomic effects than finger temperature biofeedback and/or autogenic training. EMG biofeedback produces greater effects on particular muscular groups than progressive relaxation, and thermal biofeedback has greater finger temperature effects than autogenic training. Disorders with a predominant muscular component (e.g., tension headaches) are treated more effectively by muscularly oriented methods, while disorders in which autonomic dysfunction predominates (e.g., hypertension, migraine headaches) are more effectively treated by techniques with a strong autonomic component. Anxiety and phobias tend to be most effectively treated by methods with both strong cognitive and behavioral components.