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المؤلفون: Sian Cotton, Kaitlyn Bruns, Melissa P. DelBello, Jenni E. Farrow, Amanda C. La Guardia, Michael D. Brubaker
المصدر: Journal of Mental Health Counseling. 43:59-74
مصطلحات موضوعية: 050103 clinical psychology, Bipolar I disorder, business.industry, 05 social sciences, medicine.disease, 030227 psychiatry, 03 medical and health sciences, 0302 clinical medicine, Medicine, 0501 psychology and cognitive sciences, sense organs, business, Mindfulness-based cognitive therapy, Clinical psychology
الوصف: Youth who have parents with bipolar I disorder appear to be most at risk for developing early-onset bipolar symptoms. The current study examined how one group counseling intervention, mindfulness-based cognitive therapy–child, may improve emotional awareness and influence the family environment over a 12-week treatment interval for a group of youth aged 11–16. Improving emotional awareness and the family environment may help slow symptom expression for youth at risk for developing bipolar I disorder. Changes in depressive symptoms for each participant were assessed using a single-case research design method to help better understand the mechanisms of change throughout treatment. While results indicate changes in emotional awareness, the majority were statistically nonsignificant. Notably, participants’ perception of control significantly changed, and participants reported significant positive changes in family environment. Some participants experienced decreases in depression over the course of the intervention.
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المؤلفون: Kun Qin, Sian Cotton, Luis Rodrigo Patino Duran, Xueling Suo, Thomas J. Blom, Du Lei, John A. Sweeney, Wenbin Li, Qiyong Gong, Maxwell J Tallman, Jing Yang, Kaitlyn M. Bruns, Melissa P. DelBello
المصدر: Early intervention in psychiatryREFERENCES. 16(9)
مصطلحات موضوعية: Mindfulness, Bipolar Disorder, Adolescent, medicine.medical_treatment, Grey matter, Limbic system, Neuroimaging, medicine, Humans, Genetic Predisposition to Disease, Bipolar disorder, Child, Biological Psychiatry, Mindfulness-based cognitive therapy, Cognitive Behavioral Therapy, business.industry, Brain, medicine.disease, Psychiatry and Mental health, medicine.anatomical_structure, Mood, Cognitive therapy, Pshychiatric Mental Health, business, Clinical psychology
الوصف: Background Mindfulness-based cognitive therapy for children (MBCT-C), as a psychotherapeutic intervention, has been shown to be effective for treating mood dysregulation (MD). While previous neuroimaging studies of MD have reported both pre-treatment structural and functional alterations, the effects of MBCT-C on brain morphological network organisation has not been investigated. Methods We investigated brain morphological network organisation in 10 mood-dysregulated youth with familial risk for bipolar disorder and 15 matched healthy comparison youth (HC). Effects of 12 weeks of MBCT-C were examined in the mood-dysregulated youth. Topological properties of brain networks used for analyses were constructed based on morphological similarities in regional grey matter using a graph-theory approach using MRI data. Results At baseline, compared with the HC group, the mood-dysregulated group exhibited increased global efficiency (Eglob ), decreased path length (Lp ), and abnormal nodal properties, mainly in the limbic system. Right temporal pole alterations at baseline predicted change in Child and Adolescent Mindfulness Measure scores after treatment. The mood-dysregulated group showed significant decreases in both the Eglob and Lp metrics after MBCT-C, suggesting an improved capacity for optimal information processing. Changes in Lp were correlated with changes in Emotion Regulation Checklist scores. Our results show significant topological alterations in the mood-dysregulated group as compared to controls at baseline. After MBCT-C, disrupted topological properties in the mood-dysregulated group were significantly reduced. Conclusion MBCT-C may facilitate clinically meaningful changes in the brain structural network in mood-dysregulated individuals.
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المؤلفون: Michelle Durling, Sian Cotton, Rachel S. Wasson, Jeffrey R. Strawn, Melissa P. DelBello, Richard W. Sears, Jeffrey A. Welge, Thomas J. Blom, Kristen M. Kraemer, Nina R. McCune
المصدر: Early Interv Psychiatry
مصطلحات موضوعية: Male, Bipolar Disorder, Mindfulness, Adolescent, Waiting Lists, medicine.medical_treatment, Prodromal Symptoms, Pilot Projects, Article, 03 medical and health sciences, 0302 clinical medicine, Child of Impaired Parents, Psychoeducation, Humans, Medicine, Prospective Studies, Bipolar disorder, Biological Psychiatry, Mindfulness-based cognitive therapy, Cognitive Behavioral Therapy, business.industry, Pilot trial, medicine.disease, Anxiety Disorders, Treatment period, 030227 psychiatry, Psychiatry and Mental health, Treatment Outcome, Cognitive therapy, Anxiety, Female, Pshychiatric Mental Health, medicine.symptom, business, 030217 neurology & neurosurgery, Clinical psychology
الوصف: AIM. Previous studies suggest that Mindfulness-Based Cognitive Therapy for Children (MBCT-C) is feasible and may improve anxiety and emotion regulation in youth with anxiety disorders at-risk for bipolar disorder. However, controlled studies are warranted to replicate and extend these findings. METHODS. In the current study, 24 youth with anxiety disorders who have at least one parent with bipolar disorder participated in a MBCT-C treatment period (n = 24; M(age) = 13.6, 75% girls, 79% White) with a subset also participating in a prior psychoeducation waitlist control period (n = 19 M(age) = 13.8, 68% girls, 84% White). Participants in both the waitlist and MBCT-C periods completed independently-rated symptom scales at each time point. Participants in the waitlist period received educational materials 12 weeks prior to the beginning of MBCT-C. RESULTS. There were significantly greater improvements in overall clinical severity in the MBCT-C period compared to the waitlist period, but not in clinician- and child-rated anxiety, emotion regulation or mindfulness. However, increases in mindfulness were associated with improvements in anxiety and emotion regulation in the MBCT-C period, but not the waitlist period. CONCLUSIONS. Findings suggest that MBCT-C may be effective for improving overall clinical severity in youth with anxiety disorders who are at-risk for bipolar disorder. However, waitlist controlled designs may inflate effect sizes so interpret with caution. Larger studies utilizing prospective randomized controlled designs are warranted.
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المؤلفون: Michael Privitera, Alok Dwivedi, Rachel S. Wasson, Susannah Cornes, Sian Cotton, Richard B. Lipton, Sheryl R. Haut, Jeffrey R. Strawn
المصدر: Neurology. 90:e963-e970
مصطلحات موضوعية: medicine.medical_specialty, business.industry, medicine.medical_treatment, Psychological intervention, Diaphragmatic breathing, medicine.disease, law.invention, Treatment and control groups, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Mood, Randomized controlled trial, law, medicine, Physical therapy, 030212 general & internal medicine, Neurology (clinical), Behavioral interventions, business, 030217 neurology & neurosurgery, Progressive muscle relaxation
الوصف: ObjectiveTo evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy.MethodsAdults with medication-resistant focal epilepsy (n = 66) were recruited from 3 centers and randomized to 1 of 2 interventions: (1) progressive muscle relaxation (PMR) with diaphragmatic breathing, or (2) control focused-attention activity with extremity movements. Following an 8-week baseline period, participants began 12 weeks of double-blind treatment. Daily self-reported mood and stress ratings plus seizure counts were completed by participants using an electronic diary, and no medication adjustments were permitted. The primary outcome was percent reduction in seizure frequency per 28 days comparing baseline and treatment; secondary outcomes included stress reduction and stress–seizure interaction.ResultsIn the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, p < 0.05; focused attention: 25%, p < 0.05). PMR and focused attention did not differ in seizure reduction (p = 0.38), although PMR was associated with stress reduction relative to focused attention (p < 0.05). Daily stress was not a predictor of seizures.ConclusionsBoth PMR and the focused-attention groups showed reduced seizure frequency compared to baseline in participants with medication-resistant focal seizures, although the 2 treatments did not differ. PMR was more effective than focused attention in reducing self-reported stress.ClinicalTrials.gov identifierNCT01444183.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::32d2aab74311ec09bd640744f2e8cf28
https://doi.org/10.1212/wnl.0000000000005109 -
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المؤلفون: Sarah A. Mossman, Jeffrey R. Strawn, Marissa J. Luft, Emily Harris, Anne K. Tulisiak, Jillian A. Klein, Heidi K. Schroeder, Brooks R. Keeshin, Sara T. Varney, Sian Cotton
المصدر: Current Problems in Pediatric and Adolescent Health Care. 47:15-24
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Psychopharmacology, Attitude of Health Personnel, Clinical Decision-Making, Pilot Projects, Drug Prescriptions, Article, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Humans, Pediatricians, Practice Patterns, Physicians', Child, Psychiatry, Aged, Depressive Disorder, Primary Health Care, business.industry, Mental Disorders, Health services research, General Medicine, Middle Aged, Anxiety Disorders, Mental health, Antidepressive Agents, Drug Utilization, United States, 030227 psychiatry, Tolerability, Pediatrics, Perinatology and Child Health, Antidepressant, Anxiety, Female, Clinical Competence, Health Services Research, medicine.symptom, Thematic analysis, business, Psychosocial, Psychopathology, Clinical psychology
الوصف: Among pediatricians, perceived knowledge of efficacy, tolerability, dosing, and side effects of antidepressants represent significant sources of variability in the use of these medications in youth with depressive and anxiety disorders. Importantly, the qualitative factors that relate to varying levels of comfort with antidepressants and willingness to prescribe are poorly understood. Using a mixed-methods approach, in-depth interviews were conducted with community-based and academic medical center-based pediatricians (N = 14). Interviews were audio recorded and iteratively coded; themes were then generated using inductive thematic analysis. The relationship between demographic factors, knowledge of antidepressants, dosing, and side effects, as well as prescribing likelihood scores for depressive disorders, anxiety disorders or co-morbid anxiety and depressive disorders, were evaluated using mixed models. Pediatricians reported antidepressants to be effective and well-tolerated. However, the likelihood of individual physicians initiating an antidepressant was significantly lower for anxiety disorders relative to depressive disorders with similar functional impairment. Pediatricians considered symptom severity/functional impairment, age and the availability of psychotherapy as they considered prescribing antidepressants to individual patients. Antidepressant choice was related to the physician׳s perceived knowledge and comfort with a particular antidepressant, financial factors, and the disorder-specific evidence base for that particular medication and consultation with mental health practitioners. Pediatricians noted similar efficacy and tolerability profiles for antidepressants in youth with depressive disorders and anxiety disorders, but tended to utilize "therapy first" approaches for anxiety disorders relative to depressive disorders. Parental and family factors that influenced prescribing of antidepressants by pediatricians included parental ambivalence, family-related dysfunction and impairment secondary to the child׳s psychopathology as well as the child׳s psychosocial milieu. Pediatricians consider patient- and family-specific challenges when choosing prescribing antidepressant medications and are, in general, less likely to prescribe antidepressants for youth with anxiety disorders compared to youth with depressive disorders. The lower likelihood of prescribing antidepressants for anxious youth is not related to perception of the efficacy or tolerability, but rather to a perception that anxiety disorders are less impairing and more appropriately managed with psychotherapy.
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المؤلفون: Harini Pallerla, Stephanie S. Filigno, Sian Cotton, Elizabeth A. Hente, Thomas F. Boat, Richard W. Sears, Christopher Siracusa
المصدر: The Journal of Pediatrics. 224:87-93.e1
مصطلحات موضوعية: Chronic care, Mindfulness, business.industry, medicine.medical_treatment, education, Burnout, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Health care, Well-being, Cognitive therapy, Medicine, Anxiety, 030212 general & internal medicine, medicine.symptom, business, Mindfulness-based cognitive therapy, Clinical psychology
الوصف: Objective To assess the efficacy of mindfulness-based cognitive therapy delivered onsite during work hours in reducing stress and improving well-being in an interdisciplinary chronic care health care team. Study design A longitudinal, mixed methods, observational pilot study using a survey created from validated assessment tools to measure effectiveness of training. Surveys were completed before training, and 1 and 15 months after training. Twenty-four professionals in the cystic fibrosis Centers at Cincinnati Children's Hospital and the University of Cincinnati participated in 6 mindfulness-based cognitive therapy training sessions. Sessions incorporated mindfulness, cognitive therapy, and experiential exercises for processing feelings related to stress and burnout. Results The presurvey and 1-month postsurvey responses revealed statistically significant improvements for empathy, perceived stress, depersonalization, anxiety, perspective taking, resilience, and negative affect. Sustained effects were seen at 15 months for empathy, perspective taking, and depressive symptoms. The 1-month post-training surveys reported a quarter of respondents (25%) practiced skills at least 5 times in between sessions; at 15 months, 35% reported practicing at the same frequency. Participants reported using mindfulness skills for personal stressful events (74%), work-related general stress (65%), patient-related stress (30%), sleep or general relaxation (22%), and wellness (13%). Conclusions Group mindfulness-based cognitive therapy training was feasible and effective in decreasing stress for interdisciplinary cystic fibrosis care team members who elected to participate. Further investigation is needed to determine optimal dose of training, durability of perceived benefits, and generalizability to health care professionals working with other chronic disorders.
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المؤلفون: Christina M. Luberto, Monzer Haj-Hamed, Whitney Janee Raglin Bignall, Sian Cotton, Adrianne Falkenberg Cornette
المصدر: Journal of Asthma. 52:889-896
مصطلحات موضوعية: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Universities, Urban Population, Pilot Projects, Anxiety, law.invention, Patient Education as Topic, Quality of life, Randomized controlled trial, law, Intervention (counseling), Asthma control, Humans, Immunology and Allergy, Medicine, Breathing retraining, Asthma, business.industry, Respiration, medicine.disease, Community-Institutional Relations, United States, Respiratory Function Tests, respiratory tract diseases, Test (assessment), Black or African American, Self Care, Pediatrics, Perinatology and Child Health, Quality of Life, Physical therapy, Female, medicine.symptom, business
الوصف: Asthma affects approximately seven million children/adolescents in the USA, with African-American children disproportionately affected. Breathing retraining techniques have been shown to improve asthma outcomes in adults, though research in youth is limited. The purpose of this pilot study was to test the feasibility and preliminary efficacy of a school-based randomized controlled trial of breathing retraining for asthma outcomes and anxiety symptoms in a sample of urban, African-American adolescents.Adolescents were randomized into either the intervention group (20-min breathing retraining plus education) or control group (20-min standard education). Participants completed two study visits, one month apart. Asthma control, asthma quality of life and lung functioning (FEV1 and peak flow) were the primary outcomes, and state anxiety (pre-post the intervention) and trait anxiety (over the one-month period) were the secondary outcomes.Thirty-three African-American adolescents participated in the study, with a 90% retention rate between visit 1 and visit 2. Asthma control and asthma quality of life, significantly improved over time (p ≤ 0.01) with no differences between intervention and control groups. State anxiety significantly decreased (p ≤ 0.01) immediately post intervention at both time points with no differences between groups. There were no significant differences found in lung functioning or trait anxiety over the one-month time period.These preliminary results suggest that breathing retraining is a feasible, acceptable and potentially efficacious intervention (although no significant differences between groups were found) for improving asthma symptoms in urban adolescents with asthma in a school-based setting.
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المؤلفون: Rachel S. Wasson, Elizabeth E. Hathaway, Sian Cotton, Sue Geiss, Christina M. Luberto, Lois H. Bogenschutz
المصدر: Global Advances in Health and Medicine
مصطلحات موضوعية: medicine.medical_specialty, Pediatrics, Neonatal intensive care unit, Massage, business.industry, Alternative medicine, MEDLINE, Healing Touch, Retrospective cohort study, General Medicine, Original Articles, Pain management, medicine, Level iii, Intensive care medicine, business
الوصف: Pain management is a frequent problem in the neonatal intensive care unit (NICU). Few studies examining effects of integrative care therapies on pain-related outcomes in neonates have included physiological outcomes or investigated the use of such therapies in a practice-based setting.The purpose of this practice-based retrospective study was to examine the associations between integrative care therapies, particularly massage and healing touch, and pain-related outcomes among hospitalized infants.We conducted a retrospective review of a clinical database from a level III NICU regularly delivering integrative care therapies. Paired-samples t-tests were used to examine associations between integrative care therapies and 4 pre-post outcome measures: therapist-rated pain and presentation (ranging from asleep to agitated) and neonates' heart rate and oxygen saturation.Of 186 patients (M age=68 days), 58% were male and 67% were Caucasian. Sixty-two percent received both massage and healing touch; the remainder received a single therapy. From pre-post therapy, statistically significant changes were observed in infants' heart rate (M pre=156 vs M post=140 per minute; P.001), oxygen saturation (M pre=95.0% vs.M post=97.4%; P.001), and therapist-reported pain (M pre=2.8 vs M post=0.2; P.001) and presentation (M pre=3.2 vs. M post=1.0; P.001).Observed improvements in pain-related outcomes suggest that massage and healing touch may be useful integrative therapies to consider as pain management options in the NICU.背景：疼痛控制是新生儿重症监 护室 (NICU) 经常遇到的一个难 题。在评估整合护理疗法对新生 儿疼痛相关指标之影响的研究 中，几乎没有研究探讨生理指标 或评估此类疗法在诊所环境中的 应用情况。目的：这项基于实践的回顾性研 究旨在分析整合护理疗法，特别 是按摩和康复性抚摸，与住院婴 儿的疼痛相关指标之间的关系。方法：我们对经常实施整合护理 疗法的 III 级 NICU 的临床数据 库进行了回顾性审核。我们采用 配对样本 t 检验分析了整合护理 疗法与以下 4 个治疗前-治疗后评 估指标的关系：治疗师评定的疼 痛、新生儿的疼痛表现（从睡眠 到烦躁不等）、新生儿的心率和 血氧饱和度。结果：在 186 名患儿中（平均年 龄 = 68 天），有 58% 为男 婴，67% 为白种人。62% 接受了按 摩联合康复性抚摸，其余仅接受 了单一疗法。从治疗前到治疗 后，婴儿的心率（治疗前均值 = 156 次/分，治疗后均值 = 140 次/分；p0.001）、血氧饱和度（ 治疗前均值 = 95.0%，治疗后均值 = 97.4%；p0.001）、治疗师评定 的疼痛（治疗前均值 = 2.8，治疗 后均值 = 0.2；p0.001）以及疼 痛表现（治疗前均值 = 3.2，治疗 后均值 = 1.0；p0.001）均观察 到了有统计显著性的改变。结论：疼痛相关指标的改善表 明，按摩和康复性抚摸是有效的 整合疗法，可考虑作为疼痛控制 方案用于 NICU 中。.El tratamiento del dolor es un problema frecuente en la unidad de cuidados intensivos neonatales (UCIN). Pocos de los estudios que examinan los efectos de los tratamientos integradores sobre los resultados relacionados con el dolor en neonatos han incluido los resultados fisiológicos o investigado el uso de este tipo de tratamientos en un entorno basado en la práctica.El objetivo de este estudio retrospectivo basado en la práctica fue examinar la asociación entre los tratamientos integradores de atención, especialmente el masaje y el toque sanador, y los resultados relacionados con el dolor entre los lactantes hospitalizados.Realizamos una revisión retrospectiva de una base de datos clínica de una UCIN de nivel III que proporcionaba regularmente tratamientos integradores de atención. Se utilizaron pruebas t de muestras pareadas para examinar las asociaciones entre los tratamientos integradores de atención y cuatro medidas de resultados anteriores y posteriores: dolor puntuado por el terapeuta y presentación (desde dormido hasta sueño agitado) y frecuencia cardíaca y saturación de oxígeno de los neonatos.De 186 pacientes (Medad = 68 días), el 58 % eran hombres y el 67 % eran de raza caucásica. El 62 % recibió tanto masajes como toque sanador; el resto recibió un solo tratamiento. A partir del tratamiento anterior y posterior, se observaron cambios estadísticamente significativos en la frecuencia cardíaca de los lactantes (Manterior = 156 frente a Mposterior = 140 por minuto;Las mejoras observadas en los resultados relacionados con el dolor sugieren que el masaje y el toque sanador podrían ser tratamientos integradores útiles a considerar como opciones de tratamiento del dolor en la UCIN.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::02ea3deac696bc20837681a2a6733e72
http://europepmc.org/articles/PMC4533649 -
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المؤلفون: Gary L. McPhail, Daniel H. Grossoehme, Sian Cotton
المصدر: Journal of Health Care Chaplaincy. 19:22-32
مصطلحات موضوعية: Adult, Complementary Therapies, Male, Parents, medicine.medical_specialty, Health (social science), Adolescent, Cystic Fibrosis, media_common.quotation_subject, Faith healing, Alternative medicine, Pastoral Care, Article, Young Adult, Nursing, Professional-Family Relations, Pastoral care, Humans, Medicine, Child, Qualitative Research, media_common, Modalities, business.industry, Religious studies, Cognitive reframing, Middle Aged, Prayer, Clinical Psychology, Child, Preschool, Family medicine, Female, business, Faith Healing, Aromatherapy, Qualitative research
الوصف: Complementary and alternative medicine (CAM) use, including spiritual modalities, is common in pediatric chronic diseases. However, few users discuss CAM treatments with their child's physician. Semi-structured interviews of 25 parents of children who have cystic fibrosis (CF) were completed. Primary themes were identified by thematic analyses. Most parents (19/25) used at least one CAM modality with their child. Only two reported discussing CAM use with their child's pulmonologist. Most reported prayer as helpful (81%) and multi-faceted, including individual and group prayer; using aromatherapy or scented candles as an adjunct for relaxation; and the child's sleeping with a blessed prayer. Parents ascribed sacred significance to natural oral supplements. CAM use is relevant to the majority of participating parents of children under age 13 with CF. Chaplains can play a significant role by reframing prayer's integration into chronic disease care, co-creating rituals with pediatric patients, and mediating conversations between parents and providers.
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المصدر: Journal of Asthma. 49:409-415
مصطلحات موضوعية: Complementary Therapies, Male, Pulmonary and Respiratory Medicine, Gerontology, medicine.medical_specialty, Adolescent, Urban Population, Alternative medicine, Severity of Illness Index, Quality of life, medicine, Humans, Immunology and Allergy, Anti-Asthmatic Agents, Longitudinal Studies, Psychiatry, Depression (differential diagnoses), Asthma, business.industry, medicine.disease, Mental health, Black or African American, Religion, Cross-Sectional Studies, Mental Health, Socioeconomic Factors, Pediatrics, Perinatology and Child Health, Quality of Life, Anxiety, Female, Observational study, medicine.symptom, business, Psychosocial
الوصف: Objective. Many adolescents with asthma use complementary and alternative medicine (CAM) for asthma symptom management. The purpose of this study was to investigate cross-sectional and longitudinal differences in psychosocial health outcomes between high and low CAM users among urban adolescents with asthma. Methods. Adolescents (Time 1: N = 151, Time 2: N = 131) completed self-report measures regarding the use of 10 CAM modalities, mental health, and health-related quality of life (HRQoL) following two clinic visits 1 year apart as part of a larger observational study. Multivariable regression analyses using backward elimination examined relationships between CAM use at Time 1 and outcomes at Time 1 and Time 2, controlling for key covariates and, in longitudinal analyses, Time 1 functioning. Results. Participants (M(age) = 15.8, SD = 1.85) were primarily African-American (n = 129 [85%]) and female (n = 91 [60%]) adolescents with asthma. High and low CAM users differed significantly in terms of several psychosocial health outcomes, both cross-sectionally and longitudinally. In cross-sectional multivariable analyses, greater frequency of praying was associated with better psychosocial HRQoL (R(2) = 0.22). No longitudinal relationships remained significant in multivariable analyses. Conclusions. Specific CAM techniques are differentially associated with psychosocial outcomes, indicating the importance of examining CAM modalities individually. Greater frequency of praying was cross-sectionally associated with better psychosocial HRQoL. When controlling for key covariates, CAM use was not associated with psychosocial outcomes over time. Further research should examine the effects of CAM use in controlled research settings.
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