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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: 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: Christina M. Luberto, Lauren Stahl, Jeffrey R. Strawn, Wade Weber, Sian Cotton, Richard W. Sears, James C. Eliassen, Melissa P. DelBello, L. Rodrigo Patino
المصدر: Journal of Child and Adolescent Psychopharmacology. 26:372-379
مصطلحات موضوعية: Male, medicine.medical_specialty, Bipolar Disorder, Mindfulness, Adolescent, medicine.medical_treatment, Neuropsychological Tests, Audiology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Pharmacology (medical), Longitudinal Studies, Bipolar disorder, Child, Psychiatry, Mindfulness-based cognitive therapy, Cognitive Behavioral Therapy, medicine.diagnostic_test, Separation anxiety disorder, Brain, Original Articles, medicine.disease, Anxiety Disorders, Magnetic Resonance Imaging, 030227 psychiatry, Psychiatry and Mental health, Treatment Outcome, Pediatrics, Perinatology and Child Health, Cognitive therapy, Anxiety, Female, medicine.symptom, Functional magnetic resonance imaging, Psychology, Insula, 030217 neurology & neurosurgery
الوصف: We sought to evaluate the neurophysiology of mindfulness-based cognitive therapy for children (MBCT-C) in youth with generalized, social, and/or separation anxiety disorder who were at risk for developing bipolar disorder.Nine youth (mean age: 13 ± 2 years) with a generalized, social, and/or separation anxiety disorder and a parent with bipolar disorder completed functional magnetic resonance imaging (fMRI) while performing a continuous processing task with emotional and neutral distractors (CPT-END) prior to and following 12 weeks of MBCT-C.MBCT-C was associated with increases in activation of the bilateral insula, lentiform nucleus, and thalamus, as well as the left anterior cingulate while viewing emotional stimuli during the CPT-END, and decreases in anxiety were correlated with change in activation in the bilateral insula and anterior cingulate during the viewing of emotional stimuli (p 0.05, uncorrected; p 0.005 corrected; cluster size, 37 voxels).MBCT-C treatment in anxious youth with a familial history of bipolar disorder is associated with increased activation of brain structures that subserve interoception and the processing of internal stimuli-functions that are ostensibly improved by this treatment.
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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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المؤلفون: Michael S. Yi, Susan L. Rosenthal, Sian Cotton, Yvonne Humenay Roberts, Meghan E. McGrady, Maria T. Britto
المصدر: Journal of Clinical Psychology in Medical Settings. 17:349-356
مصطلحات موضوعية: Male, medicine.medical_specialty, Adolescent, Urban Population, genetic structures, Comorbidity, Severity of Illness Index, Article, Midwestern United States, Illness perceptions, immune system diseases, Surveys and Questionnaires, Severity of illness, Humans, Medicine, Longitudinal Studies, Child, Psychiatry, Asthma, Psychiatric Status Rating Scales, business.industry, Extramural, Asthma symptoms, medicine.disease, Anxiety Disorders, respiratory tract diseases, Clinical Psychology, Health psychology, Anxiety, Female, medicine.symptom, business, Attitude to Health, psychological phenomena and processes, Clinical psychology
الوصف: Twenty to 40% of adolescents with asthma experience significant symptoms of anxiety. This study examined the mediational role of illness perceptions in the relationship between anxiety and asthma symptoms in adolescents. One hundred fifty-one urban adolescents (ages 11-18) with asthma completed measures of illness perceptions, and anxiety and asthma symptoms. Using the Baron and Kenny approach and Sobel tests, we examined whether illness perceptions mediated the anxiety-asthma symptom relationship. Three illness perceptions significantly mediated the relationship between anxiety and asthma symptoms, z = 1.97-2.13, p < .05; adjusted R(2) = 0.42-0.51, p < .05. Greater anxiety symptoms were associated with perceptions that asthma negatively impacted one's life and emotions and was difficult to control. These negative illness perceptions were, in turn, related to greater asthma symptoms. Illness perceptions helped explain the anxiety-asthma symptoms link in adolescents. Results suggest that targeting illness perceptions in adolescents with asthma and anxiety may help reduce asthma symptoms.
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المصدر: Journal of Health Care Chaplaincy. 16:95-108
مصطلحات موضوعية: Male, Parents, Religion and Psychology, Health (social science), Cystic Fibrosis, Psychological intervention, Disease, Article, Grounded theory, Treatment plan, Adaptation, Psychological, Humans, Medicine, Meaning (existential), Parent-Child Relations, Child, Patient compliance, Qualitative Research, Motivation, Treatment regimen, business.industry, Religious studies, Models, Theoretical, humanities, Clinical Psychology, Patient Compliance, Female, business, Qualitative research, Clinical psychology
الوصف: The diagnosis of a child’s life-shortening disease leads many American parents to utilize religious beliefs. Models relating religious constructs to health have been proposed. Still lacking are inductive models based on parent experience. The specific aims of this study were: 1. develop a grounded theory of parental use of religion in the year after diagnosis; 2. describe whether parents understand a relationship between their religious beliefs and their follow-through with their child’s at-home treatment regimen. Fifteen parent interviews were analyzed using grounded theory method. Parents used religion to make meaning of their child’s cystic fibrosis (CF) diagnosis. Parents imagined God as active, benevolent, and interventionist; found hope in their beliefs; felt supported by God; and related religion to their motivation to adhere to their child’s treatment plan. Religious beliefs are clinically significant in working with many parents of children recently diagnosed with CF. Interventions that improve adherence to treatment may be enhanced by including religious aspects.
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المؤلفون: Michael S. Yi, Sian Cotton, Meghan E. McGrady, Janelle Hines, Yvonne Humenay Roberts, Susan L. Rosenthal, Joel Tsevat, Daniel H. Grossoehme
المصدر: Journal of Pediatric Hematology/Oncology. 31:313-318
مصطلحات موضوعية: Male, Religion and Psychology, Coping (psychology), Forgiveness, Adolescent, media_common.quotation_subject, Psychology, Adolescent, Pilot Projects, Anemia, Sickle Cell, Article, Religiosity, Young Adult, Adaptation, Psychological, Belief in God, Spirituality, Humans, Medicine, Young adult, Child, media_common, business.industry, Data Collection, Religion and Medicine, Attendance, Hematology, Prayer, Oncology, Chronic Disease, Pediatrics, Perinatology and Child Health, Female, business, Clinical psychology
الوصف: Religious/spiritual (R/S) coping has been associated with health outcomes in chronically ill adults; however, little is known about how adolescents use R/S to cope with a chronic illness such as sickle cell disease (SCD). Using a mixed method approach (quantitative surveys and qualitative interviews), we examined R/S coping, spirituality, and health-related quality of life in 48 adolescents with SCD and 42 parents of adolescents with SCD. Adolescents reported high rates of religious attendance and belief in God, prayed often, and had high levels of spirituality (e.g., finding meaning/peace in their lives and deriving comfort from faith). Thirty-five percent of adolescents reported praying once or more a day for symptom management. The most common positive R/S coping strategies used by adolescents were: “Asked forgiveness for my sins” (73% of surveys) and “Sought God’s love and care” (73% of surveys). Most parents used R/S coping strategies to cope with their child’s illness. R/S coping was not significantly associated with HRQOL (p = NS). R/S coping, particularly prayer, was relevant for adolescents with SCD and their parents. Future studies should assess adolescents’ preferences for discussing R/S in the medical setting and whether R/S coping is related to HRQOL in larger samples.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d2c0e49739ac09569478cb3c20e018be
https://doi.org/10.1097/mph.0b013e31819e40e3 -
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المؤلفون: Sian, Cotton, Christina M, Luberto, Richard W, Sears, Jeffrey R, Strawn, Lauren, Stahl, Rachel S, Wasson, Thomas J, Blom, Melissa P, Delbello
المصدر: Early intervention in psychiatry. 10(5)
مصطلحات موضوعية: Male, Parents, Bipolar Disorder, Adolescent, Cognitive Behavioral Therapy, Psychotherapy, Group, Humans, Female, Pilot Projects, Child, Anxiety Disorders, Mindfulness
الوصف: Children and adolescents with bipolar parents have an elevated risk for anxiety disorders. However, antidepressant medications commonly used to treat symptoms of anxiety may accelerate the onset of mania in these already at-risk youth. Therefore, studies evaluating innovative non-pharmacologic treatments for anxiety in this population are urgently needed.Subjects participated in 12 weekly sessions of mindfulness-based cognitive therapy for children (MBCT-C), a manualized group psychotherapeutic intervention utilizing cognitive behavioural principles and mindfulness exercises to increase regulation of attention and non-judgmental acceptance of present moment thoughts, emotions and experiences. Independent raters administered symptoms rating scales prior to each treatment session. Spearman correlations and paired-samples signed rank tests were used to examine outcomes. After-intervention surveys and session transcripts were reviewed to assess feasibility and acceptability of the intervention.Participants included 10 youth (meanage = 13.2; 80% girls; 40% biracial) with generalized, social and/or separation anxiety disorders, and a parent with bipolar disorder. Clinician-rated anxiety was significantly reduced after intervention (meanbefore = 11.1; meanafter = 4.3; P 0.01), as well as youth-rated trait anxiety (P = 0.03). Parent-rated emotion regulation significantly increased from before to after intervention (P = 0.05). Increases in mindfulness were associated with decreases in anxiety (P = 0.03). Finally, children and parents/guardians reported high levels of feasibility, acceptability and usefulness of the intervention.Findings support the feasibility, acceptability and preliminary efficacy of MBCT-C for treating anxiety in youth at risk for bipolar disorder. Future controlled and larger studies are needed to confirm these preliminary findings.
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المؤلفون: Judy Ragsdale, Alexandra L. Quittner, Gary L. McPhail, Daniel H. Grossoehme, Sian Cotton, Michael Seid
المصدر: Journal of health care chaplaincy. 19(2)
مصطلحات موضوعية: Adult, Male, Parents, Health (social science), Psychotherapist, Adolescent, Cystic Fibrosis, Treatment adherence, media_common.quotation_subject, Disease, Grounded theory, Article, Faith, Young Adult, Spirituality, Medicine, Humans, Young adult, Child, Qualitative Research, media_common, business.industry, Religion and Medicine, Religious studies, Middle Aged, Prayer, humanities, Clinical Psychology, Child, Preschool, Patient Compliance, Female, business, Psychological Theory, Qualitative research
الوصف: A limited number of studies address parental faith and its relationship to their children's health. Using cystic fibrosis as a disease exemplar in which religion/spirituality have been shown to play a role and parental health behaviors (adherence to their child's daily recommended home treatments) are important, this study explored whether parents with different levels of adherence would describe use of faith differently. Twenty-five interviews were completed and analyzed using grounded theory methodology. Some parents described no relationship between faith and treatment adherence. However, of those who did, higher-adherence parents believed God empowered them to care for their child and they used prayer to change themselves, while lower-adherence parents described trusting God to care for their child and used prayer to change God. Clinical implications for chaplains' differential engagement with parents are presented.
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المصدر: The Journal of Alternative and Complementary Medicine. 20:A71-A72
مصطلحات موضوعية: Complementary Therapies, Male, medicine.medical_specialty, Adolescent, Adolescent, Hospitalized, MEDLINE, Anxiety, Retrospective database, Chart review, medicine, Humans, Pain Management, Child, Retrospective Studies, Integrative Medicine, Massage, business.industry, Retrospective cohort study, Original Articles, Pain management, Complementary and alternative medicine, Physical therapy, Female, Integrative medicine, medicine.symptom, business, Child, Hospitalized
الوصف: Complementary or integrative care therapies are promising adjunctive approaches to pain management for pediatric inpatients that are currently underused and understudied. The purpose of this study was to examine the potential benefits of integrative care therapies delivered to hospitalized children and adolescents at a large Midwestern academic pediatric medical center over a 1-year period.A retrospective chart review of an inpatient clinical database maintained by integrative care therapists over a 1-year period was used for the current study. Pre/post pain and relaxation scores associated with the delivery of inpatient integrative care therapies (primarily massage therapy and healing touch) were examined.Five-hundred nineteen hospitalized children and adolescents were treated by integrative care therapists for primarily pain or anxiety needs. Patients had a mean age of 10.2 years (standard deviation, 7.0), 224 were female (43%), 383 were white (74%), and most (393 [77%]) received massage therapy. Mean pain and relaxation scores decreased significantly from pre- to post-therapy across all demographic and clinical subgroups (p≤.001).Although integrative care therapies are increasingly requested and offered in children's hospitals, provision of these approaches is driven primarily by consumer demand rather than evidence-informed practice. Future controlled studies should examine the incremental effects of integrative care therapies as an adjunct to conventional treatment, assess how these therapies work mechanistically, and determine whether they improve outcomes, such as pain and cost, for hospitalized children and adolescents.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5ef368a174cd6b83b120e9b1f1869dab
https://doi.org/10.1089/acm.2014.5187.abstract
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