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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: Christina M. Luberto, Rachel S. Wasson, Meera Murthi, Susan Blocksom McDonald, Harini Pallerla, Sian Cotton, Brenna K Novak
المصدر: Global Advances in Health and Medicine
Global Advances in Health and Medicine, Vol 9 (2020)مصطلحات موضوعية: Stress reduction, 050103 clinical psychology, 2019-20 coronavirus outbreak, unemployment, Mindfulness, mindfulness, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), media_common.quotation_subject, MBSR, Health outcomes, Mindfulness-based stress reduction, 03 medical and health sciences, 0302 clinical medicine, 0501 psychology and cognitive sciences, media_common, Community based, lcsh:R5-920, lcsh:Public aspects of medicine, 05 social sciences, lcsh:RA1-1270, General Medicine, under-resourced, Unemployment, Original Article, Psychology, lcsh:Medicine (General), underemployed, 030217 neurology & neurosurgery, Clinical psychology
الوصف: Background Mindfulness-Based Stress Reduction (MBSR) often improves health outcomes, though literature primarily focuses on middle-class, employed individuals. With an estimated average of six million unemployed over the past year, and the recent uptick in unemployment due to the COVID-19 pandemic, it is important to identify methods to mitigate and reduce the negative health outcomes often associated with under- and unemployment. Objectives We aimed to 1) outline the process of partnering with a community organization to implement a modified MBSR program for under- and unemployed individuals, and 2) present pilot data on preliminary results. Methods The modified MBSR program was implemented in two phases within a job training program for under- and unemployed individuals. In Phase I, group one received an eight-week program. Based on feedback, the MBSR program was reduced to six weeks and implemented for groups two and three (Phase II). Feasibility and acceptability were evaluated utilizing a mixed-methods approach. Changes in mindfulness, perceived stress, pain interference, anxiety, depression, and sleep disturbance were assessed pre-post the modified MBSR program. Results Thirty-three participants completed the program with twenty-nine post-survey responses. The modified MBSR program was feasible and acceptable as evidenced by the enrollment rate (96%), retention rate (72%), and qualitative feedback. Fifty-percent of participants self-reported weekly home practice compliance. Perceived stress and mindfulness demonstrated significant moderate improvements ( d = .69, p = .005; d = .46, p = .001). Depression, anxiety, and pain interference results suggested small non-significant effect size improvements ( d = .27, p = .19; d = .23, p = .31; d = .25, p = .07). Effects on fatigue and sleep disturbance were negligible. Conclusion The modified MBSR program was feasible and acceptable to the organization and participants. Small to moderate improvements in mental health and pain interference outcomes were observed. Research using larger sample sizes and randomized designs is warranted.
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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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المصدر: Teaching and Learning in Medicine. 28:219-228
مصطلحات موضوعية: Male, 050103 clinical psychology, Students, Medical, Mindfulness, 020205 medical informatics, Mind–body problem, media_common.quotation_subject, education, Pilot Projects, 02 engineering and technology, Absorption (psychology), Education, Young Adult, Skills training, Perception, Adaptation, Psychological, 0202 electrical engineering, electronic engineering, information engineering, Humans, 0501 psychology and cognitive sciences, Young adult, media_common, 05 social sciences, General Medicine, Distress, Treatment Outcome, Female, Psychology, Stress, Psychological, Psychopathology, Clinical psychology
الوصف: Medical students face rigorous and stressful work environments, resulting in high rates of psychological distress. However, there has been a dearth of empirical work aimed at modifying risk factors for psychopathology among this at-risk group. Distress tolerance, defined as the ability to withstand emotional distress, is one factor that may be important in promoting psychological well-being in medical students. Thus, the aim of the current mixed-methods study was (a) to describe changes in facets of distress tolerance (i.e., emotional tolerance, absorption, appraisal, regulation) for medical students who completed a mind-body skills training group, and a no-intervention control group of students; (b) to examine the relationship between changes in psychological variables and changes in distress tolerance; and (c) to report students' perceptions of the mind-body group, with an emphasis on how the group may have affected personal and professional functioning due to improvements in distress tolerance.The mind-body program was an 11-week, 2-hour skills training group that focused on introducing, practicing, and processing mind-body skills such as biofeedback, guided imagery, relaxation, several forms of meditation (e.g., mindfulness), breathing exercises, and autogenic training.Participants were 52 first- and second-year medical students (62.7% female, Mage = 23.45, SD = 1.51) who participated in a mind-body group or a no-intervention control group and completed self-report measures before and after the 11-week period.Students in the mind-body group showed a modest improvement in all distress tolerance subscales over time (ΔM = .42-.53, p = .01-.03, d = .44-.53), whereas the control group showed less consistent changes across most subscales (ΔM = .11-.42, p = .10-.65, d = .01-.42). Students in the mind-body group qualitatively reported an improved ability to tolerate affective distress. Overall, improvements in psychological symptoms were associated with improvements in distress tolerance in the mind-body group but not in the control group.These preliminary findings provide support for the notion that improving distress tolerance through mind-body skills training might serve to protect medical students from becoming functionally impaired by psychological distress. Thus, implementing mind-body skills training into medical school education may help to improve the psychological well-being of medical students. Future studies utilizing more methodologically rigorous designs are warranted.
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المؤلفون: Carly Hueber, Rachel S. Wasson, Sian Cotton, Richard W. Sears, Kristen M. Kraemer, Christina M. Luberto
المصدر: Mindfulness. 8(6)
مصطلحات موضوعية: 050103 clinical psychology, Health (social science), Mindfulness, Social Psychology, medicine.medical_treatment, 05 social sciences, Attendance, Psychological intervention, Experimental and Cognitive Psychology, Burnout, Article, 03 medical and health sciences, 0302 clinical medicine, Developmental and Educational Psychology, Cognitive therapy, medicine, 0501 psychology and cognitive sciences, Stress measures, 030212 general & internal medicine, Occupational stress, Psychology, Applied Psychology, Clinical psychology, Mindfulness-based cognitive therapy
الوصف: Hospital employees may experience occupational stress and burnout, which negatively impact quality of life and job performance. Evidence-based interventions implemented within the hospital setting are needed to promote employees' well-being. We offered a 4-week Mindfulness-Based Cognitive Therapy group program for hospital employees, and used a mixed-methods practice-based research approach to explore feasibility, acceptability, and effects on stress and burnout. Participants were 65 hospital employees (Mage = 44.06; 85% white) who participated between September 2015 and January 2016. Participants completed validated measures of stress and burnout before and after the program, and answered open-ended satisfaction questions after the program. Groups consistently enrolled at least 10 participants, but attendance rates declined across sessions (76% at session 2 vs. 54% at session 4) due primarily to work-related scheduling conflicts. The program content was acceptable as evidenced by high perceived value (M = 9.18 out of 10), homework compliance (51% practicing at least 3 times/week), and qualitative requests for program expansion. There were large, statistically significant decreases in stress (ΔM = 2.1, p < .001, d = .85) and medium decreases in burnout (ΔM = .46, p = .01, d = .57), which were supported by qualitative themes of improved self-regulation and mindfulness skills, stress reduction, emotional well-being, and improved work productivity and patient care skills. Findings suggest that 4-week MBCT is acceptable and useful for hospital employees, though research is needed to identify alternate delivery methods or strategies to enhance session attendance.
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المؤلفون: Sian Cotton, Christina M. Luberto, Thomas J. Blom, Rachel S. Wasson, Melissa P. DelBello, Richard W. Sears, Lauren Stahl, Jeffrey R. Strawn
المصدر: Early Intervention in Psychiatry. 10:426-434
مصطلحات موضوعية: education.field_of_study, medicine.medical_specialty, Mindfulness, medicine.medical_treatment, Population, medicine.disease, 030227 psychiatry, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Intervention (counseling), medicine, Cognitive therapy, Anxiety, Bipolar disorder, Pshychiatric Mental Health, medicine.symptom, education, Psychiatry, Psychology, Mania, 030217 neurology & neurosurgery, Biological Psychiatry, Clinical psychology, Mindfulness-based cognitive therapy
الوصف: Aim 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. Methods 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. Results 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
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المصدر: Journal of Religion and Health. 53:604-613
مصطلحات موضوعية: Male, Religion and Psychology, medicine.medical_specialty, Adolescent, Urban Population, media_common.quotation_subject, Context (language use), Article, Midwestern United States, Interviews as Topic, Surveys and Questionnaires, Intervention (counseling), Spirituality, medicine, Humans, Qualitative Research, General Nursing, media_common, Asthma, Physician-Patient Relations, Public health, Religion and Medicine, Religious studies, Patient Preference, General Medicine, medicine.disease, Prayer, Religion, Adolescent Behavior, Female, Thematic analysis, Psychology, Qualitative research, Clinical psychology
الوصف: This qualitative study examined the preferences of urban adolescents with asthma for including religious/spiritual (R/S) inquiry in a variety of hypothetical clinical encounters. Twenty-one urban adolescents (M age = 15.6 years, 52 % female, 81 % African American) with asthma participated in a semi-structured interview. Interviews were transcribed and underwent a thematic analysis. R/S preferences were contextual rather than personal, driven by: (1) acuity of the hypothetical clinical context; (2) nature of the patient–provider relationship; and (3) level of R/S intervention/inquiry. Most adolescents welcomed prayer if near death, but did not see the relevance of R/S in a routine office visit.
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