-
1
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.
-
2
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.
-
3
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.
-
4
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.
-
5
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.
-
6
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.
-
7
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.
-
8
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.
-
9
المؤلفون: Judith R. Ragsdale, John P. Clancy, Michael Seid, Sian Cotton, Daniel H. Grossoehme, Melenie A. Meyers, Patricia M. Joseph
المصدر: Journal of Health Care Chaplaincy. 18:110-120
مصطلحات موضوعية: Adult, Male, Religion and Psychology, Coping (psychology), Health (social science), Cystic Fibrosis, Treatment adherence, Health outcomes, Article, Grounded theory, Adaptation, Psychological, Spirituality, Humans, Qualitative Research, Motivation, Stressor, Religious studies, Cognitive reframing, Middle Aged, Clinical Psychology, Patient Compliance, Female, Psychological Theory, Psychology, Qualitative research, Clinical psychology
الوصف: Chronic illness is a significant stressor; the majority of Americans cope utilizing spirituality. Numerous studies demonstrate links between spiritual coping and health outcomes. The purpose of this study was to determine whether persons diagnosed with cystic fibrosis (CF) as adults use spirituality to cope and influence disease management. Semi-structured interviews were completed and analyzed using grounded theory. Data saturation was reached following twelve interviews (83% female); representing 100% participation of those approached and 48% of eligible adults. Persons with late-life CF diagnoses used spirituality to make meaning, understanding themselves in a collaborative partnership with their pulmonologist and God. Supporting themes were: (a) God's intervention depended on treatment adherence and (b) spiritual meaning was constructed through positively reframing their experience. The constructed meaning differed from that of adult parents of children with CF. Late-life diagnosed adults focused on personal responsibility for health. Clinical and research implications for chaplains are presented.
-
10
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.
إعادة تعيين المنقحات
عرض المنقحات (%%عد%%)
Full Text via ClinicalKey 
PDF full text from Publisher