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Website of the Association for Contemplative Mind in Higher Education. The website includes a bibliography related to contemplative practice and contemplative education, including several papers written by fellows of the Association available as PDFs on the website.

To gain insight into the neurophysiological mechanisms involved in Zen meditation, we evaluated the effects of focused attention (FA) on breathing movements in the lower abdomen (Tanden) in novices. We investigated hemodynamic changes in the prefrontal cortex (PFC), an attention-related brain region, using 24-channel near-infrared spectroscopy during a 20-minute session of FA on Tanden breathing in 15 healthy volunteers. We found that the level of oxygenated hemoglobin in the anterior PFC was significantly increased during FA on Tanden breathing, accompanied by a reduction in feelings of negative mood compared to before the meditation session. Electroencephalography (EEG) revealed increased alpha band activity and decreased theta band activity during and after FA on Tanden breathing. EEG changes were correlated with a significant increase in whole blood serotonin (5-HT) levels. These results suggest that activation of the anterior PFC and 5-HT system may be responsible for the improvement of negative mood and EEG signal changes observed during FA on Tanden breathing.

Work stress, worry, anxiety, fatigue? Want to learn meditation, mindfulness, time-management, balance, and efficiency? Active Relaxation is a practical guide for anyone, from executives to mothers, to students, to laborers, who wants to be more productive and less anxious. It contains a plethora of simple and effective tools that help the reader reduce stress and achieve balance. The book is aimed toward people who want to live a more relaxed and balanced lifestyle, but have no time for traditional forms of relaxation, have tried them without success, or fear that relaxing may sacrifice their success.

OBJECTIVES: To evaluate the acute and chronic effects of yoga practice. DESIGN: Quantitative study using a one-group pre-posttest design. SETTING: Visao Futuro Institute, Porangaba, Sao Paulo, Brazil. PARTICIPANTS: 22 volunteers (7 men and 15 women). INTERVENTION: Six weeks of a tantric yoga program (TYP), 50 minutes per session, held twice a week from 8 a.m. to 9 a.m. The local ethics committee approved the protocol. OUTCOME MEASURES: Data were collected in the first week and at the end of the sixth week of TYP. Salivary cortisol concentration (SCC) was used to measure physiology of distress and to analyze the short- and long-term effects of TYP. Psychological distress was evaluated by applying a specific perceived stress questionnaire (PSQ). Results (mean+/-standard deviation) were analyzed by Wilcoxon test (p<0.05). RESULTS: SCC decreased 24% after the first (0.66+/-0.20 mug/dL versus 0.50+/-0.13 mug/dL) and last (1.01+/-0.37 versus 0.76+/-0.31 mug/dL) sessions, showing the short-term effect of yoga. Long-term effects were analyzed by daily rhythm of cortisol production. In the beginning, volunteers showed altered SCC during the day, with nighttime values (0.42+/-0.28) higher than those at noon (0.30+/-0.06). After the TYP, SCC was higher in the morning (1.01+/-0.37) and decreased during the day, with lower values before sleep (0.30+/-0.13). The TYP was also efficient to reduce PSQ scores (0.45+/-0.13 versus 0.39+/-0.07). Specifically, the irritability, tension, and fatigue domains on the PSQ decreased (0.60+/-0.20 versus 0.46+/-0.13), as did the fear and anxiety domains (0.54+/-0.30 versus 0.30+/-0.20). CONCLUSION: Over the short term, TYP led to the decrease of cortisol production. Over the long term, TYP induced higher cortisol production in the morning and lower production in the evening. Those effects contributed to the physical and mental well-being of the participants.

BACKGROUND: College students are vulnerable to a critical period in developmental maturation, facing rigorous academic work and learning how to function independently. Western aerobic exercise (WAE), such as running and bicycling, has been shown to improve mood and relieve stress. However, college students often have low levels of physical activity. Yoga is an ancient physical and mental practice that may affect mood and stress. However, rigorous studies examining the psychological effects of yoga are rare in peerreviewed Western journals. The aim of this research was to establish preliminary evidence for the acute effects of Vinyasa yoga on affect and stress in young-adult college students. METHODS: Twenty healthy college students age 18 years and older were recruited to participate in this pilot study. Participants attended a Vinyasa yoga class at a local studio twice weekly for 8 weeks. Affect and stress were assessed before and after each yoga session. Measures included the Positive and Negative Affective Schedule (PANAS) and the Cohen Perceived Stress scale. RESULTS: Positive affect scores increased significantly (p < 0.05) for 14 of the 16 yoga sessions (mean increase = 23.2%). Negative affect decreased significantly from pre- to postyoga (p < 0.05) for 15 of the 16 sessions (mean decrease = 22%). Repeated measures ANOVAs examining pre-post composite scores across all 8 weeks showed significant changes in PANAS, but not stress scores. CONCLUSIONS: Findings suggest that yoga practice is associated with acute improvements in affect in a young-adult college population. Future research is needed to examine the extent to which different types of yoga address the needs of different college sub-populations (e.g., eating disordered, overweight/obese, sedentary, and smokers).

To test the effects of cortisol on affective experience, the authors orally administered a placebo, 20 mg cortisol, or 40 mg cortisol to 85 men. Participants' affective responses to negative and neutral stimuli were measured. Self-reported affective state was also assessed. Participants in the 40-mg group (showing extreme cortisol elevations within the physiological range) rated neutral stimuli as more highly arousing than did participants in the placebo and 20-mg groups. Furthermore, within the 20-mg group, individuals with higher cortisol elevations made higher arousal ratings of neutral stimuli. However, cortisol was unrelated to self-reported affective state. Thus, findings indicate that acute cortisol elevations cause heightened arousal in response to objectively nonarousing stimuli, in the absence of effects on mood.
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The concept of recovery strategies includes various ways to achieve a state of well-being, prevent underrecovery syndromes from occurring and re-establish pre-performance states. A systematic application of individualised relaxation techniques is one of those. Following a counterbalanced cross-over design, 27 sport science students (age 25.22 +/- 1.08 years; sports participation 8.08 +/- 3.92 h/week) were randomly assigned to series of progressive muscle relaxation, systematic breathing, power nap, yoga, and a control condition. Once a week, over the course of five weeks, their repeated sprint ability was tested. Tests (6 sprints of 4 s each with 20 s breaks between them) were executed on a non-motorised treadmill twice during that day intermitted by 25 min breaks. RM-ANOVA revealed significant interaction effects between the relaxation conditions and the two sprint sessions with regard to average maximum speed over all six sprints, F(4,96) = 4.06, P = 0.004, [Formula: see text] = 0.15. Post-hoc tests indicated that after systematic breathing interventions, F(1,24) = 5.02, P = 0.033, [Formula: see text] = 0.18, participants performed significantly better compared to control sessions. As the focus of this study lied on basic mechanisms of relaxation techniques in sports, this randomised controlled trial provides us with distinct knowledge on their effects, i.e., systematic breathing led to better performances, and therefore, seems to be a suited relaxation method during high-intensity training.

OBJECTIVE:Despite the well-known stress of medical school, including adverse consequences for mental and behavioral health, there is little consensus about how to best intervene in a way that accommodates students׳ intense training demands, interest in science, and desire to avoid being stigmatized. The objective of this study, therefore, was to evaluate the feasibility, acceptability, and initial effectiveness of an adapted, four-week stress management and self-care workshop for medical students, which was based on the science and practice of mind-body medicine. METHODS: The current study used a prospective, observational, and mixed methods design, with pretest and posttest evaluations. Participants (n = 44) included medical and physician-scientist (MD/PhD) students from a large, southeastern medical school. Feasibility was assessed by rates of workshop enrollment and completion. Acceptability was assessed using qualitative ratings and open-ended responses that queried perceived value of the workshop. Quantitative outcomes included students׳ ratings of stress and mindfulness using validated self-report surveys. RESULTS: Enrollment progressively increased from 6 to 15 to 23 students per workshop in 2007, 2009, and 2011, respectively. Of the 44 enrolled students, 36 (82%) completed the workshop, indicating that the four-session extracurricular format was feasible for most students. Students reported that the workshop was acceptable, stating that it helped them cope more skillfully with the stress and emotional challenges of medical school, and helped increase self-care behaviors, such as exercise, sleep, and engaging in social support. Students also reported a 32% decrease in perceived stress (P < .001; d = 1.38) and a 16% increase in mindfulness (P < .001; d = 0.92) following the workshop. Changes in stress and mindfulness were significantly correlated (r = -0.42; P = .01). CONCLUSION: Together, these findings suggest that a brief, voluntary mind-body skills workshop specifically adapted for medical students is feasible, acceptable, and effective for reducing stress, increasing mindfulness, and enhancing student self-care.

Treating suicidal adolescents is fraught with challenges. Antidepressants may be associated with increased suicidal ideation in adolescents, although some data suggest that increased adolescent suicide rates are correlated with decreases in antidepressant prescribing. Adolescents hospitalized after a suicide attempt are likely to attempt suicide again after they are discharged. Such patients might not attend outpatient psychotherapy; a study of 167 adolescents discharged after a suicide attempt found that 26% never attended follow-up appointments and 11% went once. Emerging research supports the effectiveness of dialectical behavior therapy (DBT) for suicidal adolescents. DBT is a form of cognitive-behavioral therapy that combines individual therapy, skills training, and telephone coaching and is implemented by a therapist consultation team that meets weekly. This article reviews evidence supporting the efficacy of DBT for suicidal adolescents and describes principles of outpatient DBT for these patients as developed by Miller et al.
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BACKGROUND AND OBJECTIVE: The practice of yoga is associated with enhanced psychological wellbeing. The current study assessed the correlation between the duration of yoga practice with state mindfulness, mind-wandering and state anxiety. Also, we examined if an additional 20 min of yoga breathing with intermittent breath holding (experimental group) for 8 weeks would affect these psychological variables more than regular yoga practice (control group) alone. METHODS: One hundred sixteen subjects were randomly assigned to experimental (n = 60) and control (n = 56) groups. State mindfulness attention awareness scale (SMAAS), Mind-Wandering Questionnaire (MWQ) and State anxiety inventory were administered at baseline and at the end of 8 weeks. RESULTS: Baseline assessment revealed a positive correlation between duration of yoga practice with SMAAS scores and negative correlation with MWQ and state anxiety scores. At the end of 8 weeks, both groups demonstrated enhanced psychological functions, but the experimental group receiving additional yoga breathing performed better than the group practicing yoga alone. CONCLUSION: An additional practice of yoga breathing with intermittent breath holding was found to enhance the psychological functions in young adult yoga practitioners.

OBJECTIVES: Adequate relief (AR) of irritable bowel syndrome (IBS) symptoms (IBS-AR) has been used as a primary end point in many randomized controlled trials of IBS and is considered by the Rome III committee to be an acceptable primary end point. However, controversy exists on whether baseline severity confounds the effect of the treatment outcome. The aim (1) is to compare a subjective report of IBS-AR with global assessment of improvement (IBS-GAI), change in IBS symptom severity scale (IBS-SSS), and IBS quality of life (IBS-QOL); (2) to explore whether initial IBS symptom severity influences the ability of these outcome measures to detect differences post treatment; and (3) to determine whether psychological symptoms influence the sensitivity of these measures, in a randomized controlled treatment trial. METHODS: A total of 289 adult IBS patients were recruited to a treatment trial. Baseline IBS-SSS scores were used to classify IBS severity as mild (<175), moderate (175–300), or severe (>300). Questionnaires were completed at baseline and after 3 weeks of treatment with sham acupuncture or wait-list control. RESULTS: IBS baseline severity (IBS-SSS) significantly affected the proportion of patients who reported IBS-AR at 3 weeks (mild, 70%; moderate, 49.7%; severe, 38.8%) (P<0.05). However, once the patients who reported IBS-AR at baseline (28.0%) were excluded from the analysis, baseline severity no longer affected the proportion of patients reporting IBS-AR. Baseline severity did not have a significant effect on patients reporting moderate or significant improvement on the IBS-GAI (mild, 30%; moderate, 25.3%; severe, 18.8%) (P=NS). Psychological symptoms had no significant correlations with responders after adjusting for baseline severity. CONCLUSIONS: These data suggest that IBS-AR as an end point is inversely related to baseline symptom severity. However, if patients who report AR at screening were excluded from study participation, baseline symptom severity was no longer confounded with a report of AR at the study end point.
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OBJECTIVE: To investigate the effect of a short-term yoga-based lifestyle intervention on risk factors for cardiovascular disease (CVD) and markers of inflammation and endothelial function in overweight and obese men. DESIGN: Nonrandomized prospective lifestyle intervention study with pre-post design. SETTING AND LOCATION: Integral Health Clinic, an outpatient facility providing yoga-based lifestyle intervention programs for prevention and management of chronic diseases. SUBJECTS: Overweight and obese men (n=51) were enrolled in the study. Subjects who were physically unable to participate and those participating in other interventions were excluded from the study. INTERVENTION: A pretested intervention program including asanas (physical postures), pranayama (breathing exercises), group discussions, lectures, and individualized advice. OUTCOME MEASURES: The primary outcome measure was weight loss, and the secondary outcome measures were clinical and laboratory correlates of CVD risk, levels of interleukin-6 (IL-6), adiponectin, and endothelin-1 (ET-1). RESULTS: Men (n=51, body mass index [BMI] 26.26±2.42 kg/m(2)) were enrolled and underwent a yoga-based lifestyle intervention for 10 days. Of 51 subjects, 30 completed the study. There was a significant reduction in weight from Baseline to Day 10 (74.60±7.98, 72.69±8.37 kg, p<0.001, respectively), BMI (26.26±2.42, 25.69±2.47 kg/m(2), p<0.001, respectively), and systolic BP (121.73±11.58, 116.73±9.00, p=0.042, respectively). There was a significant reduction in plasma IL-6 from Baseline to Day 10 (median 2.24 vs. 1.26 pg/mL, respectively, p=0.012). There was a significant increase in the plasma adiponectin from Baseline to Day 10 (median 4.95 vs. 6.26 μg/mL, respectively, p=0.014). Plasma ET-1 level remained unchanged. CONCLUSION: These findings suggest that even a short-term yoga-based lifestyle intervention may be an important modality to reduce the risk for CVD as indicated by weight loss, reduction in systolic blood pressure, an increase in adiponectin, and decrease in IL-6 in overweight and obese men.
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Background: Chronic pelvic pain in adolescents accounts for 10% of outpatient gynecology visits, and 70% of adolescent patients whose pelvic pain is unresponsive to initial therapy have endometriosis. To date, there has been no published research investigating the use of acupuncture for adolescents with chronic pelvic pain and/or endometriosis. Methods: This paper presents two case reports describing the impact of a course of acupuncture on adolescent girls with endometriosis-related chronic pelvic pain of more than 1 year. Results: Both patients, undergoing between 9 and 15 treatments over a 7- to 12-week period, experienced modest improvement in pain as measured by oral self-reports of pain on a scale from 1 to 10, as well as selfor family-reported improvement in headaches, nausea and fatigue. No adverse effects were reported. Conclusions: These case reports provide preliminary evidence that acupuncture may be an acceptable and safe adjunct treatment therapy for some adolescents with endometriosis-related pelvic pain refractory to standard antiendometriosis therapies. These observations suggest that a prospective, randomized controlled trial of the safety and efficacy of acupuncture for this population may be warranted.
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Adolescence is a time of change that can be both exciting and stressful. In this review, we focus on the central role that disturbed sleep and daytime sleepiness occupies in interactions involving substance abuse and negative health, social, and emotional outcomes. As a means of improving sleep and lowering risk for recidivism of substance abuse, we developed and implemented a six-session group treatment to treat sleep disturbances in adolescents who have received treatment for substance abuse. The components of the treatment are stimulus control instructions, use of bright light to regularize sleep, sleep hygiene education, cognitive therapy, and Mindfulness-Based Stress Reduction. Preliminary evidence indicates that participants who completed four or more sessions in the treatment program showed improved sleep and that improving sleep may lead to a reduction in substance abuse problems at the 12-month follow-up.

Children and adolescents with Asperger syndrome occasionally exhibit aggressive behavior against peers and parents. In a multiple baseline design across subjects, three adolescents with Asperger syndrome were taught to use a mindfulness-based procedure called Meditation on the Soles of the Feet to control their physical aggression in the family home and during outings in the community. They were taught to shift the focus of their attention from the negative emotions that triggered their aggressive behavior to a neutral stimulus, the soles of their feet. Prior to training in the mindfulness-based procedure the adolescents had moderate rates of aggression. During mindfulness practice, which lasted between 17 and 24 weeks, their mean rates of aggression per week decreased from 2.7, 2.5 and 3.2 to 0.9, 1.1, and 0.9, respectively, with no instances observed during the last 3 weeks of mindfulness practice. No episodes of physical aggression occurred during a 4-year follow-up. This study suggests that adolescents with Asperger syndrome may successfully use a mindfulness-based procedure to control their aggressive behavior.
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Adolescents with conduct disorder frequently engage in aggressive and disruptive behaviors. Often these behaviors are controlled or managed through behavioral or other psychosocial interventions. However, such interventions do not always ensure lasting changes in an adolescent's response repertoire so that he or she does not engage in aggression when exposed to the same situations that gave rise to the behavior previously. Mindfulness training provides a treatment option that helps an individual focus and attend to conditions that give rise to maladaptive behavior.Using a multiple baseline design,we assessed the effectiveness of a mindfulness training procedure in modulating the aggressive behavior of three adolescents who were at risk of expulsion from school because of this behavior. The adolescents were able to learn the mindfulness procedure successfully and use it in situations that previously occasioned aggressive behavior.This led to large decreases in the aggression of all three individuals. Follow-up data showed that the adolescents were able to keep their aggressive behavior at socially acceptable levels in school through to graduation. Maladaptive behaviors, other than aggression, that the adolescents chose not to modify, showed no consistent change during mindfulness training, practice, and follow-up.
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