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Background: Borderline personality disorder (BPD) is characterized by deficits in self-regulation, including impulsivity and affective instability. Transference-focused psychotherapy (TFP) is an evidence-based treatment with proven effectiveness in reducing symptoms across multiple cognitive-emotional domains in patients with BPD. In this study, longitudinal changes in neural activation patterns and predictors of treatment response were investigated using a dimensional symptom-based approach. Methods: A functional magnetic resonance imaging (fMRI) activation paradigm was used pre and post-TFP in patients with BPD, with statistical parametric analyses, to test hypotheses concerning the identification of frontolimbic biomarkers for clinical improvement. Using a within-subjects design, BPD subjects (N=10; mean age=27.8) were scanned pretreatment, and again after approximately one-year of TFP using a disorder-specific emotional linguistic go/no-go fMRI paradigm. Results: Analyses confirmed significant treatment related effects with relative increases in dorsal prefrontal cognitive control regions (dorsal anterior cingulate cortex, dorsolateral prefrontal cortex), and relative decreases in ventrolateral prefrontal and hippocampal areas following treatment. Clinical improvement in affective lability correlated positively with activity in left posterior-medial orbitofrontal cortex/ventral striatum (small-volume-corrected p value (psvc)=0.028); right amygdala/ parahippocampal activation correlated negatively with improvements in affective lability (psvc=0.005). Pretreatment hypoactivation in the left posterior-medial orbitofrontal cortex/ventral striatum predicted improvements in affective lability (psvc=0.013), and posttreatment improvements in constraint were predicted by pretreatment right anterior-dorsal anterior cingulate cortex hypoactivation (psvc=0.002). Conclusions: Individuals with BPD whose symptoms improved following TFP demonstrated modulation of neural activity in brain regions known to be implicated in behavioral inhibition in the context of negative emotional processing.

Train to facilitate MBCT programs with guidance from Zindel Segal, one of its co-developers.Current treatments for depression provide relief for many people, yet they face significant challenges maintaining the benefits of treatment. This workshop and meditation retreat will lead you through an innovative 5-day intensive training program designed to prevent depressive relapse among people with a history of depression. Facilitators: Zindel Segal PhD C Psych, Patricia Rockman MD CCFP FCFP & Evan Collins MD FRCPC Location: Ecology Retreat Centre

The spontaneous oscillatory activity in the human brain shows long-range temporal correlations (LRTC) that extend over time scales of seconds to minutes. Previous research has demonstrated aberrant LRTC in depressed patients; however, it is unknown whether the neuronal dynamics normalize after psychological treatment. In this study, we recorded EEG during eyes-closed rest in depressed patients (N = 71) and healthy controls (N = 25), and investigated the temporal dynamics in depressed patients at baseline, and after attending either a brief mindfulness training or a stress reduction training. Compared to the healthy controls, depressed patients showed stronger LRTC in theta oscillations (4–7 Hz) at baseline. Following the psychological interventions both groups of patients demonstrated reduced LRTC in the theta band. The reduction of theta LRTC differed marginally between the groups, and explorative analyses of separate groups revealed noteworthy topographic differences. A positive relationship between the changes in LRTC, and changes in depressive symptoms was observed in the mindfulness group. In summary, our data show that aberrant temporal dynamics of ongoing oscillations in depressive patients are attenuated after treatment, and thus may help uncover the mechanisms with which psychotherapeutic interventions affect the brain.

BackgroundResting state functional connectivity (RSFC) research among adults indicates abnormalities within and between neural networks during acute depressive episodes, some of which are likely to remain into remission. The examination of RSFC among adolescents within the remitted state of MDD may implicate markers of illness course during a critical developmental window wherein secondary prevention can be implemented. Methods RSFC data were collected on a 3.0T GE scanner from adolescents (12–18, M=15.61, SD=1.90; 57% female) in full or partial remission from MDD (rMDD; n=23) and age- and gender-matched healthy controls (HC; n=10). RSFC data were examined using seed-based connectivity of the left amygdala, left dorsolateral prefrontal cortex (dlPFC), and left posterior cingulate cortex (PCC). These seeds were chosen to probe the emotional salience, cognitive control, and default mode networks, respectively. Results rMDD adolescents demonstrated relative hyperconnectivity from the left amygdala to the right PCC, as well as from the left dlPFC to the right middle frontal and left inferior frontal gyri (MFG, IFG). Amygdala to PCC connectivity was correlated with greater rumination, dlPFC to MFG connectivity was positively associated with depression severity, and dlPFC to IFG connectivity was inversely associated with mindfulness. Conclusions Aberrant functional connectivity within and between neural networks responsible for salience attribution, introspective thought, and executive control can be observed among adolescents in the remitted phase of MDD and is associated with residual clinical symptoms. These patterns may confer risk for future relapse or alternatively, support wellness.

This book argues for the central role played by absorption in the functioning of the human mind. The importance of absorption makes itself felt in different ways; the two studies combined in this book concentrate on two of them. The first study, 'The Symbolic Mind', argues that, largely as a result of language acquisition, humans have two levels of cognition, which in normal circumstances are simultaneously active. Absorption is a (or the) means to circumvent some, perhaps all, of the associations that characterize one of these two levels of cognition, resulting in what is sometimes referred to as mysitcal experience, but which is not confined to mysticism and plays a role in various "religious" phenomena, and elsewhere. In the second study, 'The Psychology of the Buddha', Prof. Bronkhorst provides a theoretical context for the observation that absorption is a source of pleasure, grapples with Freud, and illustrates his observations through translations of ancient Buddhist texts from the Pali ans Sanskrit languages along with his psychological commentary.
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After reviewing six senses of abstraction, this article focuses on abstractions that take the form of summary representations. Three central properties of these abstractions are established: ( i ) type-token interpretation; (ii) structured representation; and (iii) dynamic realization. Traditional theories of representation handle interpretation and structure well but are not sufficiently dynamical. Conversely, connectionist theories are exquisitely dynamic but have problems with structure. Perceptual symbol systems offer an approach that implements all three properties naturally. Within this framework, a loose collection of property and relation simulators develops to represent abstractions. Type-token interpretation results from binding a property simulator to a region of a perceived or simulated category member. Structured representation results from binding a configuration of property and relation simulators to multiple regions in an integrated manner. Dynamic realization results from applying different subsets of property and relation simulators to category members on different occasions. From this standpoint, there are no permanent or complete abstractions of a category in memory. Instead, abstraction is the skill to construct temporary online interpretations of a category's members. Although an infinite number of abstractions are possible, attractors develop for habitual approaches to interpretation. This approach provides new ways of thinking about abstraction phenomena in categorization, inference, background knowledge and learning.
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Both dialectical behavior therapy (DBT) and mindfulness-based cognitive therapy (MBCT) include training in mindfulness skills and address the synthesis of acceptance and change. DBT is a comprehensive treatment for borderline personality disorder (BPD). MBCT was developed for prevention of relapse in individuals with a history of depressive episodes. Both have considerable empirical support for their efficacy. Many individuals with BPD also suffer from depressive episodes, which can interfere with motivation to participate in DBT. In such cases, it may be helpful to integrate strategies designed to prevent recurrence of depressive episodes. This case study describes integration of MBCT into ongoing DBT in the treatment of an individual with BPD and a history of depressive episodes. Findings suggest that MBCT can be successfully integrated into ongoing DBT in cases in which prevention of depressive episodes is an important goal. Findings also suggest that mindfulness skills may be very helpful in enhancing the efficacy of traditional cognitive-behavioral treatment approaches. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Based on promising results with adults, Acceptance and Commitment Therapy (ACT) presents as a treatment opportunity for depressed adolescents. We present a pilot study that compares ACT with treatment as usual (TAU), using random allocation of participants who were clinically referred to a psychiatric outpatient service. Participants were 30 adolescents, aged M = 14.9 (SD = 2.55), with 73.6% in the clinical range for depression. At posttreatment on measures of depression participants in the ACT condition showed significantly greater improvement statistically (d = 0.38), and 58% showed clinically reliable change with a response ratio of 1.59 in favor of ACT. Outcomes from 3-month follow-up data are tentative due to small numbers but suggest that improvement increased in magnitude. Measures of global functioning showed statistically significant improvement for both conditions, although clinical change measures favored only the ACT condition. The results support conducting a larger trial of ACT for the treatment of adolescent depression.
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Acceptance-based interventions such as mindfulness-based stress reduction program and acceptance and commitment therapy are alternative therapies for cognitive behavioral therapy for treating chronic pain patients. To assess the effects of acceptance-based interventions on patients with chronic pain, we conducted a systematic review and meta-analysis of controlled and noncontrolled studies reporting effects on mental and physical health of pain patients. All studies were rated for quality. Primary outcome measures were pain intensity and depression. Secondary outcomes were anxiety, physical wellbeing, and quality of life. Twenty-two studies (9 randomized controlled studies, 5 clinical controlled studies [without randomization] and 8 noncontrolled studies) were included, totaling 1235 patients with chronic pain. An effect size on pain of 0.37 was found for the controlled studies. The effect on depression was 0.32. The quality of the studies was not found to moderate the effects of acceptance-based interventions. The results suggest that at present mindfulness-based stress reduction program and acceptance and commitment therapy are not superior to cognitive behavioral therapy but can be good alternatives. More high-quality studies are needed. It is recommended to focus on therapies that integrate mindfulness and behavioral therapy. Acceptance-based therapies have small to medium effects on physical and mental health in chronic pain patients. These effects are comparable to those of cognitive behavioral therapy.

This longitudinal study used psychological process measures derived from Acceptance and Commitment Therapy (ACT) and Cognitive Therapy (CT) models to prospectively predict depression and quality of life. Participants included 93 K-12 education employees who repeatedly completed surveys over the course of 4 months. Both the ACT and CT regression models were predictive of depressive symptoms after controlling for baseline depression. These models differed in their success at predicting life quality over time. In the CT models, only automatic thought frequency had predictive value while dysfunctional attitudes and cognitive reappraisal did not make unique contributions. In the ACT models, both psychological flexibility and present moment awareness made unique contributions while thought believability did not contribute. The role of awareness was moderated by psychological flexibility, suggesting that present moment sensitivity can either be a strength or a weakness depending upon one's level of openness to experience. Strengths and weaknesses of both the ACT and CT models are noted, as areas for future research.

BACKGROUND:Depression affects as many as one in five people in their lifetime and often runs a recurrent lifetime course. Mindfulness-based cognitive therapy (MBCT) is an effective psychosocial approach that aims to help people at risk of depressive relapse to learn skills to stay well. However, there is an ‘implementation cliff’: access to those who could benefit from MBCT is variable and little is known about why that is the case, and how to promote sustainable implementation. As such, this study fills a gap in the literature about the implementation of MBCT.

BACKGROUND:Depression affects as many as one in five people in their lifetime and often runs a recurrent lifetime course. Mindfulness-based cognitive therapy (MBCT) is an effective psychosocial approach that aims to help people at risk of depressive relapse to learn skills to stay well. However, there is an ‘implementation cliff’: access to those who could benefit from MBCT is variable and little is known about why that is the case, and how to promote sustainable implementation. As such, this study fills a gap in the literature about the implementation of MBCT.

BackgroundMindfulness-based cognitive therapy (MBCT) is a cost-effective psychosocial prevention programme that helps people with recurrent depression stay well in the long term. It was singled out in the 2009 National Institute for Health and Clinical Excellence (NICE) Depression Guideline as a key priority for implementation. Despite good evidence and guideline recommendations, its roll-out and accessibility across the UK appears to be limited and inequitably distributed. The study aims to describe the current state of MBCT accessibility and implementation across the UK, develop an explanatory framework of what is hindering and facilitating its progress in different areas, and develop an Implementation Plan and related resources to promote better and more equitable availability and use of MBCT within the UK National Health Service. Methods/Design This project is a two-phase qualitative, exploratory and explanatory research study, using an interview survey and in-depth case studies theoretically underpinned by the Promoting Action on Implementation in Health Services (PARIHS) framework. Interviews will be conducted with stakeholders involved in commissioning, managing and implementing MBCT services in each of the four UK countries, and will include areas where MBCT services are being implemented successfully and where implementation is not working well. In-depth case studies will be undertaken on a range of MBCT services to develop a detailed understanding of the barriers and facilitators to implementation. Guided by the study’s conceptual framework, data will be synthesized across Phase 1 and Phase 2 to develop a fit for purpose implementation plan. Discussion Promoting the uptake of evidence-based treatments into routine practice and understanding what influences these processes has the potential to support the adoption and spread of nationally recommended interventions like MBCT. This study could inform a larger scale implementation trial and feed into future implementation of MBCT with other long-term conditions and associated co-morbidities. It could also inform the implementation of interventions that are acceptable and effective, but are not widely accessible or implemented.

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