The World Health Organization formulated its definition of health following World War II, during a period when the social health of societies was in question. Since that definition in 1946, social scientists have dutifully followed its precepts and attempted to operationalize its concepts, including social well-being. But, American social scientists have found that psychosocial well-being may be a more accurate formulation of mental and social well-being, and they have questioned the reasonableness of a definition that requires complete health. It is proposed that scholars refine the WHO definition over the next several years, while at the same time creating bridges between a new conceptual definition and more detailed operational definitions. An expansion of the WHO definition may be necessary to include a spiritual dimension of health if social scientists can agree that spirituality is part of health and not merely an influence.
"Children (and adults) live in a fast-paced, demanding and stressful world. It is often difficult to slow-down our children's minds and bodies. This book was written to teach children to take a pause in their lives, to stop activity, to understand quiet time, and to think about what they are doing and where they are going"--
The purpose of this study was to compare the effects of yoga (physical activity) versus social support (verbal activity) on prenatal and postpartum depression. Ninety-two prenatally depressed women were randomly assigned to a yoga or a social support control group at 22 weeks gestation. The yoga group participated in a 20-min group session (only physical poses) once per week for 12 weeks. The social support group (a leaderless discussion group) met on the same schedule. At the end of the first and last sessions the yoga group reported less depression, anxiety, anger, back and leg pain as compared to the social support group. At the end of the last session the yoga group and the support group did not differ. They both had lower depression (CES-D), anxiety (STAI), and anger (STAXI) scores and improved relationship scores. In addition, cortisol levels decreased for both groups following each session. Estriol and progesterone levels decreased after the last session. At the postpartum follow-up assessment depression and anxiety levels were lower for both groups.
BACKGROUND: Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long-term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer-related impairments and has been shown to improve physical and mental health in people with different cancer types. OBJECTIVES: To assess effects of yoga on health-related quality of life, mental health and cancer-related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment. SEARCH METHODS: We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions. SELECTION CRITERIA: Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non-metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient-reported instruments, including health-related quality of life, depression, anxiety, fatigue or sleep disturbances. DATA COLLECTION AND ANALYSIS: Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random-effects model meta-analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi(2) test and the I(2) statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention. MAIN RESULTS: We included 24 studies with a total of 2166 participants, 23 of which provided data for meta-analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.Seventeen studies that compared yoga versus no therapy provided moderate-quality evidence showing that yoga improved health-related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD -0.48, 95% CI -0.75 to -0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD -0.25, 95% CI -0.40 to -0.09; six studies, 657 participants). The funnel plot for health-related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD -0.13, 95% CI -0.31 to 0.05; seven studies, 496 participants; low-quality evidence) or anxiety (pooled SMD -0.53, 95% CI -1.10 to 0.04; six studies, 346 participants; very low-quality evidence) in the short term and had no medium-term effects on health-related quality of life (pooled SMD 0.10, 95% CI -0.23 to 0.42; two studies, 146 participants; low-quality evidence) or fatigue (pooled SMD -0.04, 95% CI -0.36 to 0.29; two studies, 146 participants; low-quality evidence). Investigators reported no serious adverse events.Four studies that compared yoga versus psychosocial/educational interventions provided moderate-quality evidence indicating that yoga can reduce depression (pooled SMD -2.29, 95% CI -3.97 to -0.61; four studies, 226 participants), anxiety (pooled SMD -2.21, 95% CI -3.90 to -0.52; three studies, 195 participants) and fatigue (pooled SMD -0.90, 95% CI -1.31 to -0.50; two studies, 106 participants) in the short term. Very low-quality evidence showed no short-term effects on health-related quality of life (pooled SMD 0.81, 95% CI -0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD -0.21, 95% CI -0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety-related data.Three studies that compared yoga versus exercise presented very low-quality evidence showing no short-term effects on health-related quality of life (pooled SMD -0.04, 95% CI -0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD -0.21, 95% CI -0.66 to 0.25; three studies, 233 participants); no trial provided safety-related data. AUTHORS' CONCLUSIONS: Moderate-quality evidence supports the recommendation of yoga as a supportive intervention for improving health-related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low-quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.
This study evaluated the effects of yoga on posttraumatic stress disorder (PTSD) symptoms, resilience, and mindfulness in military personnel. Participants completing the yoga intervention were 12 current or former military personnel who met the Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition-Text Revision (DSM-IV-TR) diagnostic criteria for PTSD. Results were also benchmarked against other military intervention studies of PTSD using the Clinician Administered PTSD Scale (CAPS; Blake et al., 2000) as an outcome measure. Results of within-subject analyses supported the study's primary hypothesis that yoga would reduce PTSD symptoms (d = 0.768; t = 2.822; p = .009) but did not support the hypothesis that yoga would significantly increase mindfulness (d = 0.392; t = -0.9500; p = .181) and resilience (d = 0.270; t = -1.220; p = .124) in this population. Benchmarking results indicated that, as compared with the aggregated treatment benchmark (d = 1.074) obtained from published clinical trials, the current study's treatment effect (d = 0.768) was visibly lower, and compared with the waitlist control benchmark (d = 0.156), the treatment effect in the current study was visibly higher.
BACKGROUND: Stress and back pain are two key factors leading to sickness absence at work. Recent research indicates that yoga can be effective for reducing perceived stress, alleviating back pain, and improving psychological well-being.AIMS: To determine the effectiveness of a yoga-based intervention for reducing perceived stress and back pain at work. METHODS: Participants were recruited from a British local government authority and randomized into a yoga group who received one 50 min Dru Yoga session each week for 8 weeks and a 20 min DVD for home practice and a control group who received no intervention. Baseline and end-programme measurements of self-reported stress, back pain and psychological well-being were assessed with the Perceived Stress Scale, Roland Morris Disability Questionnaire and the Positive and Negative Affect Scale. RESULTS: There were 37 participants in each group. Analysis of variance and multiple linear regression showed that in comparison to the control group, the yoga group reported significant reductions in perceived stress and back pain, and a substantial improvement in psychological well-being. When compared with the control group at the end of the programme, the yoga group scores were significantly lower for perceived stress, back pain, sadness and hostility, and substantially higher for feeling self-assured, attentive and serene. CONCLUSIONS: The results indicate that a workplace yoga intervention can reduce perceived stress and back pain and improve psychological well-being. Larger randomized controlled trials are needed to determine the broader efficacy of yoga for improving workplace productivity and reducing sickness absence.
Health and human service providers have expressed growing interest in the benefits of yoga to help individuals cope with the effects of trauma, including anxiety, depression, and posttraumatic stress disorder (PTSD). Despite the growing popularity and strong appeal of yoga, providers must be mindful of the evidence regarding the efficacy of yoga in treating trauma effects as well as trauma-related mental health symptoms and illnesses. Therefore, our research team sought to answer two questions: (a) What is the evidence regarding yoga as a treatment for trauma effects, including anxiety, depression, and PTSD and (b) what are the clinical and service recommendations for using yoga with trauma-exposed individuals? Our initial scans identified a substantial body of research, including reviews. Rather than replicate earlier efforts, we undertook a systematic meta-review of 13 literature reviews, one of which included a meta-analysis. We determined the 13 reviews examined 185 distinct studies. Findings show that the evidence regarding yoga as an intervention for the effects of trauma as well as the mental health symptoms and illnesses often associated with trauma is encouraging but preliminary. Overall, the body of research is lacking in rigor as well as specificity regarding trauma. Review results also only allow for the recommendation of yoga as an ancillary treatment. Further, the reviews had considerable differences in their methods and limitations. Nonetheless, the results yielded findings concerning how clinicians and service providers can use yoga in their own practices, which is an important step for building an evidence base in this area.
Chronic low back pain (CLBP) afflicts millions of people worldwide, with particularly high prevalence in military veterans. Many treatment options exist for CLBP, but most have limited effectiveness and some have significant side effects. In general populations with CLBP, yoga has been shown to improve health outcomes with few side effects. However, yoga has not been adequately studied in military veteran populations. In the current paper we will describe the design and methods of a randomized clinical trial aimed at examining whether yoga can effectively reduce disability and pain in US military veterans with CLBP. A total of 144 US military veterans with CLBP will be randomized to either yoga or a delayed treatment comparison group. The yoga intervention will consist of 2x weekly yoga classes for 12weeks, complemented by regular home practice guided by a manual. The delayed treatment group will receive the same intervention after six months. The primary outcome is the change in back pain-related disability measured with the Roland-Morris Disability Questionnaire at baseline and 12-weeks. Secondary outcomes include pain intensity, pain interference, depression, anxiety, fatigue/energy, quality of life, self-efficacy, sleep quality, and medication usage. Additional process and/or mediational factors will be measured to examine dose response and effect mechanisms. Assessments will be conducted at baseline, 6-weeks, 12-weeks, and 6-months. All randomized participants will be included in intention-to-treat analyses. Study results will provide much needed evidence on the feasibility and effectiveness of yoga as a therapeutic modality for the treatment of CLBP in US military veterans.
<p>A multiple baseline design across three grade level groups with a comparison group was employed to investigate the effectiveness of yoga for improving time on task with 10 elementary school children who evidenced attention problems. A yoga videotape, published by Gaiam, was used that required the children to follow an adult instructor and three children who engaged in deep breathing, physical postures, and relaxation exercises for 30 minutes, twice a week, for a period of 3 weeks. Time on task was defined as the percentage of intervals observed that the students were orientating toward the teacher or task, and performing the requested classroom assignments. The results indicated effect sizes that ranged from 1.5 to 2.7 as a function of the intervention. Effect sizes at follow-up decreased, but ranged from .77 to 1.95. Peer comparison data indicated that classmates’ time on task remained essentially unchanged throughout the three phases of the study.</p>
<p>This article outlines the rationale and best practices for helping young people recover from the trauma of sexual abuse using integrative and therapeutic Yoga practices. As a model for such work, we describe a specific program, Healing Childhood Sexual Abuse with Yoga, currently offered by the authors in the Portland, OR area. The program serves both girls and boys and has a teen leadership component to allow older youth to serve as role models for preteens. This article outlines the necessary steps for working with this population, including self-inquiry, training, program design, teaching strategies, and integration with other therapies and services. A full eight-week curriculum is described, with focal points for each class, as well as suggested poses, mantras, creative activities, and mindfulness practices. The article also addresses specific contraindications and risk factors and ways they can be mitigated. Finally, it covers observed outcomes from two sequential eight-week sessions of the Healing Childhood Sexual Abuse with Yoga program.</p>
In our database of 331 parental narratives of tantrums had by children 18–60 months old, 29% of the tantrums were followed by child-initiated affiliation with parents. Four variables increased the probability of children's post tantrum affiliation (PTA): age, prolonged screaming, physiological stress, and parent-initiated separation from the child during the tantrum. The age effect may be due to increasing post tantrum persistence of negative affect, to the emergence of shame, guilt, and embarrassment over this developmental period, and/or to increasing cognitive ability, empathic capacity, or socialization. Screaming, which may be analogous to the defensive vocalizations of nonhuman primates, increases PTA when prolonged for 6 min or more. Physiological stress (indicated by autonomic activation or respiratory distress) appears linked to prolonged screaming and may mediate its effects by increasing the child's dysphoria and need for consolation. Separation (parents' departure from the scene of the tantrum or their imposition of a time out) also appears linked to prolonged screaming and may reflect parents' response to an aversive auditory stimulus. There was no evidence that PTA was associated with the presence or degree of physically expressed anger in the tantrum. PTA may be associated with distress during the tantrum. The post conflict reconciliation which occurs in several domains of human social life may be first experienced by children in the aftermath of their tantrums. Aggr. Behav. 23:329–341, 1997. © 1997 Wiley-Liss, Inc.