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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.
Zotero Collections: Psychiatry and Contemplation

Very little is currently known about the cerebral characteristics that underlie the complex processes of meditation as only a limited number of studies have addressed this topic. Research exploring structural connectivity in meditation practitioners is particularly rare. We thus acquired diffusion tensor imaging (DTI) data of high angular and spatial resolution and used atlas-based tract mapping methods to investigate white matter fiber characteristics in a well-matched sample of long-term meditators and controls (n=54). A broad field mapping approach estimated the fractional anisotropy (FA) for twenty different fiber tracts (i.e., nine tracts in each hemisphere and two inter-hemispheric tracts) that were subsequently used as dependent measures. Results showed pronounced structural connectivity in meditators compared to controls throughout the entire brain within major projection pathways, commissural pathways, and association pathways. The largest group differences were observed within the corticospinal tract, the temporal component of the superior longitudinal fasciculus, and the uncinate fasciculus. While cross-sectional studies represent a good starting point for elucidating possible links between meditation and white matter fiber characteristics, longitudinal studies will be necessary to determine the relative contribution of nature and nurture to enhanced structural connectivity in long-term meditators.

The role of contemplative practice in adult education has a long history if one includes traditional monastic education in Asia and the West. Its use in American higher education is, however, more recent and more limited. Nonetheless, on the basis of evidence from surveys and conferences, a significant community of teachers exists at all levels of higher education, from community colleges to research universities, who are using a wide range of contemplative practices as part of their classroom pedagogy. In addition to existing well-developed pedagogical and curricular methods that school critical reasoning, critical reading and writing, and quantitative analysis, this article argues that we also require a pedagogy that attends to the development of reflective, contemplative, affective, and ethical capacities in our students. The significance of these is at least as great as the development of critical capacities in students. The rationale for the inclusion of contemplative modalities is articulated within this context. On the basis of considerable experience in teaching at Amherst College, I present an "epistemology of love," which emphasizes a form of inquiry that supports close engagement and leads to student transformation and insight. This approach to knowing is implemented in the Amherst College first-year course, Eros and Insight. It includes a specific sequence of contemplative exercises that are practiced by students and integrated with more conventional course content drawn from the arts and sciences. Our experience shows that students deeply appreciate the shift from conventional coursework to a more experiential, transformative, and reflective pedagogy.

The current study investigated the feasibility of implementing a 10-week mindfulness-based intervention with a group of incarcerated adolescents. Before and after completion of the 10-week intervention, 32 participants filled out self-report questionnaires on trait mindfulness, self-regulation, and perceived stress. We hypothesized that self-reported mindfulness and self-regulation would significantly increase, and perceived stress would significantly decrease, as a result of participation in the treatment intervention. Paired t-tests revealed a significant decrease (p < .05) in perceived stress and a significant increase (p < .001) in healthy self-regulation. No significant differences were found on self-reported mindfulness. Results suggest that mindfulness-based interventions are feasible for incarcerated adolescents. Limitations and future research are discussed.
Zotero Collections: Psychology and Contemplation

Although the systematic study of meditation is still in its infancy, research has provided evidence for meditation-induced improvements in psychological and physiological well-being. Moreover, meditation practice has been shown not only to benefit higher-order cognitive functions but also to alter brain activity. Nevertheless, little is known about possible links to brain structure. Using high-resolution MRI data of 44 subjects, we set out to examine the underlying anatomical correlates of long-term meditation with different regional specificity (i.e., global, regional, and local). For this purpose, we applied voxel-based morphometry in association with a recently validated automated parcellation approach. We detected significantly larger gray matter volumes in meditators in the right orbito-frontal cortex (as well as in the right thalamus and left inferior temporal gyrus when co-varying for age and/or lowering applied statistical thresholds). In addition, meditators showed significantly larger volumes of the right hippocampus. Both orbito-frontal and hippocampal regions have been implicated in emotional regulation and response control. Thus, larger volumes in these regions might account for meditators' singular abilities and habits to cultivate positive emotions, retain emotional stability, and engage in mindful behavior. We further suggest that these regional alterations in brain structures constitute part of the underlying neurological correlate of long-term meditation independent of a specific style and practice. Future longitudinal analyses are necessary to establish the presence and direction of a causal link between meditation practice and brain anatomy.

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