Mindfulness Groups for Distressing Voices and Paranoia: A Replication and Randomized Feasibility Trial

2009 ◽  
Vol 37 (4) ◽  
pp. 403-412 ◽  
Author(s):  
Paul Chadwick ◽  
Stephanie Hughes ◽  
Daphne Russell ◽  
Ian Russell ◽  
Dave Dagnan
Keyword(s):  
Mindfulness Training ◽  
Waiting List ◽  
Feasibility Trial ◽  
Home Practice ◽  
Randomized Evaluation ◽  
Clinical Literature ◽  
Before And After ◽  
Practice Meditation ◽  
Clinical Benefits ◽  
Secondary Analyses

Background:The clinical literature cautions against use of meditation by people with psychosis. There is, however, evidence for acceptance-based therapy reducing relapse, and some evidence for clinical benefits of mindfulness groups for people with distressing psychosis, though no data on whether participants became more mindful.Aims:To assess feasibility of randomized evaluation of group mindfulness therapy for psychosis, to replicate clinical gains observed in one small uncontrolled study, and to assess for changes in mindfulness.Method:Twenty-two participants with current distressing psychotic experiences were allocated at random between group-based mindfulness training and a waiting list for this therapy. Mindfulness training comprised twice-weekly sessions for 5 weeks, plus home practice (meditation CDs were supplied), followed by 5 weeks of home practice.Results:There were no significant differences between intervention and waiting-list participants. Secondary analyses combining both groups and comparing scores before and after mindfulness training revealed significant improvement in clinical functioning (p= .013) and mindfulness of distressing thoughts and images (p= .037).Conclusions:Findings on feasibility are encouraging and secondary analyses replicated earlier clinical benefits and showed improved mindfulness of thoughts and images, but not voices.

Attentional Effort of Beginning Mindfulness Training Is Offset With Practice Directed Toward Images of Natural Scenery

2016 ◽  
Vol 49 (5) ◽  
pp. 536-559 ◽  
Author(s):  
Freddie Lymeus ◽  
Tobias Lundgren ◽  
Terry Hartig
Keyword(s):  
Attentional Control ◽  
Mindfulness Training ◽  
Waiting List ◽  
Mindfulness Practice ◽  
Natural Environments ◽  
Attentional Resources ◽  
Present Experience ◽  
Before And After ◽  
Performance Gains

Mindfulness involves curious and detached attention to present experience. Long-term mindfulness practice can improve attentional control capabilities, but practice sessions may initially deplete attentional resources as beginners struggle to learn skills and manage distractions. Without using skills or effort, people can have mindful experiences in pleasant natural environments; natural scenery may therefore facilitate mindfulness practice. Twenty-seven participants completed an 8-week mindfulness course; 14 served as waiting-list controls. We tested participants’ attention every other week before and after 15-min sessions of conventional mindfulness practice, mindfulness practice with nature images, or rest with nature images (controls). Mindfulness practice incurred attentional effort; it hampered performance gains seen in controls during practice/rest sessions, and attentionally weak participants completed fewer course exercises. Viewing nature images during practice increasingly offset the effort of mindfulness practice across the 8 weeks. Bringing skill-based and nature-based approaches together offers additional possibilities for understanding and facilitating mindfulness and restorative states.

Oral Immune Activation by Disgust and Disease-Related Pictures

2015 ◽  
Vol 29 (3) ◽  
pp. 119-129 ◽  
Author(s):  
Richard J. Stevenson ◽  
Deborah Hodgson ◽  
Megan J. Oaten ◽  
Luba Sominsky ◽  
Mehmet Mahmut ◽  
...  
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Innate Immune Response ◽  
Negative Control ◽  
Innate Immune ◽  
Innate Immune Responses ◽  
Immune Markers ◽  
Before And After ◽  
Secondary Analyses ◽  
Image Set

Abstract. Both disgust and disease-related images appear able to induce an innate immune response but it is unclear whether these effects are independent or rely upon a common shared factor (e.g., disgust or disease-related cognitions). In this study we directly compared these two inductions using specifically generated sets of images. One set was disease-related but evoked little disgust, while the other set was disgust evoking but with less disease-relatedness. These two image sets were then compared to a third set, a negative control condition. Using a wholly within-subject design, participants viewed one image set per week, and provided saliva samples, before and after each viewing occasion, which were later analyzed for innate immune markers. We found that both the disease related and disgust images, relative to the negative control images, were not able to generate an innate immune response. However, secondary analyses revealed innate immune responses in participants with greater propensity to feel disgust following exposure to disease-related and disgusting images. These findings suggest that disgust images relatively free of disease-related themes, and disease-related images relatively free of disgust may be suboptimal cues for generating an innate immune response. Not only may this explain why disgust propensity mediates these effects, it may also imply a common pathway.

scholarly journals Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA)

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019142 ◽  
Author(s):  
Kate Jolly ◽  
Jenny Ingram ◽  
Joanne Clarke ◽  
Debbie Johnson ◽  
Heather Trickey ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Infant Feeding ◽  
Feasibility Study ◽  
Breast Feeding ◽  
Controlled Trial ◽  
Feasibility Trial ◽  
Study Results ◽  
Service Staff ◽  
Before And After ◽  
Randomised Controlled

IntroductionBreast feeding improves the health of mothers and infants; the UK has low rates, with marked socioeconomic inequalities. While trials of peer support services have been effective in some settings, UK trials have not improved breast feeding rates. Qualitative research suggests that many women are alienated by the focus on breast feeding. We propose a change from breast feeding-focused interactions to respecting a woman’s feeding choices, inclusion of behaviour change theory and an increased intensity of contacts in the 2 weeks after birth when many women cease to breast feed. This will take place alongside an assets-based approach that focuses on the positive capability of individuals, their social networks and communities.We propose a feasibility study for a multicentre randomised controlled trial of the Assets feeding help Before and After birth (ABA) infant feeding service versus usual care.Methods and analysisA two-arm, non-blinded randomised feasibility study will be conducted in two UK localities. Women expecting their first baby will be eligible, regardless of feeding intention. The ABA infant feeding intervention will apply a proactive, assets-based, woman-centred, non-judgemental approach, delivered antenatally and postnatally tailored through face-to-face contacts, telephone and SMS texts. Outcomes will test the feasibility of delivering the intervention with recommended intensity and duration to disadvantaged women; acceptability to women, feeding helpers and professionals; and feasibility of a future randomised controlled trial (RCT), detailing recruitment rates, willingness to be randomised, follow-up rates at 3 days, 8 weeks and 6 months, and level of outcome completion. Outcomes of the proposed full trial will also be collected. Mixed methods will include qualitative interviews with women/partners, feeding helpers and health service staff; feeding helper logs; and review of audio-recorded helper–women interactions to assess intervention fidelity.Ethics and disseminationStudy results will inform the design of a larger multicentre RCT. The National Research Ethics Service Committee approved the study protocol.Trial registration numberISRCTN14760978; Pre-results.

Animal-Assisted Activity in Critically Ill Older Adults: A Randomized Pilot and Feasibility Trial

2020 ◽  
Vol 22 (3) ◽  
pp. 412-417
Author(s):  
Sandy Branson ◽  
Lisa Boss ◽  
Shannan Hamlin ◽  
Nikhil S. Padhye
Keyword(s):  
Stress Responses ◽  
Feasibility Trial ◽  
Eligibility Criteria ◽  
Hospital Policy ◽  
Related Factors ◽  
Icu Patients ◽  
Indwelling Catheters ◽  
Control Intervention ◽  
Number Of Patients ◽  
Before And After

Background: Limited evidence suggests the efficacy of animal-assisted activities (AAA) in improving biobehavioral stress responses in older patients in intensive care units (ICUs). Objectives: To assess the feasibility of an AAA (dog) intervention for improving biobehavioral stress response, measured by self-reported stress and anxiety and salivary cortisol, C-reactive protein, and interleukin-1β in older ICU patients, we examined enrollment, attrition, completion, data collection, and biobehavioral stress responses. Methods: ICU patients ≥60 years old were randomly assigned to a 10-min AAA intervention or control/usual ICU care. Attitudes toward pets were assessed before the intervention. Self-reported stress and anxiety and salivary stress biomarkers were collected before and after the intervention and the usual care condition. Results: The majority of patients were ineligible due to lack of decisional capacity, younger age, inability to provide saliva specimens, or critical illness. Though 15 participants were randomly allocated (AAA = 9; control = 6), only 10 completed the study. All participants completed the questionnaires; however, saliva specimens were significantly limited by volume. AAA was associated with decreases in stress and anxiety. Biomarker results were variable and revealed no specific trends associated with stress responses. Conclusions: Barriers to recruitment included an insufficient number of patients eligible for AAA based on hospital policy, difficulty finding patients who met study eligibility criteria, and illness-related factors. Recommendations for future studies include larger samples, a stronger control intervention such as a visitor without a dog, greater control over the AAA intervention, and use of blood from indwelling catheters for biomarkers.

Enhancing forensic exposures in residency training

2019 ◽  
Vol 15 (1) ◽  
pp. 13-19
Author(s):  
Tobias Wasser ◽  
Saksham Chandra ◽  
Katherine Michaelsen
Keyword(s):  
Design Methodology ◽  
Psychiatry Residents ◽  
Content Type ◽  
Forensic Evaluations ◽  
Residency Programs ◽  
General Psychiatry ◽  
Before And After ◽  
Secondary Analyses ◽  
Forensic Setting ◽  
The Impact

Purpose The purpose of this paper is to review the impact of a new, brief forensic rotation for general psychiatry residents on the variety of residents’ forensic exposures. Design/methodology/approach The authors surveyed residents who trained before and after the implementation of the new rotation to assess the impact of the rotation on the residents’ forensic experiences during training across a variety of domains. Findings Even in a highly clinical forensic setting, residents participating in the required rotation reported significantly greater variety of forensic experiences than those who had not completed the required rotation, including types of settings and assessments, Rotation completers reported greater exposure to various types of settings and assessments, and courtroom-related experiences, as well as the overall number of forensic exposures. The two groups did not differ in their forensic exposures in general psychiatry settings, civil-forensic evaluations or diverse forensic populations. Secondary analyses showed that increased exposure to court-based experiences and multiple forensic settings was associated with forensic fellowship interest. Originality/value This study demonstrates that a brief, mandatory forensic clinical rotation may increase residents’ exposure to forensic settings, assessments and courtroom-related experiences and that increased exposure to courtroom-based experiences in particular may increase interest in forensic fellowship. While not surprising, the results demonstrate that residents were not otherwise having these forensic experiences and that even time-limited forensic rotations can enhance the breadth of residents’ forensic exposures. Further, the rotation achieved these outcomes without using typical forensic sites but instead highly clinical sites, which may be particularly encouraging to residency programs without ready access to classic forensic rotation sites. This study contributes to the small but expanding body of the literature describing the value of increasing psychiatry residents’ training in clinical forensic psychiatry.

A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

2020 ◽  
Author(s):  
Esra Giray ◽  
Nezih Onur Ermerak ◽  
Yeliz Bahar-Ozdemir ◽  
Melihat Kalkandelen ◽  
Mustafa Yuksel ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Chest Wall ◽  
Feasibility Trial ◽  
Control Group ◽  
Pectus Carinatum ◽  
Short Term ◽  
Similar Frequency ◽  
Custom Made ◽  
Before And After ◽  
And Control

Abstract Introduction Pectus carinatum (PC) is a congenital chest wall deformity which is characterized by the protrusion of the sternum and costal cartilages. Although orthotic and exercise therapies are commonly offered by physicians for PC treatment, there is a lack of evidence on the benefits of exercises and how long the orthosis should be worn. The aim of this study is to investigate the effects and feasibility of custom-made compression orthosis and exercises in the treatment of PC. Materials and Methods Patients with PC aged 7 to 17 years old were randomized into three groups: compression orthosis 23 hours, compression orthosis 8 hours, and control group. All groups received exercises for 1 hour a day for 3 weeks. Additionally, compression orthosis 23 hours group wore the orthosis for 23 hours a day, while compression orthosis 8 hours group wore the orthosis for 8 hours a day. PC protrusion, pressure of correction, thorax lateral and anteroposterior parameters, external chest wall measurements, and Nuss Questionnaire were evaluated before and after the treatment. Also, adverse effects, retention, and compliance were assessed. Feasibility was evaluated by calculating the percentages of recruitment, retention, and safety. Results The compression orthosis 23 hours group showed greater improvements than the other groups. After treatment, all groups showed significant changes in protrusion, pressure of correction, and external chest wall measurements. Adverse events occurred with similar frequency across groups. Retention percentages did not differ among groups. Conclusion Compression orthosis use for 23 hours can be recommended rather than its use for 8 hours because 23 hours of orthosis use has better correction and similar adverse effects.

Mindfulness Training by Telephone Before and After Orthopedic Surgery: A Feasibility Study

2020 ◽  
Vol 26 (3) ◽  
pp. 249-251
Author(s):  
Chun Nok Lam ◽  
Olivia Silke ◽  
John Itamura ◽  
George Salem ◽  
David S. Black
Keyword(s):  
Feasibility Study ◽  
Orthopedic Surgery ◽  
Mindfulness Training ◽  
Before And After

scholarly journals Vibrator-Assisted Start–Stop Exercises Improve Premature Ejaculation Symptoms: A Randomized Controlled Trial

2019 ◽  
Vol 49 (5) ◽  
pp. 1559-1573 ◽  
Author(s):  
Daniel Ventus ◽  
Annika Gunst ◽  
Stefan Arver ◽  
Cecilia Dhejne ◽  
Katarina G. Öberg ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Premature Ejaculation ◽  
Mindfulness Meditation ◽  
Controlled Trial ◽  
Waiting List ◽  
Control Group ◽  
Adequate Treatment ◽  
Treatment Groups ◽  
Sexual Distress ◽  
Before And After

AbstractPremature ejaculation (PE) is associated with decreased quality of life, lower confidence and self-esteem, and higher levels of depression, anxiety, and interpersonal difficulties. Here we investigated the effectiveness of vibrator-assisted start–stop exercises for treatment of PE, and whether the treatment effect could be enhanced by an additional psychobehavioral intervention. Fifty participants with a mean age of 41.7 years were included and randomized into two treatment groups and a waiting list control group. Participants were instructed to perform start–stop exercises while stimulating the penis with a purpose-made vibrator, 3 times a week for 6 weeks. Additionally, participants in one of the treatment groups received additional psychoeducation and performed mindfulness meditation-based body scan exercises three times a week. Data were gathered through online questionnaires before and after treatment, as well as 3 and 6 months after treatment. The interventions reduced PE symptoms with large effect sizes (partial η2 = .20 across the three groups, d [95% CI] = 1.05 [.27, 1.82] and 1.07 [.32, 1.82] for treatment groups compared to waiting list control group). The additional psychobehavioral intervention did not further reduce PE symptoms, but did decrease PE-associated negative symptoms such as levels of sexual distress, anxiety, and depression. No side effects were reported. Vibrator-assisted start–stop exercises can be offered as an adequate treatment option for PE.

Switching From Morphine to Methadone to Improve Analgesia and Tolerability in Cancer Patients: A Prospective Study

2001 ◽  
Vol 19 (11) ◽  
pp. 2898-2904 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Alessandra Casuccio ◽  
Fabio Fulfaro ◽  
Liliana Groff ◽  
Roberto Boffi ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Therapeutic Option ◽  
Oral Morphine ◽  
Oral Methadone ◽  
Before And After ◽  
Clinical Benefits ◽  
A Prospective Study

PURPOSE: To evaluate the clinical benefits of switching from morphine to oral methadone in patients who experience poor analgesia or adverse effects from morphine. PATIENTS AND METHODS: Fifty-two consecutive cancer patients receiving oral morphine but with uncontrolled pain and/or moderate to severe opioid adverse effects were switched to oral methadone administered every 8 hours using different dose ratios. Intensity of pain and adverse effects were assessed daily, and the symptom distress score (DS) was calculated before and after switching. RESULTS: Data were analyzed for 50 patients. Switching was considered effective in 80% of the patients; results were achieved in an average of 3.65 days. In the 10 patients who switched to methadone because of uncontrolled pain, a significant reduction in pain intensity (P < .005) and an average of a 33% increase in methadone doses necessary (P < .01) were found after an average of 3.5 days. DS significantly decreased from an average of 8.4 to 4.5 (P < .0005). In the 32 patients switching because of uncontrolled pain and morphine-related adverse effects, significant improvement was found in pain intensity (P < .0005), nausea and vomiting (P < .03), constipation (P < .001), and drowsiness (P < .01), but a significant increase in the methadone dose of an average of 20% (P < .004) was required. CONCLUSION: In most patients with cancer pain referred for poor pain control and/or adverse effects, switching to oral methadone is a valid therapeutic option. In the clinical setting of poor pain control, higher doses of methadone are necessary with respect to the equianalgesic calculated dose ratios previously published.

The feasibility and effectiveness of running mindfulness groups in an early intervention in psychosis service

2014 ◽  
Vol 7 ◽  
Author(s):  
Carly Samson ◽  
Clare Mallindine
Keyword(s):  
Early Intervention ◽  
Critical Period ◽  
Mindfulness Training ◽  
Emotional States ◽  
Psychotic Experiences ◽  
Group Setting ◽  
Mindfulness Skills ◽  
Before And After ◽  
Potential Benefits ◽  
Early Intervention In Psychosis

AbstractThere is increasing evidence that mindfulness techniques can be used safely and effectively in the treatment of psychosis, but the potential benefits of these techniques for individuals during the early stages requires further exploration. This study investigated whether mindfulness training in a group setting is associated with a reduction in distress and an improvement in mindfulness skills for people who have psychotic experiences. Data are reported from eight participants who completed measures before and after attending a mindfulness group. There was a reduction in CORE and DASS scores and an increase in mindfulness skills following participation in the group. These findings suggest that mindfulness training can be beneficial for reducing distress and negative emotional states associated with early psychotic experiences during the critical period.

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