Effects of the Brain Wave Modulation Technique Administered Online on Stress, Anxiety, Global Distress, and Affect During the First Wave of the COVID-19 Pandemic: A Randomized Clinical Trial

This study aims to evaluate the effects of an innovative mind-body practice named the brain wave modulation technique (BWM-T) on stress, anxiety, global distress, and affect. The technique was administered online through a web-based video conferencing platform. The intervention started on week four of the first quarantine in Italy (week commencing 30th March 2020), for a duration of 4 weeks and ended before lockdown measures were loosened. 310 people participated in the study, mean age 28.73 years old (SD = 9.16), 77.8% women. Of these, about half were randomly assigned to the experimental group and the other half served as controls. Participants completed online psychological tests before and after the intervention. 266 people (144 experimental, 122 controls) completed the post-intervention tests. Consistent with our hypothesis, the study’s findings indicate a reduction in the levels of stress, anxiety, global distress, and negative affect in the experimental group, compared to the control group. Moreover, the experimental group also showed higher levels of positive affect, compared to controls after the intervention. The present findings add to the current literature in suggesting that the BWM-T reduced stress not only when administered face-to face but also when administered online during the COVID-19 pandemic. Moreover, we also noted that the BWM-T has an effect on anxiety, global distress, and affect, which we had not investigated in previous studies.

The relationship between global distress, mentalizing and well-being in a German teacher sample

Many studies have linked global distress including higher psychological symptom severity and high levels of stress with low levels of well-being among teachers, indicating a need to identify and empirically evaluate protective factors. Mentalizing—the capacity to understand behavior in terms of intentional mental states—may be a candidate protective factor to mediate this association, enhancing well-being in the face of high levels of global distress. The present study examines whether the capacity to mentalize can buffer subjectively experienced stress and psychological symptom severity in a sample of teachers. 215 teachers completed questionnaires measuring self-rated experiences of stress, psychological symptoms, mentalizing capacities and well-being in a cross-sectional design. Structural equation modeling was used to test mediation effects. Our findings show that mentalizing was positively associated with well-being. In addition, mentalizing counteracted the negative influence of stress and psychological symptom severity. However, a structural equation model assessing the mediating effect of global distress on well-being via mentalizing was not significant. Therefore, the data indicate that teachers’ capacity to mentalize, regardless of psychological symptom load and subjective experience of stress, has a positive impact on their well-being. The study highlights the protective function of mentalizing and forms a framework for psychological interventions to increase teachers’ well-being.

Outside the Eye of the Storm: Can Moderate Hurricane Exposure Improve Social, Psychological, and Attachment Functioning?

High-intensity disaster can harm psychological functioning. Could moderate-intensity disaster improve psychological and attachment functioning through its effects on social functioning? We used a prospective quasi-experimental cohort design to investigate this possibility among college students. Hurricane cohort participants ( N = 209) completed assessments before, 2 weeks, and 6 weeks after Hurricane Sandy. Two matched comparison cohorts ( Ns > 140) were assessed 4 months and 1 year later. The hurricane cohort, in contrast to matched comparison cohorts, reported increased social support, reduced global distress, reduced negative emotion, and reduced attachment avoidance at the end of the semester. Increased social support mediated the relationship between hurricane cohort and reduced global distress, negative emotion, attachment avoidance, and attachment anxiety, and increased positive emotion and self-esteem at 6 weeks poststorm. The results suggest moderate disaster exposure can benefit short-term social, psychological, and attachment functioning, underscoring the critical role of the social context in stress adaptation.

Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: effectiveness in people with autism spectrum disorders

Aims and method Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment designed to address disorders associated with overcontrol, including autism spectrum disorders (ASD). To date, no studies have reported on the effectiveness of RO DBT for people with ASD. Forty-eight patients were referred to a RO DBT programme, of whom 23 had a diagnosis of ASD. Outcome was measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE) and the Questionnaire about the Process of Recovery. Results The intervention was effective, with a medium effect size of 0.53 for improvement in CORE global distress. End-point CORE global distress score was predicted from initial severity and a diagnosis of ASD. Participants with a diagnosis of ASD who completed the therapy had significantly better outcomes than completing participants without an ASD diagnosis. Clinical implications These findings provide preliminary support for RO DBT as an effective intervention for ASD in routine settings.

Integrating PROs with prognostic value into oncologic care: High ESAS global distress score associated with lower overall survival in advanced cancer patients.

12021 Background: Despite compelling data supporting their use, patient reported outcomes (PROs) are not widely integrated into routine cancer care. In our Palliative Care (PC) practice, all patients complete the Edmonton Symptom Assessment Scale (ESAS), a simple, validated 10-item PRO tool which uses a 0 to 10 rating of 10 common symptoms (pain, fatigue, nausea, drowsiness, appetite, sleep, dyspnea, well-being, anxiety & depression). Our team has previously validated the Global Distress Score (GDS), a sum of 9 physical + psychosocial ESAS items. Here, we studied the implementation of the GDS as a streamlined way to capture the overall symptom burden while providing prognostic value. Methods: We queried a PC database for patients w metastatic cancer at time of 1st PC visit. GDS was calculated & grouped into 3 cohorts based on previous work & clinical experience: high (GDS of 35+), Moderate (16-34) or Low (0-15). Overall Survival was defined as time from 1st PC visit date to death. Regression analysis, ANOVA and t-tests were conducted. Results: 333 patients met the inclusion criteria: median age 62.4y (range 20.5-88.4y), 25 AYA (15-39y), 169 mid age (35-64y), 140 seniors (65y+); 190 female 143 male; median prior therapies 2 (range 0-11), 227 patients were in 2nd line + above therapy. Median ECOG PS 2; 124 patients w ECOG PS 3 & 33 w ECOG PS 4. 262 patients had died at time of analysis. Lower OS was associated w higher GDS (r 0.21, P < 0.001). OS in Low, Mod, High GDS cohorts was 13.1m, 7.9m, & 3.7m, respectively (p < 0.001). There were no sig OS difference between 3 age cohorts (AYA 5.2m, mid age 6m, seniors 5.4m, p0.56). Conclusions: Higher GDS score was associated with a clinically significant decrease in overall survival highlighting the potential of the ESAS as a PRO tool in prognostication and clinical decision making for patients with advanced cancers with a high symptom burden. In the realm of increasingly complex PRO instruments, the ESAS represents a simple, well-validated tool which, in our studies and 25 years of clinical experience, takes the patient less than a minute to complete, with subscores such as the GDS which carry a highly prognostic utility for patients with advanced cancers.

Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers

Background: There is increasing interest in complementary approaches such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the effects of TC/QG delivered in group classes at a comprehensive cancer center. Methods: Patients and caregivers who participated in TC or QG completed assessments before and after an in-person group class. Assessments included questions about expectancy/satisfaction and common cancer symptoms (Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed included global (GDS), physical (PHS), and psychosocial (PSS). Results: Three hundred four participants (184 patients, 120 caregivers) were included in the analysis. At baseline, caregivers had a greater expectancy for change in energy level as a result of class participation compared with patients (22.9% vs 9.9%). No significant difference was observed between baseline patient and caregiver PSS. Clinically significant improvement in well-being was observed among patients in TC classes (1.0) and caregivers in QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating in QG experienced clinically significant improvement. Both TC and QG classes were associated with clinically significant improvements (ESAS GDS decrease ≥3) in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of participants responded that their expectations were met. Conclusions: Patients and caregivers participating in TC or QG group classes were satisfied overall and experienced significant improvement in global distress. Additional research is warranted to explore the integration of TC and QG in the delivery of supportive cancer care.

Effects of Tai Chi and Qi Gong group class participation on self-reported symptoms in cancer patients and caregivers: A preliminary report.

100 Background: Tai chi and qi gong are movement-based, mind-body approaches offered as part of an integrative oncology program at a comprehensive cancer center. We explored the effects of tai chi and qi gong group class participation on cancer patient and caregiver self-reported symptoms. Methods: Patients and caregivers attending a tai chi and/or qi gong group class completed the Edmonton Symptom Assessment Scale (ESAS) immediately before and after participation. The ESAS assessed 10 symptoms (scale 0-10, 10 worst possible); ESAS subscales analyzed included global (GDS), physical (PHS), and psychosocial (PSS). Descriptive statistics; Chi-Squared test, Fisher’s exact test, Wilcoxon rank-sum test and Wilcoxon signed-rank test were used for data analysis. Results: 304 participants (Oct 2017-April 2019; 184 patients, 120 caregivers; 72% women, 60% white; mean age 58) were included in the analysis. For patients (symptom reduction by class type: tai chi -4.5 SD 7.6; qi gong -6.1 SD 7.9) and caregivers (tai chi -3.7 SD 6.3; qi gong -4.0 SD 7.8), both class types contributed to clinically and statistically significant improvement (ESAS GDS decrease ≥3; p’s ≤0.0001) in global distress. Patients (-2.07 SD 5.49) and caregivers (-2.34 SD 3.71) participating in tai chi experienced clinically and statistically significant improvement in physical distress (ESAS PHS decrease ≥2; p’s ≤0.0001). For the individual symptom of well-being, we observed clinically and statistically significant improvement for caregivers participating in qi gong (-1.2 SD 2) and patients participating in tai chi (-1.0 SD 1.8) (p’s ≤0.0001). For fatigue, patients (-1.4) and caregivers (-1.0) participating in qi gong experienced clinically and statistically significant improvement (p’s ≤0.0001). Conclusions: Patients and caregivers participating in both class types experienced significant improvement in physical and global distress. Additional research is warranted to learn more about how differences in class content (tai chi vs qi gong) and participants may contribute to observed differences in symptom change.

Outside the Eye of the Storm: Can Moderate Hurricane Exposure Improve Social, Psychological, and Attachment Functioning?

High-intensity disaster can harm psychological functioning. Could moderate-intensity disaster improve psychological and attachment functioning through its effects on social functioning? We used a prospective quasi-experimental cohort design to investigate this possibility among college students. Hurricane cohort participants (N = 209) completed assessments before, two weeks, and six weeks after Hurricane Sandy. Two matched comparison cohorts (Ns &gt; 140) were assessed four months and one year later. The hurricane cohort, in contrast to matched comparison cohorts, reported increased social support, reduced global distress, reduced negative emotion, and reduced attachment avoidance at the end of the semester. Increased social support mediated the relationship between hurricane cohort and reduced global distress, negative emotion, attachment avoidance, and attachment anxiety, and increased positive emotion and self-esteem at six weeks post-storm. The results suggest moderate disaster exposure can benefit short-term social, psychological, and attachment functioning, underscoring the critical role of the social context in stress adaptation.