Body, Mind & Spirit Articles and Latest News

Efficacy of 2 interventions for panic disorder in patients presenting to the ED with chest pain.

Am J Emerg Med. 2011 Nov;29(9):1051-61

Authors: Pelland MÈ, Marchand A, Lessard MJ, Belleville G, Chauny JM, Vadeboncoeur A, Poitras J, Foldes-Busque G, Bacon SL, Lavoie KL

Abstract
BACKGROUND: Brief and efficacious interventions for panic disorder (PD) in patients presenting to emergency departments (EDs) for chest pain are essential. This study assessed the effects of 2 interventions for this population: a brief cognitive-behavioral therapy delivered by psychologists, and a 6-month pharmacologic treatment initiated and managed by the ED physician. The relative efficacy of both interventions was also examined.
MATERIALS AND METHODS: Forty-seven adult patients meeting the diagnostic criteria for PD upon presentation to the ED were assigned to 1 of 3 experimental conditions: a brief cognitive-behavioral therapy (7 sessions), a pharmacologic intervention (paroxetine; 6 months); and a usual care control condition. The primary outcome was severity of PD on Anxiety Disorder Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and secondary outcomes included measures of PD symptoms, depressive symptoms, and cardiac anxiety. Outcome measures were taken at baseline, postintervention, as well as at 3- and 6-month follow-ups.
RESULTS: Patients receiving either intervention demonstrated significant reductions of PD severity (P = .012), frequency of panic attacks (P = .048), and depressive symptoms (P = .027).
CONCLUSION: Taken together, these findings suggest that empirically validated interventions for PD initiated in an ED setting can be feasible and efficacious, and future studies should assess their impact on both the direct (ie, health care utilization) and indirect (ie, lost productivity) costs associated with PD morbidity in this population.

PMID: 20870368 [PubMed - indexed for MEDLINE]

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Dissociated control as a signature of typological variability in high hypnotic suggestibility.

Conscious Cogn. 2011 Sep;20(3):727-36

Authors: Terhune DB, Cardeña E, Lindgren M

Abstract
This study tested the prediction that dissociative tendencies modulate the impact of a hypnotic induction on cognitive control in different subtypes of highly suggestible individuals. Low suggestible (LS), low dissociative highly suggestible (LDHS), and high dissociative highly suggestible (HDHS) participants completed the Stroop color-naming task in control and hypnosis conditions. The magnitude of conflict adaptation (faster response times on incongruent trials preceded by an incongruent trial than those preceded by a congruent trial) was used as a measure of cognitive control. LS and LDHS participants displayed marginally superior up-regulation of cognitive control following a hypnotic induction, whereas HDHS participants’ performance declined. These findings indicate that dissociative tendencies modulate the influence of a hypnotic induction on cognitive control in high hypnotic suggestibility and suggest that HS individuals are comprised of distinct subtypes with dissimilar cognitive profiles.

PMID: 21147539 [PubMed - indexed for MEDLINE]

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Prosodic adaptations to pitch perturbation in running speech.

J Speech Lang Hear Res. 2011 Aug;54(4):1051-9

Authors: Patel R, Niziolek C, Reilly K, Guenther FH

Abstract
PURPOSE: A feedback perturbation paradigm was used to investigate whether prosodic cues are controlled independently or in an integrated fashion during sentence production.
METHOD: Twenty-one healthy speakers of American English were asked to produce sentences with emphatic stress while receiving real-time auditory feedback of their productions. The fundamental frequency (F0) of the stressed word in each 4-word sentence was selectively shifted in a sensorimotor adaptation protocol. Speakers experienced either an upward or a downward shift of the stressed word, which gradually altered the perceived stress of the sentence.
RESULTS: Participants in the Up and Down groups adapted to F0 shifts by altering the contrast between stressed and unstressed words differentially, such that the two groups deviated from each other in the perturbation phase. Furthermore, selective F0 perturbation in sentences with emphatic stress resulted in compensatory changes in both F0 and intensity.
CONCLUSIONS: Present findings suggest that F0 and intensity are controlled in an integrated fashion to maintain the contrast between stressed and unstressed words. When a cue is impaired through perturbation, speakers not only oppose the perturbation but enhance other prosodic cues to achieve emphatic stress.

PMID: 21173388 [PubMed - indexed for MEDLINE]

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A randomized study of a novel Zen dialogue method for producing spiritual and well-being enhancement: implications for end-of-life care.

J Holist Nurs. 2011 Sep;29(3):201-10

Authors: Johnson M

Abstract
OBJECTIVES: To test the hypothesis that a novel Zen dialogue-based method can bring about significant improvements in spiritual, meditation, and well-being parameters.
DESIGN: A pretest-posttest design was used with participants being randomly assigned to either treatment or no treatment group at the Zen Center. The participants were 14 females and 2 males within each group with no prior formal Zen or meditation training. Those participants in the treatment group received intensive interaction for 1 day with an experienced Zen teacher using a dialogue method to induce a deep meditative state without instruction in formal meditation sitting practice. The outcome was measured with multiple previously standardized instruments designed to assess meditation states, well-being, and spirituality.
RESULTS: A repeated-measures analysis of variance showed statistically significant differences between the treatment and control groups for all parameters measured. In addition, the meditative state measure suggested qualities consistent with deep meditation experiences. The results justify further investigation of the technique as a rapid spiritual intervention tool particularly for clients facing end-of-life issues.

PMID: 21177528 [PubMed - indexed for MEDLINE]

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Improving spatial abilities through mindfulness: effects on the mental rotation task.

Conscious Cogn. 2011 Sep;20(3):801-6

Authors: Geng L, Zhang L, Zhang D

Abstract
In this study, we demonstrate a previously unknown finding that mindful learning can improve an individual’s spatial cognition without regard to gender differences. Thirty-two volunteers participated in the experiment. Baselines for spatial ability were first measured for the reaction time on the mental rotation task. Next, the participants were randomly assigned to either a mindful or mindless learning condition. After learning, the mental rotation task showed that those in the mindful learning condition responded faster than those in the mindless learning condition. This study provides promising evidence for applying mindful learning to education.

PMID: 21377899 [PubMed - indexed for MEDLINE]

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Commitment to health: a predictor of dietary change.

J Clin Nurs. 2011 Oct;20(19-20):2830-6

Authors: Kelly CW

Abstract
AIMS AND OBJECTIVES: To determine the predictive validity of three behavioural variables on changes in diet: commitment to health (commitment), confidence in ability to change dietary behaviours (confidence) and belief about the importance of changing dietary behaviours (importance).
BACKGROUND: Literature supports the Transtheoretical Model of Behavior Change as a framework for understanding dietary behaviour change. Less certain are behavioural variables associated with stage movement for action to maintenance stage for dietary behaviour change. This research considered three variables: self-efficacy (’confidence’), decisional balance scale (’importance’) and ‘commitment’. Published literature supports the importance of each of these behavioural variables, but not their predictive abilities.
DESIGN: A cross-sectional survey was used for 499 manufacturing workers from multiple work-sites.
METHODS: Subjects’ dietary health behaviours were measured by determining how long they consistently ate a low-fat diet, with analysis of variance addressing the stages-of-change model: precontemplation, contemplation, preparation, action, maintenance.
RESULTS: Commitment best predicted change from action to maintenance stage (p < 0·05). Importance (p < 0·05) was somewhat significant, but confidence (p > 0·05) was not.
CONCLUSIONS: Commitment was the best predictor of dietary change, from the action to the maintenance stage of change.
RELEVANCE TO CLINICAL PRACTICE: Clinicians working with patients in the action stage of dietary change can use a stage-based approach and should evaluate commitment to health as part of an overall assessment. Those with high-level commitment will successfully change from action to maintenance with minimal professional assistance. Those with middle-level commitment risk relapse to a pre-action stage will benefit most from professional intervention. Those in the lower level of commitment are most likely to revert to a pre-action stage of change and may be not be ready for dietary change.

PMID: 21592243 [PubMed - indexed for MEDLINE]

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Using extended cognitive behavioral treatment and medication to treat dependent smokers.

Am J Public Health. 2011 Dec;101(12):2349-56

Authors: Hall SM, Humfleet GL, Muñoz RF, Reus VI, Prochaska JJ, Robbins JA

Abstract
OBJECTIVES: We evaluated smoking-cessation efficacy of an extended course of sustained-release bupropion (bupropion SR) and cognitive-behavioral treatment (CBT).
METHODS: Participants who smoked at least 10 cigarettes per day and who smoked within 30 minutes of arising (n = 406) completed a 12-week smoking-cessation treatment including group counseling, nicotine-replacement therapy, and bupropion SR. Participants were then randomly assigned to 1 of 5 conditions: (1) no further treatment, (2) active bupropion SR for 40 weeks, (3) placebo for 40 weeks, (4) active bupropion SR and 11 sessions of CBT for 40 weeks (A-CBT), or (5) placebo and 11 sessions of CBT for 40 weeks. Participants were assessed at baseline and at weeks 12, 24, 52, 64, and 104.
RESULTS: A-CBT was not superior to the other 3 extended treatments. From weeks 12 through 104, all extended treatment conditions were superior to standard treatment. At weeks 64 and 104, the 2 CBT conditions produced significantly higher abstinence rates than did the other 3 conditions.
CONCLUSIONS: Brief contact with providers can increase abstinence during treatment. CBT may increase long-term abstinence after extended treatment is terminated.

PMID: 21653904 [PubMed - indexed for MEDLINE]

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Changes in alcohol intake in response to transdiagnostic cognitive behaviour therapy for eating disorders.

Behav Res Ther. 2011 Sep;49(9):573-7

Authors: Karačić M, Wales JA, Arcelus J, Palmer RL, Cooper Z, Fairburn CG

Abstract
OBJECTIVE: The aim of this study was to examine how alcohol intake changes during and after transdiagnostic cognitive behaviour therapy for eating disorders (CBT-E). Additionally, the paper considers the relationship between alcohol consumption, eating disorder diagnosis and current major depressive episode at the time of first assessment.
METHOD: One hundred and forty nine outpatients with an eating disorder (body mass index over 17.5) were divided into high or low alcohol intake groups (HIG and LIG) according to their intake at pre-treatment assessment. Their alcohol intake and eating disorder psychopathology were examined over the course of treatment and follow-up.
RESULTS: There was no difference between the groups on response of the eating disorder to treatment. The HIG significantly reduced their alcohol intake following treatment whilst the intake of the LIG remained stable over the course of treatment and follow-up. There were no group differences in major depression and overall severity of eating disorder at baseline.
CONCLUSIONS: The response to CBT-E was not influenced by baseline level of alcohol use. The mean alcohol intake of the heavy drinking subjects decreased without being specifically addressed by the treatment.

PMID: 21704306 [PubMed - indexed for MEDLINE]

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Effects of hardware heterogeneity on the performance of SVM Alzheimer’s disease classifier.

Neuroimage. 2011 Oct 1;58(3):785-92

Authors: Abdulkadir A, Mortamet B, Vemuri P, Jack CR, Krueger G, Klöppel S,

Abstract
Fully automated machine learning methods based on structural magnetic resonance imaging (MRI) data can assist radiologists in the diagnosis of Alzheimer’s disease (AD). These algorithms require large data sets to learn the separation of subjects with and without AD. Training and test data may come from heterogeneous hardware settings, which can potentially affect the performance of disease classification. A total of 518 MRI sessions from 226 healthy controls and 191 individuals with probable AD from the multicenter Alzheimer’s Disease Neuroimaging Initiative (ADNI) were used to investigate whether grouping data by acquisition hardware (i.e. vendor, field strength, coil system) is beneficial for the performance of a support vector machine (SVM) classifier, compared to the case where data from different hardware is mixed. We compared the change of the SVM decision value resulting from (a) changes in hardware against the effect of disease and (b) changes resulting simply from rescanning the same subject on the same machine. Maximum accuracy of 87% was obtained with a training set of all 417 subjects. Classifiers trained with 95 subjects in each diagnostic group and acquired with heterogeneous scanner settings had an empirical detection accuracy of 84.2±2.4% when tested on an independent set of the same size. These results mirror the accuracy reported in recent studies. Encouragingly, classifiers trained on images acquired with homogenous and heterogeneous hardware settings had equivalent cross-validation performances. Two scans of the same subject acquired on the same machine had very similar decision values and were generally classified into the same group. Higher variation was introduced when two acquisitions of the same subject were performed on two scanners with different field strengths. The variation was unbiased and similar for both diagnostic groups. The findings of the study encourage the pooling of data from different sites to increase the number of training samples and thereby improving performance of disease classifiers. Although small, a change in hardware could lead to a change of the decision value and thus diagnostic grouping. The findings of this study provide estimators for diagnostic accuracy of an automated disease diagnosis method involving scans acquired with different sets of hardware. Furthermore, we show that the level of confidence in the performance estimation significantly depends on the size of the training sample, and hence should be taken into account in a clinical setting.

PMID: 21708272 [PubMed - indexed for MEDLINE]

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The role of treatment expectancy in youth receiving exposure-based CBT for obsessive compulsive disorder.

Behav Res Ther. 2011 Sep;49(9):536-43

Authors: Lewin AB, Peris TS, Lindsey Bergman R, McCracken JT, Piacentini J

Abstract
The purpose of this investigation was to examine correlates of parent, child, and therapist treatment expectations and their role in the exposure-based treatment of childhood obsessive compulsive disorder (OCD). Treatment expectations were assessed among 49 youth with primary OCD, their parents, and therapists as part of the baseline evaluation and post-treatment clinical outcomes were determined by blind evaluators. Baseline depressive symptoms, child/parent-rated functional impairment, externalizing behavior problems, number of comorbid psychiatric disorders, and a lower perception of control were associated with lower pre-treatment expectations. Parent expectation was associated with parental OCD symptoms, child depressive symptoms and child-reported impairment. Therapist expectations inversely correlated with child depressive symptoms, externalizing problems, and child-rated impairment. Pre-treatment OCD severity and prior treatment history were not linked to expectancy. Finally, higher treatment expectations were linked to better treatment response, lower attrition, better homework compliance, and reduced impairment.

PMID: 21723534 [PubMed - indexed for MEDLINE]

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