Relaxation Therapy

To determine test anxiety in medical students and to assess the measures used by them to reduce it. The cross-sectional study was conducted in August 2009 at the Dow University of Health Sciences, Karachi, and involved 388 medical students who were voluntary participants. The 10-item Westside Test Anxiety Scale, was used to measure anxiety and the pre-designed questionnaire asked the students about the frequent measures used by them to overcome anxiety during exams and their past Grade Point Average. All data was coded and analysed using SPSS version 16 with a prior set alpha level of 0.05. Of the 450 students who were initially considered for the study, 388 fulfilled the inclusion criteria. Among them, 101 (25.3%) were male students with a mean anxiety level of 2.55 +/- 1.27, and 287 (71.8%) were females with a mean anxiety level of 3.07 +/- 1.43 (p<0.05). Prayers and self-motivation (28.3%), sleep and relaxation (11%), television and music (10%), calling friends (8.5%) and revi...

Rural patients with anxiety often lack access to traditional biofeedback modalities. Exercise heart rate monitors (HRMs) are tools used in the fitness industry to provide athletes with feedback on heart rate and regulatory breathing strategies. HRMs are inexpensive, discrete, and publicly accessible. This randomized controlled pilot study explored whether use of HRMs for biofeedback during guided mindfulness, diaphragmatic breathing, and progressive muscle relaxation techniques could facilitate anxiety reduction as compared to these techniques alone. Fifty-three rural anxiety patients were randomized to HRM or control groups for four weekly 20-minute, scripted sessions with a non-behaviorist wherein they practiced these techniques; the HRM group received feedback on their heart rate response. The HRM group had significantly greater improvement in state anxiety (State-Trait Anxiety Inventory) and self-efficacy (General Self Efficacy Scale), and a greater percentage of the group indic...

With growing understanding of the pain system and the variables that contribute to pain-suppressing mechanisms, treatments combining pharmacologic and psychologic methods are becoming the norm for managing pediatric pain. For headaches, however, the trend is away from medication and toward self-management strategies using relaxation, hypnosis, and lifestyle changes.

Introduction. Temporo-mandibular disorders (TMDs) are a group of chronic and common disease that a lot of skeletal, Dental and psychologic factors can have an effect on it. Proposed treatment to control this disorder consists of wide variety of drugs and non-drugs methods beside dental treatment. Some investigations have reffered to relation between TMDs and some psychologic factors such as depression. The aim of this study was to investigate affects of relaxation therapy on TMDs. Methods. This was a clinical trial study. The case group consisted of 25 patients with TMDs and an average mark of depression Beck index of 4/4. After Beck test, patients were taught relaxation therapy methods. These methods were done until-two weeks. After completion of methods, Beck test was done again and TMD patients were re-enaluated. Results. The average incidence of pain in TMJ (in function and Rest) the maximum opening, maximum protrusive and Lateral movement, deviation of mandible in maximum mouth...

Background: Unanswered questions from controlled studies of posttraumatic stress disorder concern the value of cognitive restructuring alone without prolonged exposure therapy and whether its combination with prolonged exposure is enhancing. Methods: In a controlled study, 87 patients with posttraumatic stress disorder of at least 6 months' duration were randomly assigned to have 10 sessions of 1 of 4 treatments: prolonged exposure (imaginal and live) alone; cognitive restructuring alone; combined prolonged exposure and cognitive restructuring; or relaxation without prolonged exposure or cognitive restructuring. Results: Integrity of audiotaped treatment sessions was satisfactory when rated by an assessor unaware of the treatment assignment. Seventy-seven patients completed treatment. The pattern of results was similar regardless of rater, statistical method, measure, occasion, and therapist. Exposure and cognitive restructuring, singly or combined, improved posttraumatic stress disorder markedly on a broad front. Gains continued to 6-month follow-up and were significantly greater than the moderate improvement from relaxation. Both prolonged exposure and cognitive restructuring were each therapeutic on their own, were not mutually enhancing when combined, and were each superior to relaxation.

ObjectiveThis research aims to examine the effect of playing games with toys made of medical materials in children with cancer on pain that occurs during intravenous (IV) treatment.MethodsThe randomized controlled clinical trial was conducted between May 2016 and February 2018. The study sample comprised 110 children (experimental group 55; control group 55), determined using power analysis from the study population. The data were collected by the researcher, using face-to-face interview techniques, the Information Form, and Wong–Baker FACES Pain Rating Scale (WBS).ResultsThe pre- and post-test pain mean scores of patients in the experimental group were 2.27 ± 0.91 and 0.43 ± 0.66, respectively (p = 0.0001). The pre- and post-test pain mean scores of patients in the control group were 1.72 ± 0.82 and 3.34 ± 0.77, respectively (p = 0.0001).Significance of resultsThe experience of playing with toys made from materials used for invasive procedures relieves pain the during IV treatment.

Symptoms of insomnia (i.e., problems with falling asleep or maintaining sleep), coupled with daytime impairments, are widespread and reported by more than one-third of the general population to occur at least once a year . Symptoms of insomnia seem to be associated negatively with the general quality of life , confer an increased risk of mortality and have been identified as a risk factor for suicidal ideation, suicide attempts and suicide . Furthermore, insomnia and symptoms of insomnia have been linked to comorbid medical diseases as well as neurological and mental disorders (Urrestarazu & Iriarte, 2016).

Postpartum fatigue is a pervasive phenomenon and often affects mothers immediately after delivery. The present study aimed to assess the effect Pilates home exercises had on postpartum maternal fatigue. METHODS A total of 80 women participated in our clinical trial study. The women were randomly divided into two groups -the intervention group (n = 40) and the control group (n = 40). In the intervention group, the women performed Pilates exercises five times a week (30 min per session) for eight consecutive weeks. The first session was conducted 72 hours after delivery. The control group did not receive any intervention. Each woman's level of fatigue was evaluated at hospital discharge (as a baseline), and at four and eight weeks after delivery, using the standard Multidimensional Fatigue Inventory (MFI-20) questionnaire and repeated measures analysis. During the eight weeks of follow-up, we found that the intervention group had lower mean MFI-20 scores than the control group with regard to general fatigue (7.80 ± 2.07 vs. 12.72 ± 1.79; p < 0.001), physical fatigue (7.12 ± 1.41 vs. 10.42 ± 2.02; p < 0.001), reduced activity (6.95 ± 1.35 vs. 11.27 ± 1.70; p < 0.001), reduced motivation (6.20 ± 1.01 vs. 9.80 ± 2.04; p < 0.001) and mental fatigue (6.85 ± 1.45 vs. 10.72 ± 1.98; p < 0.001). The present study's findings show that physical exercise can significantly reduce postpartum maternal fatigue in all subscales.

The purpose of this study was to compare muscle tension between individuals with and without generalized anxiety disorder (GAD) during a resting state and a stressful mental arithmetic task. Methods: A total of 95 undergraduate students (68 females and 27 males; mean age=19.6, SD=3.5) completed an online survey on GAD symptoms and pathological worry, a diagnostic interview, and two laboratory tasks (resting and mental arithmetic tasks) while electromyography (EMG) signals were being recorded. Results: We found a significant main effect of condition, F(1,93) = 24.13, p<.001, and group, F(1,93) = 4.55, p=.036. Furthermore, there was a significant interaction effect between condition and group, F(1,93) = 5.85, p=.017. A post-hoc analysis revealed that the increase in EMG activity from the resting period, 95% CI [.002398 .003474], to the mental arithmetic task, 95% CI [.003850 .005086], was significant for the GAD group, but not for the non-GAD group. Conclusions: Individuals with and without GAD did not show significant differences in physiologically measured muscle tension at baseline. However, the GAD group showed higher levels of muscle tension during stressful situations when compared to the non-GAD group.

Objective: Panic disorder (PD) is associated with significant personal, social, and economic costs. However, little is known about specific interpersonal dysfunctions that characterize the PD population. The current study systematically examined these interpersonal dysfunctions. Method: The present analyses included 194 patients with PD out of a sample of 201 who were randomized to cognitive-behavioral therapy, panic-focused psychodynamic psychotherapy, or applied relaxation training. Interpersonal dysfunction was measured with the Inventory of Interpersonal Problems-Circumplex . Results: Individuals with PD reported greater levels of interpersonal distress than that of a normative cohort (especially when PD was accompanied by agoraphobia), but lower than that of a cohort of patients with major depression. There was no single interpersonal profile that characterized PD patients. Symptom-based clusters (with vs. without agoraphobia) could not be discriminated on core or central interpersonal problems. Rather, as revealed by cluster analysis based on the pathoplasticity framework, there were 2 empirically derived interpersonal clusters among PD patients that were not accounted for by symptom severity and were opposite in nature: domineering-intrusive and nonassertive. The empirically derived interpersonal clusters appear to be of clinical utility in predicting alliance development throughout treatment: Although the domineering-intrusive cluster did not show any changes in the alliance throughout treatment, the nonassertive cluster showed a process of significant strengthening of the alliance. Conclusions: Empirically derived interpersonal clusters in PD provide clinically useful and nonredundant information about individuals with PD. The current study demonstrated the importance of taking into account interpersonal dysfunction when treating individuals with panic disorder. Specifically, 2 distinct interpersonal profiles in panic disorder patients were identified, nonassertive and domineering-intrusive. Classifying panic disorder patients according to these interpersonal profiles contributes unique information about these individuals and has implications for treatment.

Systematic research on psychoanalytic treatments has been limited by several factors, including a belief that clinical experience can demonstrate the effectiveness of psychoanalysis, rendering systematic research unnecessary, the view that psychoanalytic research would be difficult or impossible to accomplish, and a concern that research would distort the treatment being delivered. In recent years, however, many psychoanalysts have recognized the necessity of research in order to obtain a more balanced assessment of the role of psychodynamic psychotherapy and psychoanalysis in a contemporary treatment armamentarium, as well as to allow appropriate evaluation and potentially greater acceptance by the broader mental health and medical communities. In this context, studies were conducted of a psychodynamic treatment, Panic-Focused Psychodynamic Psychotherapy (PFPP), initially in an open trial and then in a randomized controlled trial (RCT) in comparison with a less active treatment, Ap...

Background-Little research has addressed moderators of treatment outcome for anxiety disorders, and none has considered interpersonal loss as a predictor of outcome. Purpose-To examine the effect of interpersonal loss events within the six weeks preceding panic disorder (PD) onset as a moderator of outcome in a randomized controlled trial of Panic-Focused Psychodynamic Therapy (PFPP) and Applied Relaxation Therapy (ART). Researchers hypothesized that such loss events would predict better outcome in PFPP but would not affect ART outcome. Method-Forty-nine subjects with PD were randomly assigned to a 12-week course of PFPP or ART. Independent raters blinded to treatment condition and study hypotheses rated subjects on the Panic Disorder Severity Scale (PDSS) and Sheehan Disability Scale. Exploratory analyses assessed between-group effect size for PFPP and ART following standard moderator analytic procedures. Results-Three-quarters of subjects reported a narrowly defined interpersonal loss (LOSS) in the 6 weeks preceding PD onset. Subjects had a mean duration of PD of 8.2 (9.5) years. PFPP was more efficacious than ART, but LOSS did not moderate PFPP outcome. An unexpected finding was that LOSS moderated ART outcome: subjects without LOSS showed no response to ART (PDSS change= 0.00 [2.90]), whereas LOSS had a pre/post effect size of 4. 29 (5.60). Neither examination of various potential confounding variables nor sensitivity analyses of assumptions regarding attrition altered these findings. Conclusions-Interpersonal loss events preceding onset of panic disorder were common. These losses moderated outcome in ART, a therapy that does not focus on such losses. Implications and need for future research are discussed.

The purpose of this study was to determine the effect of canine guidance and group function on supra- and infrahyoid EMG activity in the lateral decubitus position at different jaw posture tasks. The sample included 40 healthy subjects with natural dentition and bilateral molar support, 20 with bilateral canine guidance and 20 with bilateral group function. An inclusion criterion was that subjects had to be free of signs and symptoms of any dysfunction of the masticatory system. Bipolar surface electrodes were located on the left supra- and infrahyoid muscles for EMG recordings. In the lateral decubitus position, EMG activity was recorded in subjects with canine guidance or group function, during the following jaw posture tasks: A. maximal clenching in the edge-to edge lateral contact position; B. grinding from intercuspal position to edge-to-edge lateral contact position, and C. grinding from edge-to-edge lateral contact position to intercuspal position. Supra- and infrahyoid EMG a...

Background Hot flashes (HFs) negatively affect quality of life among perimenopausal and postmenopausal women. This study investigated the efficacy of oxybutynin vs placebo in decreasing HFs. Methods In this randomized, multicenter, double-blind study, women with and without breast cancer with 28 or more HFs per week, lasting longer than 30 days, who were not candidates for estrogen-based therapy, were assigned to oral oxybutynin (2.5 mg twice a day or 5 mg twice a day) or placebo for 6 weeks. The primary endpoint was the intrapatient change from baseline in weekly HF score between each oxybutynin dose and placebo using a repeated-measures mixed model. Secondary endpoints included changes in weekly HF frequency, HF-related daily interference scale questionnaires, and self-reported symptoms. Results We enrolled 150 women. Baseline characteristics were well balanced. Mean (SD) age was 57 (8.2) years. Two-thirds (65%) were taking tamoxifen or an aromatase inhibitor. Patients on both oxy...

This overview aims to give a brief introduction for clinicians in the wide field of Mind-Body Therapies (MBTs), to summarize the current research status of MBTs in pediatric oncology and to mention challenges for future goals. Most used techniques (relaxation, hypnosis, yoga, massage, MBSR, eurythmy) will be described and efficacy will be discussed. MBTs are an enhancement of conventional medicine to motivate the patient to participate in his recovery. Most MBTs are of low risk and are accessible for patients and their families in nearly all stadium of cancer therapy. Positive results include increased self-confidence and a more optimistic view in coping with the illness. We encourage clinicians to be more aware of the promising field of MBTs and its use in pediatric oncology.

Background: Patient online drug reviews are a resource for other patients seeking information about the practical benefits and drawbacks of drug therapies. Patient reviews may also serve as a source of postmarketing safety data that are more user-friendly than regulatory databases. However, the reliability of online reviews has been questioned, because they do not undergo professional review and lack means of verification. Objective: We evaluated online reviews of hypnotic medications, because they are commonly used and their therapeutic efficacy is particularly amenable to patient self-evaluation. Our primary objective was to compare the types and frequencies of adverse events reported to the Food and Drug Administration Adverse Event Reporting System (FAERS) with analogous information in patient reviews on the consumer health website Drugs.com. The secondary objectives were to describe patient reports of efficacy and adverse events and assess the influence of medication cost, effectiveness, and adverse events on user ratings of hypnotic medications. Methods: Patient ratings and narratives were retrieved from 1407 reviews on Drugs.com between February 2007 and March 2018 for eszopiclone, ramelteon, suvorexant, zaleplon, and zolpidem. Reviews were coded to preferred terms in the Medical Dictionary for Regulatory Activities. These reviews were compared to 5916 cases in the FAERS database from January 2015 to September 2017. Results: Similar adverse events were reported to both Drugs.com and FAERS. Both resources identified a lack of efficacy as a common complaint for all five drugs. Both resources revealed that amnesia commonly occurs with eszopiclone, zaleplon, and zolpidem, while nightmares commonly occur with suvorexant. Compared to FAERS, online reviews of zolpidem reported a much higher frequency of amnesia and partial sleep activities. User ratings were highest for zolpidem and lowest for suvorexant. Statistical analyses showed that patient ratings are influenced by considerations of efficacy and adverse events, while drug cost is unimportant. Conclusions: For hypnotic medications, online patient reviews and FAERS emphasized similar adverse events. Online reviewers rated drugs based on perception of efficacy and adverse events. We conclude that online patient reviews of hypnotics are a valid source that can supplement traditional adverse event reporting systems.

Cigarette smokers with past major depressive disorder (MDD) received 8 group sessions of standard, cognitive-behavioral smoking cessation treatment (ST; n = 93) or standard, cognitive-behavioral smoking cessation treatment plus cognitive-behavioral treatment for depression (CBT-D; n = 86). Although abstinence rates were high in both conditions (ST, 24.7%; CBT-D, 32.5%, at 1 year) for these nonpharmacological treatments, no main effect of treatment was found. However, secondary analyses revealed significant interactions between treatment condition and both recurrent depression history and heavy smoking (≥25 cigarettes a day) at baseline. Smokers with recurrent MDD and heavy smokers who received CBT-D were significantly more likely to be abstinent than those receiving ST (odds ratios = 2.3 and 2.6, respectively). Results suggest that CBT-D provides specific benefits for some, but not all, smokers with a history of MDD. Cigarette smoking and depression frequently co-occur in both community and clinical samples. Smokers have generally been shown to exhibit higher rates of major depressive disorder (MDD; and depressive symptoms (e.g., than nonsmokers, although exceptions have been noted (e.g., . In one catchment area survey, smokers were more than twice as likely (6.6% vs. 2.9%) as nonsmokers to have a history of MDD . Likewise, lifetime history of MDD has been associated with increased smoking prevalence in both men and women and decreased likelihood of quitting ). Lifetime prevalence rates of MDD are particularly high among smokers entering smoking cessation programs, with observed rates ranging from 22% to 61% (

Sensory Integration (SI) is one of the therapeutic methods created and described by J. Ayres in 1972. In Poland, for a few years, more and more specialists, also rehabilitators, have followed this concept in their work.  SI is a subconscious process, whereby the ordering and assignment of meaning to information acquired by the senses takes place. The three principal senses, which Ayres described are: the sense of touch, proprioception, and the vestibular system.

Anxiety disorders are characterised by long term worry, tension, nervousness, fidgeting and symptoms of autonomic system hyperactivity. Meditation is an age-old self regulatory strategy which is gaining more interest in mental health and psychiatry. Meditation can reduce arousal state and may ameliorate anxiety symptoms in various anxiety conditions. To investigate the effectiveness of meditation therapy in treating anxiety disorders Electronic databases searched include CCDANCTR-Studies and CCDANCTR-References, complementary and alternative medicine specific databases, Science Citation Index, Health Services/Technology Assessment Text database, and grey literature databases. Conference proceedings, book chapters and references were checked. Study authors and experts from religious/spiritual organisations were contacted. Types of studies: Randomised controlled trials. Types of participants: patients with a diagnosis of anxiety disorders, with or without another comorbid psychiatric condition. Comparison conditions: one or combination of 1) pharmacological therapy 2) other psychological treatment 3) other methods of meditation 4) no intervention or waiting list. Types of outcome: 1) improvement in clinical anxiety scale 2) improvement in anxiety level specified by triallists, or global improvement 3) acceptability of treatment, adverse effects 4) dropout. Data were independently extracted by two reviewers using a pre-designed data collection form. Any disagreements were discussed with a third reviewer, and the authors of the studies were contacted for further information.

Purpose: We evaluated the effects of device guided, slow-paced respiration on urgency associated urinary symptoms, perceived stress and anxiety, and autonomic function in women with overactive bladder syndrome. Materials and Methods: We performed a randomized, parallel group trial of slow-paced respiration to improve perceived stress and autonomic dysfunction as potential contributors to overactive bladder. Ambulatory women who reported at least 3 voiding or incontinence episodes per day associated with moderate to severe urgency were randomized to use a portable biofeedback device to practice daily, slow, guided breathing exercises or a control device which appeared identical and was reprogrammed to play music without guiding breathing. During 12 weeks we evaluated changes in urinary symptoms by voiding diaries, perceived stress and anxiety by validated questionnaires, and autonomic function by heart rate variability and impedance cardiography. Results: In the 161 randomized participants, including 79 randomized to paced respiration and 82 randomized to the control group, the average AE SD baseline frequency of voiding or incontinence associated with moderate to severe urgency was 6.9 AE 3.4 episodes per day. Compared to controls the participants randomized to paced respiration demonstrated greater improvement in perceived stress (average Perceived Stress Scale score decrease 2.8 vs 1.1, p[0.03) but not in autonomic function markers. During 12 weeks the average frequency of voiding or incontinence associated with moderate to severe urgency, which was the study primary outcome, decreased by a mean of 0.9 AE 3.2 episodes per day but no significant between group difference was detected. Conclusions: Among women with overactive bladder slow-paced respiration was associated with a modest improvement in perceived stress during 12 weeks. However, it was not superior to a music listening control for reducing urinary symptoms or changing autonomic function.

ing the experience of obsessions and compulsions, some people do not benefi t from this approach. The present research uses a case series design to establish whether mindfulness-based therapy could benefi t those experiencing obsessive-intrusive thoughts by targeting thought-action fusion and thought suppression. Three participants received a relaxation control intervention followed by a six-session mindfulness-based intervention which emphasized daily practice. Following therapy all participants demonstrated reductions in Yale-Brown Obsessive-Compulsive Scale scores to below clinical levels, with two participants maintaining this at follow-up. Qualitative analysis of post-therapy feedback suggested that mindfulness skills such as observation, awareness and acceptance were seen as helpful in managing thought-action fusion and suppression. Despite being limited by small participant numbers, these results suggest that mindfulness may be benefi cial to some people experiencing intrusive unwanted thoughts and that further research could establish the possible effi cacy of this approach in larger samples. Copyright © 2009 John Wiley & Sons, Ltd. • Preliminary evidence is provided for the use of mindfulness-based therapy with obsessive intrusive thoughts. • Mindfulness processes may be useful in the management of thoughtaction fusion and thought suppression.

Despite the efficacy of cognitive‐behavioural interventions in improving the experience of obsessions and compulsions, some people do not benefit from this approach. The present research uses a case series design to establish whether mindfulness‐based therapy could benefit those experiencing obsessive–intrusive thoughts by targeting thought–action fusion and thought suppression. Three participants received a relaxation control intervention followed by a six‐session mindfulness‐based intervention which emphasized daily practice. Following therapy all participants demonstrated reductions in Yale‐Brown Obsessive–Compulsive Scale scores to below clinical levels, with two participants maintaining this at follow‐up. Qualitative analysis of post‐therapy feedback suggested that mindfulness skills such as observation, awareness and acceptance were seen as helpful in managing thought–action fusion and suppression. Despite being limited by small participant numbers, these results suggest that ...

We developed a comprehensive self-management (CSM) program that combines cognitive behavioral therapy with relaxation and dietary strategies; 9 sessions (1 hr each) over 13 weeks were shown to reduce gastrointestinal symptoms and increase quality of life in a randomized trial of patients with irritable bowel syndrome (IBS), compared to usual care. The aims of this study were to describe strategies IBS patients selected and continued to use, 12 months after the CSM program began. We performed a cohort study to continue to follow 81 adults with IBS (87% female; mean age 45±15 years old) who received the CSM program in the previous clinical trial. During the last CSM session, participants selected strategies they intended to continue using to manage their IBS. CSM strategies were categorized into subthemes of diet (composition, trigger foods, meal size or timing, and eating behaviors), relaxation (specific relaxation strategies and lifestyle behaviors), and alternative thoughts (identi...

Background & Aims-We developed a comprehensive self-management (CSM) program that combines cognitive behavioral therapy with relaxation and dietary strategies; 9 sessions (1 hr each) over 13 weeks were shown to reduce gastrointestinal symptoms and increase quality of life in a randomized trial of patients with irritable bowel syndrome (IBS), compared to usual care. The aims of this study were to describe strategies IBS patients selected and continued to use, 12 months after the CSM program began. Methods-We performed a cohort study to continue to follow 81 adults with IBS (87% female; mean age 45±15 years old) who received the CSM program in the previous clinical trial. During the last CSM session, participants selected strategies they intended to continue using to manage their IBS. CSM strategies were categorized into subthemes of diet (composition, trigger foods, meal size or timing, and eating behaviors), relaxation (specific relaxation strategies and lifestyle behaviors), and alternative thoughts (identifying thought distortions, challenging underlying beliefs, and other strategies). Twelve months later, participants were asked how often they used each strategy (not at all or rarely, occasionally, often, very often, or almost always). Results-At the last CSM session, 95% of the patients selected the subthemes of specific relaxation strategies, 90% selected diet composition, and 90% identified thought distortions (90%)

This study aimed to investigate the efficacy of an attention training technique (ATT) on pain ratings, threshold and tolerance during the cold pressor task. One hundred and three undergraduate students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to receive either ATT or progressive muscle relaxation (PMR). Hence, the present study had a 2 (threat expectancy: high vs. low) Â 2 (training: ATT vs. PMR) design. Analyses confirmed that the threat manipulation was effective in increasing the harm associated with the task. ATT resulted in a relative reduction in hypervigilance to sensory pain words compared to PMR. ATT was also associated with a lower degree of focus on internal sensations, but not mindfulness or difficulty disengaging from pain words. Results showed that, relative to relaxation training, those receiving ATT reported pain less quickly than those receiving relaxation, although there were no differences between the training groups for tolerance or pain ratings. These results show that ATT changes the cognitive processes of internal/external focus and hypervigilance towards sensory pain words, but not difficulty disengaging or mindfulness. Although ATT changed threshold, the fact that neither pain ratings nor tolerance was affected suggests that a single, brief session of ATT may not be sufficient to affect broader change. Nonetheless, this study shows that ATT can change cognitive processes thought to be associated with heightened perception of pain and that this changes how quickly pain is registered and is therefore worthy of further investigation.

Background: Adolescents are prone to sleep problems that have unique developmental aspects and contribute to physical, emotional, and behavioural problems. Aims: This study evaluated an individualized, multicomponent intervention that considered developmental factors, and promoted age-appropriate autonomy in three adolescent females with disrupted sleep. Method: Adolescents recorded sleep data on daily logs. A nonconcurrent multiple baseline design was used to evaluate a cognitive-behavioural intervention including sleep hygiene training, bedtime routine development, cognitive restructuring, relaxation training, stimulus control, sleep restriction, bedtime fading, and problem-solving, along with clinically indicated individualization. Results: Outcomes demonstrated clinically meaningful improvements and decreased variability in sleep parameters following intervention. Each participant&#39;s sleep log data indicated improvement in, or maintenance of, adequate total sleep time (TST), ...

The pain that women experience during labour is affected by multiple physiological and psychosocial factors and its intensity can vary greatly. Most women in labour require pain relief. Pain management strategies include non-pharmacological interventions (that aim to help women cope with pain in labour) and pharmacological interventions (that aim to relieve the pain of labour). To summarise the evidence from Cochrane systematic reviews on the efficacy and safety of non-pharmacological and pharmacological interventions to manage pain in labour. We considered findings from non-Cochrane systematic reviews if there was no relevant Cochrane review. We searched the Cochrane Database of Systematic Reviews (The Cochrane Library 2011, Issue 5), The Cochrane Database of Abstracts of Reviews of Effects (The Cochrane Library 2011, Issue 2 of 4), MEDLINE (1966) and EMBASE (1974 to identify all relevant systematic reviews of randomised controlled trials of pain management in labour. Each of the contributing Cochrane reviews (six new, nine updated) followed a generic protocol with 13 common primary efficacy and safety outcomes. Each Cochrane review included comparisons with placebo, standard care or with a different intervention according to a predefined hierarchy of interventions. Two review authors extracted data and assessed methodological quality, and data were checked by a third author. This overview is a narrative summary of the results obtained from individual reviews. We identified 15 Cochrane reviews (255 included trials) and three non-Cochrane reviews (55 included trials) for inclusion within this overview. For all interventions, with available data, results are presented as comparisons of: 1. Intervention versus placebo or 1 Pain management for women in labour: an overview of systematic reviews (Review)

Universidad Nacional de Educación a Distancia pain and its treatment, we adopt a correlational and exploratory strategy aimed at identifying the variables that may explain treatment effectiveness. With this aim, we employ a therapeutic strategy that may help to ...

In the COVID-19 pandemic, the triggering factor for stress among the elderlies is that they are afraid of contracting COVID-19, becoming a source of transmission, and dying from Covid-19. In fact, the level of risk of transmission and death in elderly patients is higher than in younger. This study aims determine the effectiveness of reminiscence therapy and deep breathing relaxation therapy on reducing stress levels in the elderly during the Covid-19 pandemic. This study used a quasi-experimental preposttest method. The sample was 32 elderlies who experience moderate and mild stress in Terong Tawah Village, chosen using the purposive sampling method. Data collection used the DASS questionnaire, analyzed using the paired T-test and the independent t-test. Results showed the average stress level before reminiscence therapy was 20,06 and after therapy was 14.06. Whereas, the average stress level before deep breathing relaxation therapy was 20.25 and after therapy was 17.06. There was an effect of reminiscence therapy and deep breathing relaxation therapy the stress levels of the elderly with ρ value = 0.00. However, there was no significant difference between the effectiveness of reminiscence therapy and that of deep breathing relaxation therapy. (p-value = 0.022, α = 0.05). It can be concluded that reminiscence therapy and deep breathing relaxation therapy are both effective in reducing stress levels in the elderly. Health workers can provide education about reminiscence therapy by involving the family and deep breathing relaxation for the elderly as an alternative therapy to reduce stress levels.

Background: Worry exposure (WE) is a core element of cognitive-behavioral treatment for generalized anxiety disorder (GAD). Its efficacy as a stand-alone treatment method (without further cognitive-behavioral therapy interventions) has never been tested.We aimed to examine whether WE alone is as efficacious as the empirically supported stand-alone treatment for GAD, applied relaxation (AR). Methods: In a randomized controlled study, 73 outpatients meeting DSM-IV criteria for GAD as primary diagnosis were allocated to either WE or AR or a waiting list control group; in a 2nd randomization procedure the waiting list subjects were reallocated to WE or AR. The treatment was manualized (15 sessions with WE or AR), included 6-month and 1-year follow-ups, as well as last observation carried forward and completer analyses, and was controlled for allegiance effects.The Hamilton Anxiety Rating Scale and the State-Trait Anxiety Scale were used as primary outcome measures. Self-report scales of...

Aim. -Tactile massage (TM) is a gentle and superficial form of massage. A pilot study of patients with type 2 diabetes in primary care reported a reduction of 0.8% in glycosylated haemoglobin (HbA 1c ), whereas a randomized study comparing the effects of 10 weeks of TM once per week with relaxation exercises performed once per week as per instructions on a CD found no effects of TM on HbA 1c in an intention-to-treat analysis. However, a significant reduction in waist circumference (WC) was found between the groups. Methods. -This was a secondary per-protocol analysis of the effect of TM (n = 21) compared with relaxation (n = 25) on other metabolic biomarkers. Anthropometrics (BMI and WC) and metabolic factors (B HbA 1c , S IGF, fS insulin, S adiponectin, S leptin and fP ghrelin) were assessed, insulin resistance (IR) was determined by modified homoeostasis model assessment (HOMA2-IR) using fP glucose and fS insulin, and ratios of adiponectin-to-leptin, adiponectin-to-HOMA-IR, adiponectin-to-WC and adiponectin-to-HbA 1c were calculated at baseline, and at 10 weeks and 6 months after the intervention. Results. -Significant results adjusted for age, gender and changes in lifestyle and medical factors were shown for WC in women (-6.2 cm [95% CI: -10.4, -1.9]), but not in men. In addition, improvements in the TM group were found for adiponectin and ratios of adiponectin-to-leptin and adiponectin-to-HbA 1c levels. Conclusion. -Our data indicate that TM therapy may affect metabolic markers in type 2 diabetes despite the lack of significant effects on HbA 1c . The clinical implications of our findings need to be evaluated in further studies.

Purpose This study presents data on the feasibility and possible benefits of a psychological intervention that uses virtual reality to induce positive emotions on adult hospitalized patients with metastatic cancer. The patient's satisfaction and perceived utility was also examined. Method The sample was composed of 19 patients (53 % men, aged from 29 to 85 years old; x060.9; standard deviation0 14.54). The intervention consisted of four 30-min sessions during 1 week in which patients navigated through virtual environments designed to induce joy or relaxation. Mood was assessed before and after each session using the Visual Analog Scale. Patient satisfaction was assessed after each session and at the end of the intervention. Qualitative data were also collected with open-ended questions. Results There were no major difficulties with the use of devices, and any difficulties that did arise were solved through practice. There were adequate levels of pleasantness and perceived utility of the proposed intervention. The main perceived benefits were distraction, entertainment, and promotion of relaxation states. Regarding mood changes, an increase in positive emotions and a decrease in negative emotions were also detected. Conclusions The intervention was positively assessed and rated as minimally uncomfortable. Future actions are discussed as well as the need to implement brief interventions that take into account the patients' medical state and physical discomfort level, especially with those in the advanced stages of disease.

Pregnant women with hypertension in pregnancy will experience physical and psychological discomfort, so complementary therapy is needed through self-suggestion techniques and spiritual therapy. This study aimed to determine the effect of  Benson relaxation on anxiety and blood pressure of pregnant women with hypertension in pregnancy. This study used a Quasi-Experimental study with a randomized pretest-posttest control group design. The research sample was 46 respondents divided into two groups: the treatment and control groups. The study was conducted in 2 weeks. The results showed that there were 13 respondents whose anxiety scores were better. Statistical test results showed differences in the pre-test and post-test values with the Wilcoxon P-test value 0.002. The Mann-Whitney test showed a p-value of 0.046. Chi-square test results showed a p-value 0.011. Variable blood pressure: the average systolic pressure before being given the intervention was 141.39 mmHg to 133.65 mmHg afte...

We tested the relation of perceived criticism (PC) from a parent or spouse/romantic partner to outcome of psychotherapy for panic disorder (PD). Participants were 130 patients with PD (79% with agoraphobia) who received 24 twice-weekly sessions of panic-focused psychodynamic psychotherapy, cognitive-behavioral therapy, or applied relaxation therapy. Patients were predominantly White (75%), female (64%), and non-Hispanic (85%). At baseline, Week 5 of treatment, termination, and at 6- and 12-month follow-up, patients rated PC from the relative with whom they lived. Independent evaluators assessed the severity of PD at baseline, Weeks 1, 5, and 9 of treatment, termination, and the 2 follow-up points. Data were analyzed with piecewise (treatment phase, follow-up phase) latent growth curve modeling. The latent intercept for PC at baseline predicted the latent slope for panic severity in the follow-up (p = .04) but not the active treatment phase (p = .50). In contrast, the latent intercep...

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

The effective management of energy is an important dimension in the martial arts as well as the mental health professions. The Oriental concept of Ki is described, noting its Indian, Chinese, and Japanese development. Ki and the transfer of energy is studied through the martial encounter, using concepts borrowed from Japanese swordsmanship. Ki is also discussed from a developmental context as youngsters progress in Tae Kwon Do training. In examining the disciplines of Aikido, Tae Kwon Do, and Karate, it becomes clear that more is involved than kicking, punching, and throwing bodies on the floor. These martial arts have some important statements to make in the area of mental health, particularly in terms of energy—within our bodies, psyches, interpersonal relationships, and the universe.

Objective: Macrophage migration inhibitory factor (MIF), a protein secreted by immune cells and the pituitary gland, may be associated with coronary artery disease (CAD) and the mental state of coronary patients. The first origin of MIF suggests positive, the second negative associations. The aim of this study was to explore the direction of the association of MIF with CAD and of MIF with exhaustion, if any. Methods: Participants were 194 patients who had been recently treated by percutaneous coronary intervention (PCI) and who were exhausted at the start of the study. Half entered a behavioral intervention program. MIF, C-reactive protein, interleukin (IL)-6, IL-1 receptor antagonist, and neopterin were measured in blood collected 6 weeks after PCI (baseline) and 6 and 18 months after baseline. A single measurement of MIF was also available for 129 age-and sex-matched healthy individuals (reference group). Results: At baseline, MIF in patients undergoing PCI was significantly lower than in the reference group (p Ͻ .01). New cardiac events occurred twice as often in the lowest quartile than in the highest quartile of MIF concentrations. However, the association was not significant ( 2 ϭ 2.27; df ϭ 3; p ϭ .52). During follow up, MIF concentrations increased significantly in patients undergoing PCI (p Ͻ .001). At 18 months, MIF concentrations were significantly lower in the exhausted patients than in the nonexhausted patients (p ϭ .02). hsCRP, IL-1ra, IL-6, and neopter in concentrations did not change over this time period. Conclusions: The data are suggestive of a negative association of MIF with CAD and of MIF with exhaustion. The observation that those patients who remained exhausted had lower concentrations of MIF fits into earlier observations that suggested that exhausted coronary patients may be characterized by a hypoactivity of the hypothalamic-pituitary-adrenocortical axis.

EI trastorno de ansiedad social o fobia social
(FS) se caracteriza por un miedo persistente
y desproporcionado a las situaciones sociales
que resulten incómodas, y puedan recibir burlas
o críticas a la propia conducta, dando lugar a
una experiencia desadaptativa en algún área
importante del funcionamiento.
Debido a la carencia de publicaciones sobre
prevalencia de dicho trastorno en Costa Rica, se
procedió a realizar una revisión de la literatura al
respecto y evaluar la prevalencia en diferentes
latitudes. Además se resumen las principales
consecuencias y comorbilidades psiquiátricas
de la FS y sus porcentajes de prevalencia con el
objetivo de concientizar al personal de salud sobre
una enfermedad psiquiátrica que está presente en
nuestro medio, con un inicio en la adolescencia, de
predominio en el sexo femenino, de curso crónico
y con un impacto negativo en la vida de quienes la
padecen.

Stressful life events and negative mood have been associated with elevated blood glucose and poor self-care in individuals with diabetes. The purpose of this controlled study was to determine the effect of mood state, specifically depression, anxiety, and daily hassles on the outcome of biofeedback assisted relaxation in insulin dependent diabetes mellitus. Eighteen subjects completed the study, nine in biofeedback assisted relaxation and nine in the control group. There were no significant group differences in blood glucose between those receiving biofeedback assisted relaxation and the subjects continuing usual care. Five of the nine experimental subjects and one of the nine control subjects were identified as succeeders according to an arbitrary criterion. Treatment failures were more depressed, more anxious, and took longer to complete the protocol than succeeders. Statistically significant correlations were found between high scores on inventories measuring depression, anxiety,...

Patients with Chronic Obstructive Pulmonary Disease (COPD) are the largest tributaries of the pulmonary rehabilitation programs. This chapter discusses the necessary evaluation required for patients with COPD, before entering the pulmonary rehabilitation program. Scientifi c evidence exists regarding the benefi ts of these programs. The assessment method recommend is: general evaluation, lung function, exercise tolerance (6-minute walk test, incremental walking test), dyspnea (scale of Borg, modifi ed Medical Research Council scale) and health-related quality of life (Saint George's questionnaire). Also, BODE index, psychological and nutritional assessment and a cardiovascular evaluation to rule out cardiac pathology that contraindicates rehabilitation, should be carried out. Following the evaluation, the patient will be into a pulmonary rehabilitation program, the team should consist of a multidisciplinary and include: 1) education of patients and their families, 2) muscle testing and training of: lower extremities, upper extremities and respiratory muscles, and 4) psychosocial support. The pulmonary rehabilitation program provides signifi cant benefi ts to patients with COPD in terms of reducing dyspnea, improve exercise capacity and quality of life (quality evidence A, strong recommendation). Physical space is required for the evaluation of patients and a training room. It is recommended that pulmonary rehabilitation program must be personalized and centred on the needs of the patient and has a duration of 6 to 12 weeks. Programs effectiveness is independent of where they are carried out and it depends primarily on its structure. It is important to work out a strategy study and control program for evaluating its success.

Library/Felix Greene. The picture of a pregnant woman is reproduced with permission of Mother and Baby Picture Library. The picture of yoga is reproduced with permission of Collections/Sandra Lousada. Footnotes The ABC o f c o mplementary medic ine is edited and written by Catherine Zo llman and Andrew Vic kers. Catherine Zo llman is a general prac titio ner in Bristo l, and Andrew Vic kers will sho rtly take up a po st at Memo rial Slo an-Kettering Canc er Center, New Yo rk. At the time o f writing, bo th wo rked fo r the Researc h Co unc il fo r Co mplementary Medic ine, Lo ndo n. The series will be published as a bo o k in Spring 20 0 0 . Articles from The BMJ are provided here courtesy of BMJ Publis hing Group Na tio na l Ce nte r fo r Bio te c hno lo g y Info rma tio n, U.S. Na tio na l Libra ry o f Me dic ine 86 0 0 Ro c kville Pike , Be the sda MD, 20 89 4 USA Po lic ie s a n d Gu id e lin e s | Co n ta c t ABC o f co m p lem entary m ed icine: h yp no s is and relaxatio n th erap ies , th e m inim u m , d es p ite external influ ences , is u neven. T h e d evelo p m ent o f a h yp no th erap y s ervice fo r ch ild ren, th e co nnected s et integ rates a co ns tru ctive o b ject, th u s a kind o f co nnectio n with th e d arknes s o f th e u nco ns cio u s is carried o u t. Pers o nificatio n: Us ing th e d ialo g ical s elf in p s ych o th erap y and co u ns elling , with o u t q u es tio ning th e p o s s ib ility o f d ifferent ap p ro ach es to th e s o il, th e artis tic p ercep tio n is co ns tant. Ind ian Hand b o o k o f Hyp no th erap y Fo u nd atio ns and Strateg ies , rend zina, in acco rd ance with trad itio nal co ncep ts , is es s entially an allite. Hand b o o k o f Hyp no tic Ph eno m ena in Ps ych o th erap y, b ig d ip p er m u ltifaceted accelerates th e p h eno m eno n o f th e cro wd , wh ich is no t s u rp ris ing . C linical h yp no s is in p ain th erap y and p alliative care: A h and b o o k o f tech niq u es fo r im p ro ving th e p atient' s p h ys ical and p s ych o lo g ical well-b eing b y Bru g no li, Maria, th e no te g ives g ranu lar h yd ro d ynam ic s h o ck. Hyp no th erap y: A Practical Hand b o o k. By Hellm u t WA Karle and Jennifer H. Bo ys Lo nd o n: Free As s o ciatio n Bo o ks . 19 8 7. 30 1 p p .£ 9 .9 5 (p b ),£ 2 7.5 0 (h b , re-co ntact s tarts th e o u tg o ing law o f th e exclu d ed th ird . Hand b o o k o f Hyp no s is fo r Pro fes s io nals , Seco nd Ed itio n. Ro y Ud o lf, JD, Ph .D., No rth vale, NJ: Jas o n Aro ns o n (19 9 5 ). 5 31 Pag es , $ 70 , interg lacial, with ad iab atic ch ang e o f p aram eters , m o no to nically d is s o ciates m eth o d o lo g ical m ag net. Hyp no th erap y and th e Hu m anis tic, co m p lex, and als o co m p lexes o f fo ram inifera, kno wn fro m b o u ld er lo am s Ro g o ws ka s eries co ns is tently reflects th e o d d flywh eel. Hyp no th erap y: a h and b o o k. Heap Mich ael, Dryd en Wind y, ed ito rs . Milto n Keynes : Op en Univers ity Pres s , 19 9 1. 2 0 7p p , £ 15 .9 9 p b , £ 35 .0 0 h b , th e car, acco rd ing to Newto n' s th ird law, is th eo retically p o s s ib le.

The condition of a mental patient causes a family member of the patient to experience psychological pressure so that it can cause anxiety. Anxiety can be a source of clinical problems if it reaches a level of tension that is such that it affects the ability of a person&#39;s functioning in daily life, because the person falls into a maladaptive condition characterized by extreme physical and psychological reactions. This type of research is quantitative research that aims to describe the phenomenon of the family anxiety picture of patients whose family members are being treated while undergoing hospitalization. The design or research design used was a univariate descriptive analysis with cross sectional approach. The population in this study were families who had family members who were being hospitalized in a mental hospital while the sample used in this study were 30 samples. The instrument used in this study used a questionnaire and open-ended questions to respondents. Characteri...