Psychobiological factors of resilience and depression in late life.

In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind-body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD

ARE ALTERNATIVE TREATMENTS EFFECTIVE? ISSUES & METHODS INVOLVED IN MEASURING EFFECTIVENESS OF ALTERNATIVE TREATMENTS

This paper reviews common research methods which have been used in alternative medicine. We focus on a case series method called the before-after treatment experimental design. How this method can be used by practitioners to measure the effectiveness of their treatments is explored in depth. We address what variables should be measured before, during and after treatment. References to commonly used measurement instruments for physical, emotional and spiritually based variables are included

Complementary Alternative Medicine: an Education of Guided Self-care in the Elderly Population for Management of Chronic Conditions

The elderly population, specifically the residents in the Skilled Nursing Facility (SNF) or nursing homes, suffer from chronic conditions, many of which have a psychological and behavioral component. Conventional medicine treats the chronic conditions from one symptom to another through pharmacological interventions, which resulted in polypharmacy. Gathering evidenced-base practice of Complementary Alternative Medicine (CAM) will maximize opportunities for the elderly population to manage chronic conditions. The application of Parse’s Theory of Human Becoming (HBT) with self-guided education of CAM modalities in SNF explores the significant concepts of personal meaning, rhythmical patterns, and transcendence. Grounded on HBT, the self- guided education of self-hand massage using aromatherapy, meditation, and mindfulness coloring art augment holistic health by addressing the physical, mental, emotional, and spiritual dimensions of care in the residents of SNF. The implementation of the project presents how effective the self-guided education of CAM modalities in improving health outcomes through the resident\u27s experience, the involvement of front-line staff, and the Quality Steering Committee feedback. The self-guided education of CAM modalities provides a useful tool of evidenced-base care in the SNF located in urban, MN

Mental health interventions and priorities for research for adult survivors of torture and systematic violence: a review of the literature

This research describes the development and findings of a literature review and analysis meant to inform the international torture and trauma treatment community. The review focuses on interventions that have been used among populations affected by torture, based on a review of journals indexed in commonly used search engines. Work on the review began in September 2008 and continued to be updated until March 2014. In total, 88 studies of interventions for torture victims were identified. Studies ranged from randomized controlled trials utilizing evidence-based treatments to case studies employing non-structured, supportive therapies. Based on the results of the analysis, we have included recommendations for interventions that demonstrate effectiveness in treating survivors of torture and other systematic violence who suffer from PTSD, depression, and anxiety.  Priorities for mental health research for survivors of torture and other systematic violence are also recommended. &nbsp

A Mindful Approach to Diabetes Self-management Education with Stress Reduction and Healthy Coping for US Veterans with Diabetes

Negative emotional states impact the performance of diabetes self-care behaviors and may jeopardize metabolic control leading to acute and chronic complications. In addition, daily self-care demands commonly result in diabetes-related distress, adding to disease burden. Healthy coping is recognized as being essential to successful diabetes self-management, but little is offered during routine diabetes education to cultivate this key self-care behavioral outcome. Approximately 40% of the US population uses some form of Complementary and Alternative Medicine. The study of Mindfulness Meditation in chronic health conditions including diabetes is an emerging science. We conducted two pilot studies of Mindfulness in relation to measures of stress and glycemic control in individuals with diabetes who are at increased risk for complications of stress: women and US Veterans. In a preliminary mixed-methods pilot study of Mindfulness-Based Stress Reduction in six women with type 2 diabetes, two qualitative themes emerged: 1) improved coping, and 2) connecting mind and body. Quantitative analysis showed positive pre-post changes in Mindfulness, perceived stress, diabetes-related distress, and Hba1c that demonstrated moderate to large effect sizes. A MINDFUL APPROACH TO DIABETES SELF-MANAGEMENT EDUCATION WITH STRESS REDUCTION AND HEALTHY COPING FOR US VETERANS WITH DIABETES Monica Marten DiNardo Ph.D. University of Pittsburgh, 2013 University of Pittsburgh, [year] v A second study of US Veterans with diabetes (n=35) who were recruited from a Diabetes Education program within the Veterans Affairs Healthcare System found a high rate of retention (71%) and satisfaction among participants who received the Mindfulness intervention. Ninety-two percent of Veterans who participated in the 90-minute mindfulness training class and 30- minute booster session plus home Mindfulness practice over a 3-month period would recommend the class to other people with diabetes. Nonparametric repeated measures analysis of variance found significant improvements in diabetes-related distress, and in 3-facets of mindfulness (observing, describing and acting with awareness). Pairwise comparisons showed a significant improvement in diabetes self-management behaviors and attainment of goals that correlated positively with measures of diabetes-related coping and negatively with diabetes-related distress. Hba1c decreased significantly from baseline to 3 months (8.35% 1.6; 7.31% SD 1.22; z=-2.154, p=.03; d=.73). These findings support the feasibility, acceptability, and possible benefits of a Mindfulness-based program offered as part of routine diabetes education for Veterans with diabetes, and warrant further study

I think I can: The Effectiveness of a Biofeedback Intervention on Surgical Patients’ Self-Efficacy

In pursuit of the Quadruple Aim, hospitals and health care clinics are adapting a biopsychosocial perspective in order to best meet both patient and system needs. One specialty area of healthcare with stark interactions of biological, psychological, and social factors is orthopedic surgery. Literature suggests self-efficacy may be an important factor for improving health outcomes post-surgery; biofeedback interventions have been repeatedly shown to increase patient self-efficacy. The current study examined effectiveness of a biofeedback intervention on orthopedic patients’ self-efficacy, pain interference, and physiological regulation. Researchers recruited 12 orthopedic patients to participate in the study and randomly assigned them to either the control or experimental condition. All participants completed pre/post self-report measures and biofeedback measurements as well as engaged in a daily self-regulation exercise; participants in the experimental condition also partook in weekly biofeedback interventions. Results were analyzed using a mixed two-way MANOVA and a three-way ANOVA with repeated measures. Although there were no statistically significant results, there were clinically significant effect sizes in patients’ pain interference and self-regulatory abilities, suggesting biofeedback interventions are an effective strategy for teaching pain management and self-regulation. Together, these findings provide further evidence to support a holistic approach to healthcare and have numerous implications for post-operative rehabilitation