Bodily experiences of patients diagnosed with anorexia nervosa during treatment with the body monochord : A modified grounded theory approach

This study explored the subjective bodily experiences of patients with a diagnosis of anorexia nervosa (AN) during vibro-acoustic stimulation sessions with the Body Monochord (BoMo), a body sound treatment instrument. A total of 20 female patients diagnosed with AN received two BoMo treatments. Subsequent to the treatments, semi-structured interviews were conducted. Analysis was conducted using Grounded Theory. The following main categories were identified: differentiated perception, focussed attention, emergence of bodyrelated feelings, emergence of emotions, emergence of thoughts, emergence of inner images, relaxation, spatial and temporal experience, new bodily experiences and self-reflection. The subjective experiences during the BoMo treatment were independent of patient body shape and weight, were not exclusively focussed on usual illnessrelated body problem areas like the belly and the thighs and had both positive and negative connotations. New therapeutic approaches that are suited to handling and integrating new bodily experiences in patients diagnosed with AN may develop from these observations. Due to the variety of issues that emerge during the treatments BoMo might present a meaningful extension to verbal psychotherapy

Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer

Objective: To test the psychometric properties, internal consistency, dimensional structure, and convergent validity of the German version of the Demoralization Scale- II (DS-II), and to examine the association between demoralization, sociodemographic, disease- and treatment-related variables in patients with cancer. Methods: We recruited adult patients with cancer at a Psychosocial Counseling Center and at oncological wards. Participants completed the 16-item DS-II, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-2 (GAD-2), Distress Thermometer (DT), and Body Image Scale (BIS). We analyzed internal consistency of the DS-II using Cronbach‘s Alpha (a). We tested the dimensional structure of the DS-II with Confirmatory Factor Analyses (CFA). Convergent validity was expressed through correlation coefficients with established measures of psychological distress. The associations between demoralization, sociodemographic, disease- and treatmentrelated variables were examined with ANOVAs. Results: Out of 942 eligible patients, 620 participated. The average DS-II total score was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20, and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency ranged from high to excellent with a = 0.93 for the DS-II total scale, a = 0.90 for the Meaning and Purpose subscale, and a = 0.87 for the Distress and Coping Ability subscale. The one-factor and the two-factor model yielded similar model fits, with CFI and TLI ranging between 0.910 and 0.933, SRMR < 0.05. The DS-II correlated significantly with depression (PHQ-9: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress (DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29, SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60). Conclusion: The DS-II has very good psychometric properties and can be recommended as a reliable tool for assessing demoralization in patients with cancer. The results support the implementation of a screening for demoralization in specific risk groups due to significantly increased demoralization scores

Exploring the ubiquinone binding cavity of respiratory complex I

Proton pumping respiratory complex I is a major player in mitochondrial energy conversion. Yet little is known about the molecular mechanism of this large membrane protein complex. Understanding the details of ubiquinone reduction will be prerequisite for elucidating this mechanism. Based on a recently published partial structure of the bacterial enzyme, we scanned the proposed ubiquinone binding cavity of complex I by site-directed mutagenesis in the strictly aerobic yeast Yarrowia lipolytica. The observed changes in catalytic activity and inhibitor sensitivity followed a consistent pattern and allowed us to define three functionally important regions near the ubiquinone-reducing iron-sulfur cluster N2. We identified a likely entry path for the substrate ubiquinone and defined a region involved in inhibitor binding within the cavity. Finally, we were able to highlight a functionally critical structural motif in the active site that consisted of Tyr-144 in the 49-kDa subunit, surrounded by three conserved hydrophobic residues

Subjective Experience of Relaxation - Induced by Vibroacoustic Stimulation by a Body Monochord or CD Music - A Randomised, Controlled Study in Patients With Psychosomatic Disorders

Vibroacoustic stimulation via a Body Monochord can induce states of relaxation and subjective well-being. Sometimes unpleasant experiences such as fear, loss of control and unpleasant imagery can occur. Previous results were mainly deduced from investigations in healthy subjects. In this study, we examined psychosomatic patients’ subjective experiences during a single treatment with a Body Monochord in comparison to a listening session of relaxation music via audio CD. Diagnosed disorders were anxiety disorders n = 14, depressive disorders n = 18, adjustment disorder n = 27 and somatoform disorders n = 6. Each of the two treatments took approximately 20 minutes and was presented to the patients in random order. Subjective experiences were recorded via a shortened version of the Phenomenology of Consciousness Inventory. Neither clinical disorders nor psychometric scales for depressiveness and anxiety showed any influence on the emotional experience of the Body Monochord. However, patients with higher depression and anxiety scores showed a tendency to experience the CD music as less emotionally positive. The experience of relaxation induced by the Body Monochord is characterised to a greater extent by release of control (paired t-test: p = .003, effect size Cohen’s d = .54). Contrary to listening sessions of the CD music, the intensity of imagery during the treatment with the Body Monochord was not related to positive emotional feelings. Possibly during treatment with the Body Monochord psychological defence mechanisms of subjects are more reduced; this may make it easier for unconscious or preconscious contents to appear

Relaxation – Induced by Vibroacoustic Stimulation via a Body Monochord and via Relaxation Music – Is Associated with a Decrease in Tonic Electrodermal Activity and an Increase of the Salivary Cortisol Level in Patients with Psychosomatic Disorders

<div><p>Vibroacoustic stimulation by a Body Monochord can induce relaxation states of various emotional valence. The skin conductance level (SCL) of the tonic electrodermal activity is an indicator of sympathetic arousal of the autonomic nervous system and thus an indicator of the relaxation response. Salivary cortisol is considered to be a stress indicator of the HPA-axis.</p><p>The effects of the treatment with a Body Monochord and listening to relaxation music (randomized chronological presentation) on SCL and salivary cortisol in relation to the emotional valence of the experience were examined in patients with psychosomatic disorders (N = 42). Salivary cortisol samples were collected immediately before and after the expositions. Subjective experience was measured via self-rating scales.</p><p>Overall, both the exposure to the Body Monochord as well as the exposure to the relaxation music induced an improvement of patients’ mood and caused a highly significant reduction of SCL. A more emotionally positive experience of relaxation correlated with a slightly stronger reduction of the SCL. Both treatment conditions caused a slight increase in salivary cortisol, which was significant after exposure to the first treatment. The increase of salivary cortisol during a relaxation state is contrary to previous findings. It is possible that the relaxation state was experienced as an emotional challenge, due to inner images and uncommon sensations that might have occurred.</p></div

Salivary cortisol.

<p>Salivary cortisol levels measured immediately before the first treatment after the resting condition, immediately after the first treatment and after the second treatment for the two groups with different chronological order of the two kinds of treatment (N = 36).</p

Electrodermal activity (SCL) of the patients who discontinued the treatment session.

<p>Individual courses of the SCL of the patients who discontinued the treatment session with the Body Monochord (N = 7) or the CD music (N = 1) because of unpleasant feelings or occurring imageries. The last measurement points refer to the last minute immediately before termination of the treatment exposure.</p

Electrodermal activity (SCL).

<p>Course of SCL during the two kinds of treatment (Body Monochord, CD music). The left diagram shows the courses of the SCL when the Body Monochord was presented as first and the CD music was presented as second exposure. The right diagram shows the courses of the SCL when the CD music was presented as first and the Body Monochord was presented as second exposure.</p

Berlin Mood Questionnaire (BSF).

<p>Perceived states of mood measured via the Berlin Mood Questionnaire (BSF) at the resting condition, after the exposure to the Body Monochord, and after the exposure to the CD music. (N = 37).</p

Medication, taken by the patients about 3 hours before physiological measurements.

<p>Medication, taken by the patients about 3 hours before physiological measurements.</p