Chewing gum modifies state-anxiety and alertness under conditions of social stress

Objectives: The finding that chewing gum can moderate state-anxiety under conditions of acute stress¹ has proved difficult to replicate.2,4 The present study examines the extent to which chewing gum can moderate state-anxiety under conditions of acute social stress. Method: In a between-participants design, 36 participants completed a task comprising a mock job interview (a variation on the Trier Social Stress Task3, which included a mental arithmetic component) whilst either chewing gum or without gum. Self-rated measures of mood and anxiety were taken at baseline, after a 10-minute presentation preparation stage, after the 10-minute presentation, and following a 5-minute recovery stage. Results: Post-presentation measures reflected increased state-anxiety and decrease self-rated calmness and contentedness. Chewing gum attenuated the rise in state-anxiety whilst increasing self-rated alertness. Chewing gum did not affect contentedness or calmness. Conclusions: The findings indicate that chewing gum can act to reduce anxiety under conditions of acute social stress: a finding consistent with Scholey et al.1 Furthermore, the data add to the growing body of literature demonstrating that chewing gum can increase alertness.1,2,4,

Chewing gum moderates multi-task induced shifts in stress, mood, and alertness: A re-examination

The finding that chewing gum can moderate stress and mood changes following a multi-task cognitive stressor (Scholey, Haskell, Robertson, Kennedy, Milne, and Wetherell, 2009) was re-examined. In a repeated measures cross-over design, thirty participants completed a 20-minute multi-tasking stressor on consecutive days, both with and without chewing gum. Both prior to and post stressor, participants provided salivary cortisol samples and self-rated measures of stress, state anxiety, calmness, contentedness, and alertness. Contrary to Scholey et al. (2009), chewing gum failed to attenuate both salivary cortisol levels and the increase in self-rated stress. Self-rated anxiety, calmness, and contentedness were not impacted by chewing gum. This suggests that the stress effects reported by Scholey et al. may be constrained by particular features of that study (e.g. morning testing). However, consistent with Scholey et al. (2009), chewing gum was shown to increase alertness following the stressor. The mechanisms underpinning heightened alertness are unclear; however, such increases may be linked to greater cerebral activity following the chewing of gum (Fang Li, Lu, Gong, and Yew, 2005)

Predicting outcome in acute low back pain using different models of patient profiling

This is a non-final version of an article published in final form in Spine, 34(18), 1970 - 1975, 2009. Copyright © 2009 Lippincott Williams & Wilkins, Inc.Study Design. Prospective observational study of prognostic indicators, using data from a randomized, controlled trial of physiotherapy care of acute low back pain (ALBP) with follow-up at 6 weeks, 3 months, and 6 months. Objective. To evaluate which patient profile offers the most useful guide to long-term outcome in ALBP. Summary of Background Data. The evidence used to inform prognostic decision-making is derived largely from studies where baseline data are used to predict future status. Clinicians often see patients on multiple occasions so may profile patients in a variety of ways. It is worth considering if better prognostic decisions can be made from alternative profiles. Methods. Clinical, psychological, and demographic data were collected from a sample of 54 ALBP patients. Three clinical profiles were developed from information collected at baseline, information collected at 6 weeks, and the change in status between these 2 time points. A series of regression models were used to determine the independent and relative contributions of these profiles to the prediction of chronic pain and disability. Results. The baseline profile predicted long-term pain only. The 6-week profile predicted both long-term pain and disability. The change profile only predicted long-term disability (P 0.05). A similar result was obtained when the order of entry was reversed. When predicting long-term disability, after the 6-week profile was entered at the first step, the change profile was not significant when forced in at the second step. However, when the change profile was entered at the first step and the 6-week clinical profile was forced in at the second step, a significant contribution of the 6-week profile was found. Conclusion. The profile derived from information collected at 6 weeks provided the best guide to long-term pain and disability. The baseline profile and change in status offered less predictive value

Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective

This study sought to explore the impact of the psychological variables anxiety and depression, on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4–6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and one-third of the sample experienced levels of anxiety in psychiatric proportions whilst under one-third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care

Cognitive Impairment in Men With Testicular Cancer Prior to Adjuvant Therapy

BACKGROUND: Cognitive dysfunction experienced by individuals with cancer represents an important survivorship issue because of its potential to affect occupational, scholastic, and social activities. Whereas early efforts to characterize cognitive dysfunction primarily focused on the effects of chemotherapy, more recent evidence indicates that impairment may exist before systemic treatment. This study characterized cognitive dysfunction before adjuvant chemotherapy in a sample of men diagnosed with nonseminomatous germ cell tumors (NSGCT) of the testis. METHODS: Men with newly diagnosed NSGCT were recruited after orchiectomy but before adjuvant chemotherapy. Patients completed neuropsychological tests to assess attention, learning, language, executive function, and motor function. Self-report measures of depression and anxiety were also administered. An overall cognitive function index was computed for participants. Cognitive impairment was defined as a z-score of less than or equal to -1.5 on 2 or more tests, or a z-score of less than or equal to -2.0 on a single test. RESULTS: Approximately 46% of patients exhibited cognitive impairment at the time of assessment, which is significantly greater than would be expected considering healthy population norms (binomial test: P <.0001). Patients exhibited impairments in motor function, verbal learning, and executive function much more frequently relative to normative expectations (binomial test: P <.0001). CONCLUSIONS: The prevalence of cognitive impairment in men with newly diagnosed NSGCT is unexpectedly high before the receipt of adjuvant chemotherapy. Efforts to track cognitive function over time and to develop effective interventions are warranted. Cancer 2011;117:190-6. (C) 2010 American Cancer Society

Towards a neurocognitive approach to Dance Movement Therapy for mental health: A systematic review

Dance/Movement Therapy (DMT) has become an increasingly recognized and used treatment, though primarily used to target psychological and physical wellbeing in individuals with physical, medical, or neurological illnesses. To contribute to the relative lack of literature within the field of DMT for clinical mental health disorders, using a narrative synthesis, we review the scope of recent, controlled studies of DMT in samples with different psychiatric disorders including depression, schizophrenia, autism, and somatoform disorder. A systematic search of electronic databases (PubMed, Science Direct, World of Science, and Clinicaltrials.gov) was conducted to identify studies examining the effects of DMT in psychiatric populations. 15 studies were eligible for inclusion. After reviewing the principal results of the studies, we highlight strengths and weaknesses of this treatment approach and examine the potential efficacy of using bodily movements as a tool to reduce symptoms. We conclude by placing DMT within the context of contemporary cognitive neuroscience research, drawing out implications of such an orientation for future research, and discussing potential mechanisms by which DMT might reduce psychiatric symptoms. DMT has clear potential as a treatment for a range of conditions and symptoms and thus further research on its utility is warranted

Somatization and psychological distress among women with vulvar vestibulitis syndrome

ObjectiveTo investigate the distribution of psychological characteristics and pain reporting among women with vulvar vestibulitis syndrome (VVS).MethodsIn this exploratory study, 109 women with VVS completed a battery of questionnaires to assess pain with intercourse and psychological characteristics (e.g. somatization, anxiety, distress). The distribution of these characteristics was compared, first with a conventional binary classification schema (primary and secondary) and subsequently with a 3â category schema (primary, latent primary, secondary).ResultsSeverity of pain with intercourse did not differ among the subgroups using either classification schema. Women with primary VVS consistently showed higher levels of somatization, anxiety, and distress compared with those with secondary VVS. Using a 3â tiered classification system, we found no difference between latent primary diagnosis and the other 2 groups (primary and secondary).ConclusionThis study highlights the critical need for research on subtype definition and the role of psychological factors in VVS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135448/1/ijgo38.pd

Concord grape Juice, cognitive function and driving performance: a 12 week, placebo controlled, randomised, crossover trial in mothers of pre-teen children

Background: Daily consumption of Concord grape juice (CGJ) over three to four months has been shown to improve memory function in adults with mild cognitive impairment, and reduce blood pressure in hypertensive adults. These benefits are likely due to the high concentration of polyphenols in CGJ. Increased stress can impair cognitive function and elevate blood pressure. Thus we examined the potential beneficial effect of CGJ in individuals experiencing somewhat stressful demanding lifestyles. Objective: To examine the effects of twelve weeks’ daily consumption of CGJ on cognitive function, driving performance, and blood pressure in healthy, middle-aged working mothers. Design: Twenty five healthy mothers of pre-teen children, aged 40-50 years, who were employed for > 30 hours/week consumed 12oz (355ml) CGJ (containing 777mg total polyphenols) or an energy, taste and appearance matched placebo daily for twelve weeks according to a randomised, crossover design with a four week washout. Verbal and spatial memory, executive function, attention, blood pressure and mood were assessed at baseline, six weeks and twelve weeks. Immediately following the cognitive battery, a subsample of seventeen females completed a driving performance assessment in the University of Leeds Driving Simulator. The twenty five minute driving task required participants to match the speed and direction of a lead vehicle. Results: Significant improvements in immediate spatial memory and driving performance were observed following CGJ relative to placebo. There was evidence of an enduring effect of CGJ such that participants who received CGJ in arm 1 maintained better performance in the placebo arm. Conclusions: Cognitive benefits associated with chronic consumption of flavonoid-rich grape juice are not exclusive to adults with mild cognitive impairment. Moreover, these cognitive benefits are apparent in complex everyday tasks such as driving. Effects may persist beyond cessation of flavonoid consumption and future studies should carefully consider the length of washout within crossover designs