Effectiveness of the Relaxation Response-Based Group Intervention for Treating Depressed Chinese American Immigrants: A Pilot Study

Background:: This study examined the feasibility, safety and efficacy of an 8-week Relaxation Response (RR)-based group. Methods:: Twenty-two depressed Chinese American immigrants were recruited. Outcomes measures were response and remission rates, the Hamilton Rating Scale for Depression, Clinical Global Impressions Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, and the Multidimensional Scale of Perceived Social Support Scale. Results: Participants (N = 22) were 82% female, mean age was 53 (±12). After intervention, completers (N = 15) showed a 40% response rate and a 27% remission rate, and statistically significant improvement in most outcome measures. Discussion: The RR-based group is feasible and safe in treating Chinese American immigrants with depression

Temporal dynamics of emotional responding: amygdala recovery predicts emotional traits

An individual’s affective style is influenced by many things, including the manner in which an individual responds to an emotional challenge. Emotional response is composed of a number of factors, two of which are the initial reactivity to an emotional stimulus and the subsequent recovery once the stimulus terminates or ceases to be relevant. However, most neuroimaging studies examining emotional processing in humans focus on the magnitude of initial reactivity to a stimulus rather than the prolonged response. In this study, we use functional magnetic resonance imaging to study the time course of amygdala activity in healthy adults in response to presentation of negative images. We split the amygdala time course into an initial reactivity period and a recovery period beginning after the offset of the stimulus. We find that initial reactivity in the amygdala does not predict trait measures of affective style. Conversely, amygdala recovery shows predictive power such that slower amygdala recovery from negative images predicts greater trait neuroticism, in addition to lower levels of likability of a set of social stimuli (neutral faces). These data underscore the importance of taking into account temporal dynamics when studying affective processing using neuroimaging

Genomic and Clinical Effects Associated with a Relaxation Response Mind-Body Intervention in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease

Introduction: Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) can profoundly affect quality of life and are influenced by stress and resiliency. The impact of mind-body interventions (MBIs) on IBS and IBD patients has not previously been examined. Methods: Nineteen IBS and 29 IBD patients were enrolled in a 9-week relaxation response based mind-body group intervention (RR-MBI), focusing on elicitation of the RR and cognitive skill building. Symptom questionnaires and inflammatory markers were assessed pre- and post-intervention, and at short-term follow-up. Peripheral blood transcriptome analysis was performed to identify genomic correlates of the RR-MBI. Results: Pain Catastrophizing Scale scores improved significantly post-intervention for IBD and at short-term follow-up for IBS and IBD. Trait Anxiety scores, IBS Quality of Life, IBS Symptom Severity Index, and IBD Questionnaire scores improved significantly post-intervention and at short-term follow-up for IBS and IBD, respectively. RR-MBI altered expression of more genes in IBD (1059 genes) than in IBS (119 genes). In IBD, reduced expression of RR-MBI response genes was most significantly linked to inflammatory response, cell growth, proliferation, and oxidative stress-related pathways. In IBS, cell cycle regulation and DNA damage related gene sets were significantly upregulated after RR-MBI. Interactive network analysis of RR-affected pathways identified TNF, AKT and NF-κB as top focus molecules in IBS, while in IBD kinases (e.g. MAPK, P38 MAPK), inflammation (e.g. VEGF-C, NF-κB) and cell cycle and proliferation (e.g. UBC, APP) related genes emerged as top focus molecules. Conclusions: In this uncontrolled pilot study, participation in an RR-MBI was associated with improvements in disease-specific measures, trait anxiety, and pain catastrophizing in IBS and IBD patients. Moreover, observed gene expression changes suggest that NF-κB is a target focus molecule in both IBS and IBD—and that its regulation may contribute to counteracting the harmful effects of stress in both diseases. Larger, controlled studies are needed to confirm this preliminary finding. Trial Registration ClinicalTrials.Gov NCT0213674

Enhancing exposure therapy with acute exercise : an initial test

Exposure-based therapies are one of the most effective strategies for treating a large range of anxiety disorders; yet there remains a substantial (20-50%) non-response rate. Since exposure therapies are based on fear extinction principles, strategies that can enhance the acquisition and retention of fear extinction memories should, theoretically, facilitate the outcome of exposure therapy. Pharmacological agents acting as cognitive enhancers have shown some effectiveness in augmenting exposure therapy. Aerobic exercise may similarly act as a cognitive enhancer as it has been shown to affect learning and memory processes broadly. The current study builds upon the extant literature by conducting an initial test of the efficacy of acute aerobic exercise for enhancing exposure therapy outcomes. Adults with a marked fear of heights were randomized to either 30-minutes of vigorous aerobic exercise or rest immediately prior to 30-minutes of virtual reality exposure therapy (VRET). Participants’ fear of heights was assessed 1- and 2-weeks later by clinician ratings and self-report questionnaires. On average, participants showed significant decreases in fear of heights from baseline to 1- and 2-weeks post-VRET, but these changes did not significantly differ by treatment condition. This remained true even after including potential moderators of treatment condition. These findings do not support acute exercise as an augmentation strategy for exposure therapy. Clinical and research implications are discussed.Psycholog

Exercise for mental health

With its far reaching physical and mental health benefits, exercise has the potential of being a strong transdiagnostic treatment tool in the arsenal of a clinician. This dissertation addresses how exercise may facilitate treatment goals by intervening on key mechanisms underlying the maintenance and amelioration of anxiety and depressed mood. This dissertation details three studies designed to introduce and generate further lines of inquiry related to the specific application of exercise in a clinical setting: 1) What are the mechanisms underlying the mental health benefits of exercise? 2) Can specific mental health benefits of exercise be harnessed to broadly facilitate the process of psychotherapy? And 3) What dose of exercise is required to obtain specific treatment outcomes? Specifically, the first study investigated whether exercise can serve as a method to learn arousal reappraisal techniques, thereby improving an individual’s ability to manage stressful events. The results from the first study provided initial evidence that exercise can facilitate learning arousal reappraisal techniques and this learning may help reduce stress reactivity. The second study examined the efficacy of acute aerobic exercise to augment exposure therapy for acrophobia. The results from the second study provided no evidence that exercise immediately prior to an exposure therapy session facilitates exposure therapy outcomes. The final study examined how attendance relates to the efficacy of an exercise-aided smoking cessation intervention for individuals with high anxiety sensitivity. The results from the third study suggested early treatment discontinuation did not impact the efficacy of an exercise-aided smoking cessation intervention. The studies reported on in this dissertation add to an ever-growing area of research regarding the application of exercise for improving mental health. By continuing to pursue and expand these lines of research, exercise intervention parameters may be optimized to achieve specific mental health benefits. Equipped with such knowledge, exercise can become a widely available, easily accessible treatment method many clinicians could offer their patients. Having accessible a range of strategies that engage therapeutic targets allows clinicians to attend to patient preferences and needs when seeking to ameliorate mental health disorders.Psycholog

Targeting Anxiety Sensitivity With Evidence-Based Psychoeducation: A Randomized Waitlist-Controlled Trial of a Brief Standalone Digital Intervention

Anxiety sensitivity, or the fear of anxiety, represents an important transdiagnostic target in the prevention and treatment of anxiety disorders, which typically emerge between childhood and early adulthood. Recent work demonstrated that single-session digital psychoeducation interventions delivered on computers in a lab setting can effectively reduce anxiety sensitivity. This evidence suggests that digital psychoeducation interventions have potential as a scalable and cost-effective approach to targeting anxiety sensitivity in emerging adults. Toward this aim, we developed the Anxiety Insight Modules (AIM), which promote insights about the function of anxiety, the activating role of thoughts, the harmless nature of sensations that often co-occur with anxiety, and the negative impact of trying to avoid anxiety. To facilitate a more accurate estimate of the potential for scalability, participants tested AIM on their personal devices at their preferred schedule and pace without the involvement of clinicians or staff. Undergraduate students with high levels of anxiety sensitivity (N = 159) were randomized to gain immediate access to AIM (n = 77) or to a waitlist control that gained access to AIM after the 2-week follow-up assessment (n = 82). All of the participants who gained immediate access to AIM, as well as 91.67% of participants in the waitlist who participated in the follow-up, completed the full set of modules, suggesting high levels of engagement. Immediate access to AIM had a medium-to-large effect on anxiety sensitivity in a 2-week follow-up comparison with waitlist control (d = 0.57–0.76). Participants that completed AIM showed acute reductions in anxiety sensitivity. Given this preliminary evidence of its effectiveness, further research is warranted to determine the factors that moderate and mediate AIM's impact on anxiety sensitivity in order to optimize its delivery and facilitate scalability.24 month embargo; available online: 30 April 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Correction: Genomic and Clinical Effects Associated with a Relaxation Response Mind-Body Intervention in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease.

[This corrects the article DOI: 10.1371/journal.pone.0123861.]

Outcome measures after intervention and at 3-week follow-up for irritable bowel syndrome (IBS) (N = 19) and inflammatory bowel disease (IBD) (N = 29).

<p>*P<0.05</p><p>**P<0.01</p><p>***P<0.001</p><p>Indicate mixed model analysis estimating change from baseline scores</p><p>Outcome measures after intervention and at 3-week follow-up for irritable bowel syndrome (IBS) (N = 19) and inflammatory bowel disease (IBD) (N = 29).</p

Network representation of the biological functions significantly altered by 8-weeks of RR-MBI in IBD patients.

<p>Networks shown: A) Cellular morphology and tissue development related genes with UBC, MAPK8, NF-κB and ERK1/2 as primary regulatory nodes; B) Genes involved in cell death, apoptosis and inflammation with UBC, APP and IRF7 as a critical regulatory node. We used the Ingenuity Pathways Analysis tool (IPA 8.0) to generate the networks of genes altered by RR-MBI in <b>IBD</b> patients and merged the major networks with obvious related functions. Each node represents a gene and each edge represent a molecular interaction. The intensity of the node color indicates the degree of upregulation (red) and downregulation (green), while white nodes indicate non-modified genes that may be affected in a non-transcriptional manner.</p