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Anguis Carreño M, Marín Yago A, Jurado Bellón J, Baeza-Mirete M, Muñoz-Rubio GM, Rojo Rojo A. An Exploratory Study of ICU Pediatric Nurses' Feelings and Coping Strategies after Experiencing Children Death. Healthcare (Basel) 2023; 11:healthcare11101460. [PMID: 37239746 DOI: 10.3390/healthcare11101460] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND This study aims to explore the feelings and experiences of nursing staff when faced with the death of a pediatric patient in the ICU. METHODOLOGY A qualitative study based on hermeneutic phenomenology was conducted through semi-structured interviews. Ten nurses (30% of staff) from the Pediatric Intensive Care Unit of a referral hospital were interviewed in April 2022. Text transcripts were analysed using latent content analysis. RESULTS Content analysis indicated that the interviewees had feelings of sadness and grief; they had a misconception of empathy. They had no structured coping strategies, and those they practiced were learned through personal experience, not by specific training; they reported coping strategies such as peer support, physical exercise, or strengthening ties with close family members, especially their children. The lack of skills to cope with the death and the absence of support from personnel management departments were acknowledged. This can lead to the presence of compassion fatigue. CONCLUSIONS The feelings that PICU nurses have when a child they care for die are negative feelings and sadness, and they possess coping strategies focused on emotions learned from their own experience and without institutional training support. This situation should not be underestimated as they are a source of compassion fatigue and burnout.
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Affiliation(s)
| | - Ana Marín Yago
- Pediatric Intensive Care Unit, Hospital Universitario Virgen de la Arrixaca, Public Murcian Healthcare System, 30120 Murcia, Spain
| | - Juan Jurado Bellón
- Pediatric Intensive Care Unit, Hospital Universitario Virgen de la Arrixaca, Public Murcian Healthcare System, 30120 Murcia, Spain
| | - Manuel Baeza-Mirete
- Faculty of Nursing, Catholic University of Murcia (UCAM), 30107 Murcia, Spain
| | - Gloria María Muñoz-Rubio
- Intensive Care Unit, Hospital Universitario Virgen de la Arrixaca, Public Murcian Health System, 30120 Murcia, Spain
| | - Andrés Rojo Rojo
- Faculty of Nursing, Catholic University of Murcia (UCAM), 30107 Murcia, Spain
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A systematic review of interventional trials reporting relationships between silent mantram repetition and health in adults. Complement Ther Clin Pract 2023; 50:101709. [PMID: 36444780 DOI: 10.1016/j.ctcp.2022.101709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/07/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
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3
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Riepenhausen A, Wackerhagen C, Reppmann ZC, Deter HC, Kalisch R, Veer IM, Walter H. Positive Cognitive Reappraisal in Stress Resilience, Mental Health, and Well-Being: A Comprehensive Systematic Review. EMOTION REVIEW 2022. [DOI: 10.1177/17540739221114642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Stress-related psychopathology is on the rise, and there is a pressing need for improved prevention strategies. Positive appraisal style, the tendency to appraise potentially threatening situations in a positive way, has been proposed to act as a key resilience mechanism and therefore offers a potential target for preventive approaches. In this article, we review n = 99 studies investigating associations of positive cognitive reappraisal, an important sub-facet of positive appraisal style, with outcome-based resilience and relevant other outcomes, which are considered resilience-related. According to the studies reviewed, positive cognitive reappraisal moderates the relation between stressors and negative outcomes and is positively related to several resilience-related outcomes. It also mediates between other resilience factors and resilience, suggesting it is a proximal resilience factor.
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Affiliation(s)
- Antje Riepenhausen
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carolin Wackerhagen
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Zala C. Reppmann
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hans-Christian Deter
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Medical Clinic, Psychosomatics, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Ilya M. Veer
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Henrik Walter
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
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Mantram Repetition as a Portable Mindfulness Practice: Applications During the COVID-19 Pandemic. Mindfulness (N Y) 2020; 13:1418-1429. [PMID: 33224309 PMCID: PMC7667218 DOI: 10.1007/s12671-020-01545-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
Objective Mantram or holy name repetition has long been practiced in every major religious tradition. Repetition of a mantram as a mindfulness practice is helpful for stress management and resilience building. The objective of this article is to provide an overview of the key features of mantram and the Mantram Repetition Program (MRP) developed in the US Veterans Healthcare System, the evidence base for the MRP, and its applications. Methods MRP practices are portable and do not require an extended or regularized period of sitting, in contrast to most methods of meditation. Core functions of MRP practices include focus shifting, frame activation, and fostering of mindfulness. We review scientific research, including multiple randomized trials, that has investigated the MRP. Results Research on the MRP has documented reductions in posttraumatic stress symptoms, insomnia, hyperarousal, and depression, as well as enhancement of quality of life, self-efficacy, and mindfulness. Mantram repetition may possess comparative advantages for managing symptoms of various mental health conditions, including posttraumatic stress disorder, HIV/AIDS, cancer, and chronic diseases. Conclusions MRP practices can be integrated into daily routines to manage stress and improve coping, safety, efficacy, calmness, and resilience. The inclusion of mantram repetition alongside conventional mindfulness-based practices for stress management will improve their cultural and religious inclusiveness, enabling societies and organizations to build greater collective resilience. Mantram repetition can be readily used in the COVID-19 pandemic, focusing on healthcare workers, patients, and the public.
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Lotfalizadeh M, Miri S, Foroughameri G, Farokhzadian J. The effect of anger management skills training on anger status of the people with HIV. Perspect Psychiatr Care 2020; 56:605-613. [PMID: 31984531 DOI: 10.1111/ppc.12475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study investigated the effect of anger management skills training on the anger status of people with HIV. DESIGN AND METHODS This interventional study was conducted on 60 people with HIV. The intervention group was trained on anger management skills. Data were collected using Spielberger's State-Trait Anger Expression Inventory-II. FINDINGS The intervention group's training on anger management skills showed a significant reduction in mean scores of the state-trait anger, and anger expression as well as a significant increase in mean scores of anger control-out and anger control-in. PRACTICE IMPLICATIONS Expert counselors, psychologists, community health, and psychiatric nurses are recommended to train anger management skills to people with HIV.
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Affiliation(s)
- Mehri Lotfalizadeh
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman, Iran
| | - Sakineh Miri
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Golnaz Foroughameri
- Department of Community Health Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Jamileh Farokhzadian
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Department of Community Health Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Cultivating a conflict-positive workplace: How mindfulness facilitates constructive conflict management. ORGANIZATIONAL BEHAVIOR AND HUMAN DECISION PROCESSES 2020. [DOI: 10.1016/j.obhdp.2020.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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7
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Finkelstein-Fox L, Park CL, Kalichman SC. Health benefits of positive reappraisal coping among people living with HIV/AIDS: A systematic review. Health Psychol Rev 2019; 14:394-426. [PMID: 31284849 DOI: 10.1080/17437199.2019.1641424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
People living with HIV/AIDS (PLWHA) often face significant stress, ranging from perceiving identity changes to encountering barriers to daily health behavior engagement. To manage these experiences, many people use positive reappraisal coping (including benefit finding and perceiving growth). Effective coping is highly important for PLWHA; stress reduction has salutary effects on multiple indicators of health. The present systematic review, conducted in PubMed, PsycINFO, and CINAHL, synthesises findings from 33 studies of PLWHA, addressing effects of positive reappraisal on health-related outcomes for adults living with HIV as a chronic illness. Studies were evaluated based on methodological considerations, measurement of key variables, and implications for specific aspects of health. Results suggest that positive reappraisal is often beneficial when dealing with the implications of a potentially traumatic HIV diagnosis on one's identity, although effects may be contextually bound. Implications of these findings are reviewed, emphasizing the importance of positive reappraisal for enhancing health promotion and self-management of HIV. Although the present review is limited by inclusion of multiple disparate outcomes and exclusion of non-English-language articles, these findings inform a comprehensive model of direct and indirect effects of positive reappraisal on emotional, functional, physiological, and behavioural aspects of health useful for guiding future research.
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Affiliation(s)
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
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8
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Conklin QA, Crosswell AD, Saron CD, Epel ES. Meditation, stress processes, and telomere biology. Curr Opin Psychol 2018; 28:92-101. [PMID: 30553080 DOI: 10.1016/j.copsyc.2018.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/26/2018] [Accepted: 11/12/2018] [Indexed: 12/17/2022]
Abstract
Both theoretical and empirical work support the notion that meditation training can improve telomere regulation, which may ultimately contribute to healthy aging. Yet, the psychological and biological mechanisms underlying these changes remain underspecified, as do the contexts and boundary conditions in which these changes occur. Here we summarize studies investigating the effects of various meditation-based interventions on telomere biology, making suggestions for future research. We then propose a model describing how meditation training may impact acute and habitual stress responses as pathways to improved cell aging.
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Affiliation(s)
| | | | | | - Elissa S Epel
- University of California, San Francisco, United States.
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9
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Saunders DM, Leak J, Carver ME, Smith SA. Application of a faith-based integration tool to assess mental and physical health interventions. JOURNAL OF THE GEORGIA PUBLIC HEALTH ASSOCIATION 2017; 7:26-38. [PMID: 29354795 PMCID: PMC5771442 DOI: 10.21633/jgpha.7.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Methods Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. Results The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Conclusions Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed.
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Affiliation(s)
| | - Jean Leak
- Refreshing Springs Outreach Sykesville, MD
| | | | - Selina A Smith
- Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, GA
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10
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van der Heijden I, Abrahams N, Sinclair D. Psychosocial group interventions to improve psychological well-being in adults living with HIV. Cochrane Database Syst Rev 2017; 3:CD010806. [PMID: 28291302 PMCID: PMC5461871 DOI: 10.1002/14651858.cd010806.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Being diagnosed with human immunodeficiency virus (HIV), and labelled with a chronic, life-threatening, and often stigmatizing disease, can impact on a person's well-being. Psychosocial group interventions aim to improve life-functioning and coping as individuals adjust to the diagnosis. OBJECTIVES To examine the effectiveness of psychosocial group interventions for improving the psychological well-being of adults living with HIV/AIDS. SEARCH METHODS We searched the following electronic databases up to 14 March 2016: the Cochrane Central Register of Controlled Trials (CENTRAL) published in the Cochrane Library (Issue 2, 2016), PubMed (MEDLINE) (1996 to 14 March 2016), Embase (1996 to 14 March 2016), and Clinical Trials.gov. SELECTION CRITERIA Randomized controlled trials (RCTs) or quasi-RCTs that compared psychosocial group interventions with versus control (standard care or brief educational interventions), with at least three months follow-up post-intervention. We included trials that reported measures of depression, anxiety, stress, or coping using standardized scales. DATA COLLECTION AND ANALYSIS Two review authors independently screened abstracts, applied the inclusion criteria, and extracted data. We compared continuous outcomes using mean differences (MD) with 95% confidence intervals (95% CIs), and pooled data using a random-effects model. When the included trials used different measurement scales, we pooled data using standardized mean difference (SMD) values. We reported trials that we could not include in the meta analysis narratively in the text. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 16 trials (19 articles) that enrolled 2520 adults living with HIV. All the interventions were multifaceted and included a mix of psychotherapy, relaxation, group support, and education. The included trials were conducted in the USA (12 trials), Canada (one trial), Switzerland (one trial), Uganda (one trial), and South Africa (one trial), and published between 1996 and 2016. Ten trials recruited men and women, four trials recruited homosexual men, and two trials recruited women only. Interventions were conducted with groups of four to 15 people, for 90 to 135 minutes, every week for up to 12 weeks. All interventions were conducted face-to-face except two, which were delivered by telephone. All were delivered by graduate or postgraduate trained health, psychology, or social care professionals except one that used a lay community health worker and two that used trained mindfulness practitioners.Group-based psychosocial interventions based on cognitive behavioural therapy (CBT) may have a small effect on measures of depression, and this effect may last for up to 15 months after participation in the group sessions (SMD -0.26, 95% CI -0.42 to -0.10; 1139 participants, 10 trials, low certainty evidence). Most trials used the Beck Depression Inventory (BDI), which has a maximum score of 63, and the mean score in the intervention groups was around 1.4 points lower at the end of follow-up. This small benefit was consistent across five trials where participants had a mean depression score in the normal range at baseline, but trials where the mean score was in the depression range at baseline effects were less consistent. Fewer trials reported measures of anxiety, where there may be little or no effect (four trials, 471 participants, low certainty evidence), stress, where there may be little or no effect (five trials, 507 participants, low certainty evidence), and coping (five trials, 697 participants, low certainty evidence).Group-based interventions based on mindfulness have not demonstrated effects on measures of depression (SMD -0.23, 95% CI -0.49 to 0.03; 233 participants, 2 trials, very low certainty evidence), anxiety (SMD -0.16, 95% CI -0.47 to 0.15; 62 participants, 2 trials, very low certainty evidence), or stress (MD -2.02, 95% CI -4.23 to 0.19; 137 participants, 2 trials, very low certainty evidence). No mindfulness based interventions included in the studies had any valid measurements of coping. AUTHORS' CONCLUSIONS Group-based psychosocial interventions may have a small effect on measures of depression, but the clinical importance of this is unclear. More high quality evidence is needed to assess whether group psychosocial intervention improve psychological well-being in HIV positive adults.
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Affiliation(s)
- Ingrid van der Heijden
- Medical Research CouncilGender and Health UnitFrancie van Zijl DriveTygerbergWestern CapeSouth Africa7505
| | - Naeemah Abrahams
- Medical Research CouncilGender and Health UnitFrancie van Zijl DriveTygerbergWestern CapeSouth Africa7505
| | - David Sinclair
- Liverpool School of Tropical MedicineDepartment of Clinical SciencesPembroke PlaceLiverpoolUKL3 5QA
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11
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Abstract
Women and families are the fastest growing segment of the homeless population. Negative attitudes of nurses toward homeless women are a major barrier to homeless women seeking health care. This cross-sectional, mixed-methods pilot study, conducted primarily by nurses, tested the Mantram Repetition Program for the first time with 29 homeless women. The Mantram Repetition Program is a spiritually based skills training that teaches mantram (sacred word) repetition as a cost-effective, personalized, portable, and focused strategy for reducing stress and improving well-being. For the cross-sectional, pretest-posttest design portion of the study, the hypothesis that at least half of the homeless women would repeat their mantram at least once a day was supported with 88% of the women repeating their mantram 1 week later. The qualitative portion of this study using phenomenology explored the women's thoughts on mantram week 2. Themes of mantram repetition, mantram benefits, and being cared for emerged. This groundbreaking, interventional, mixed-methods pilot study fills a gap in interventional homeless research.
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12
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Gonçalves JPB, Lucchetti G, Menezes PR, Vallada H. Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials. Psychol Med 2015; 45:2937-49. [PMID: 26200715 PMCID: PMC4595860 DOI: 10.1017/s0033291715001166] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Despite the extensive literature assessing associations between religiosity/spirituality and health, few studies have investigated the clinical applicability of this evidence. The purpose of this paper was to assess the impact of religious/spiritual interventions (RSI) through randomized clinical trials (RCTs). METHOD A systematic review was performed in the following databases: PubMed, Scopus, Web of Science, PsycINFO, Cochrane Collaboration, Embase and SciELO. Through the use of a Boolean expression, articles were included if they: (i) investigated mental health outcomes; (ii) had a design consistent with RCTs. We excluded protocols involving intercessory prayer or distance healing. The study was conducted in two phases by reading: (1) title and abstracts; (2) full papers and assessing their methodological quality. Then, a meta-analysis was carried out. RESULTS Through this method, 4751 papers were obtained, of which 23 remained included. The meta-analysis showed significant effects of RSI on anxiety general symptoms (p < 0.001) and in subgroups: meditation (p < 0.001); psychotherapy (p = 0.02); 1 month of follow-up (p < 0.001); and comparison groups with interventions (p < 0.001). Two significant differences were found in depressive symptoms: between 1 and 6 months and comparison groups with interventions (p = 0.05). In general, studies have shown that RSI decreased stress, alcoholism and depression. CONCLUSIONS RCTs on RSI showed additional benefits including reduction of clinical symptoms (mainly anxiety). The diversity of protocols and outcomes associated with a lack of standardization of interventions point to the need for further studies evaluating the use of religiosity/spirituality as a complementary treatment in health care.
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Affiliation(s)
- J. P. B. Gonçalves
- Department of Psychiatry,
University of Sao Paulo Medical School, Sao
Paulo, SP, Brazil
| | - G. Lucchetti
- Federal University of Juiz de Fora,
Juiz de Fora, Minas Gerais,
Brazil
| | - P. R. Menezes
- Department of Preventive Medicine,
University of Sao Paulo Medical School, Sao
Paulo, SP, Brazil
| | - H. Vallada
- Department of Psychiatry,
University of Sao Paulo Medical School, Sao
Paulo, SP, Brazil
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Smoski MJ, Keng SL, Ji JL, Moore T, Minkel J, Dichter GS. Neural indicators of emotion regulation via acceptance vs reappraisal in remitted major depressive disorder. Soc Cogn Affect Neurosci 2015; 10:1187-94. [PMID: 25617820 DOI: 10.1093/scan/nsv003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 01/13/2015] [Indexed: 11/13/2022] Open
Abstract
Mood disorders are characterized by impaired emotion regulation abilities, reflected in alterations in frontolimbic brain functioning during regulation. However, little is known about differences in brain function when comparing regulatory strategies. Reappraisal and emotional acceptance are effective in downregulating negative affect, and are components of effective depression psychotherapies. Investigating neural mechanisms of reappraisal vs emotional acceptance in remitted major depressive disorder (rMDD) may yield novel mechanistic insights into depression risk and prevention. Thirty-seven individuals (18 rMDD, 19 controls) were assessed during a functional magnetic resonance imaging task requiring reappraisal, emotional acceptance or no explicit regulation while viewing sad images. Lower negative affect was reported following reappraisal than acceptance, and was lower following acceptance than no explicit regulation. In controls, the acceptance > reappraisal contrast revealed greater activation in left insular cortex and right prefrontal gyrus, and less activation in several other prefrontal regions. Compared with controls, the rMDD group had greater paracingulate and right midfrontal gyrus (BA 8) activation during reappraisal relative to acceptance. Compared with reappraisal, acceptance is associated with activation in regions linked to somatic and emotion awareness, although this activation is associated with less reduction in negative affect. Additionally, a history of MDD moderated these effects.
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Affiliation(s)
- Moria J Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA,
| | - Shian-Ling Keng
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore 117570, Singapore
| | - Jie Lisa Ji
- Duke Institute for Brain Sciences, Duke University, Durham, NC 27708, USA
| | - Tyler Moore
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Jared Minkel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA, and
| | - Gabriel S Dichter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA, and Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
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Mindful Attention Increases and Mediates Psychological Outcomes Following Mantram Repetition Practice in Veterans With Posttraumatic Stress Disorder. Med Care 2014; 52:S13-8. [DOI: 10.1097/mlr.0000000000000200] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hanley AW, Garland EL. Dispositional Mindfulness Co-varies with Self-Reported Positive Reappraisal. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014; 66:146-152. [PMID: 24904191 DOI: 10.1016/j.paid.2014.03.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emerging research suggests that mindfulness is associated with positive reappraisal and that mindfulness practice may be a means of encouraging positive reappraisal capacities. These findings, linking mindfulness with the promotion of cognitive coping strategies, challenge traditional Western conceptualizations of mindfulness as non-discursive. This study explored the relationship between dispositional mindfulness and self-reported positive reappraisal across five distinct samples: a general sample of American adults, contemplative practitioners, college students chronic pain outpatients, and alcohol dependent inpatient. Results indicate that dispositional mindfulness is positively related with self-reported positive reappraisal in all five studies as well as in an aggregated analysis combining all five studies. Furthermore, a second set of analyses statistically controlling for factors previously associated with positive reappraisal (i.e., psychological well-being, positive affect, and positive refocusing), provided evidence that mindfulness is uniquely associated with self-reported positive reappraisal. While more research is needed to refine our understanding of the relationship between mindfulness and positive reappraisal, the present investigation contributes to the growing evidence base supporting the hypothesized link between dispositional mindfulness and self-reported reappraisal by demonstrating a significant association between these constructs across a variety of samples and in the largest combined dataset on this phenomenon collected to date (N=819).
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Kremer H, Ironson G. Longitudinal spiritual coping with trauma in people with HIV: implications for health care. AIDS Patient Care STDS 2014; 28:144-54. [PMID: 24601735 DOI: 10.1089/apc.2013.0280] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
This 10-year study (N=177) examines how people with HIV use spirituality to cope with life's trauma on top of HIV-related stress (e.g., facing death, stigma, poverty, limited healthcare) usual events. Spirituality, defined as a connection to a higher presence, is independent from religion (institutionalized spirituality). As a dynamic adaptive process, coping requires longitudinal studying. Qualitative content-analysis of interviews/essays yielded a coding of specific aspects and a longitudinal rating of overall spiritual coping. Most participants were rated as spiritual, using spiritual practices, about half experienced comfort, empowerment, growth/transformation, gratitude, less than one-third meaning, community, and positive reframing. Up to one-fifth perceived spiritual conflict, struggle, or anger, triggering post-traumatic stress, which sometimes converted into positive growth/transformation later. Over time, 65% used spiritual coping positively, 7% negatively, and 28% had no significant use. Spirituality was mainly beneficial for women, heterosexuals, and African Americans (p<0.05). Results suggest that spirituality is a major source of positive and occasionally negative coping (e.g., viewing HIV as sin). We discuss how clinicians can recognize and prevent when spirituality is creating distress and barriers to HIV treatment, adding a literature review on ways of effective spiritual assessment. Spirituality may be a beneficial component of coping with trauma, considering socio-cultural contexts.
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Affiliation(s)
| | - Gail Ironson
- Department of Psychology, University of Miami, Miami, Florida
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Acute pain relief after Mantram meditation in children with neuroblastoma undergoing anti-GD2 monoclonal antibody therapy. J Pediatr Hematol Oncol 2014; 36:152-5. [PMID: 24065045 DOI: 10.1097/mph.0000000000000024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nonpharmacologic, mind-body interventions are used to reduce anxiety in pediatric patients. Anti-ganglioside GD2 monoclonal antibody (anti-GD2 MoAb 3F8) therapy is the standard of care for high-risk neuroblastoma and pain is its major side effect. We performed a retrospective analysis of children undergoing anti-GD2 MoAb 3F8 treatment who received guided meditation. Meditation involved concentrating on the repetition of rhythmic, melodic sounds purported to slow breathing and induce a relaxation response. A total of 71% patients completed a session at first (n=19) or second attempt (n=5). Patients received fewer analgesic doses to manage anti-GD2 MoAb 3F8-induced pain when participating in meditation (n=17, mean=-0.4 dose, P<0.01). Mantram meditation is a feasible outpatient intervention associated with reduced analgesic requirements.
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Swift AU, Tate RB. Themes from older men's lay definitions of successful aging as indicators of primary and secondary control beliefs over time: The Manitoba Follow-up Study. J Aging Stud 2013; 27:410-8. [DOI: 10.1016/j.jaging.2013.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 09/04/2013] [Accepted: 09/24/2013] [Indexed: 01/10/2023]
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McIntosh RC, Seay JS, Antoni MH, Schneiderman N. Cognitive vulnerability for depression in HIV. J Affect Disord 2013; 150:908-15. [PMID: 23726660 DOI: 10.1016/j.jad.2013.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 05/03/2013] [Indexed: 11/26/2022]
Abstract
UNLABELLED Biased inhibitory processing, frequency and valence of automatic thoughts, and inability to use positive schemas to regulate negative mood are cognitive factors linked to depression. These processes may underlie the established link between adaptive cognitive coping strategies (acceptance and positive reframing) and depression in persons with HIV. How individual differences in HIV-related neurocognitive deficits moderate such effects is unknown. In a secondary analysis, we tested the direct effects of coping on depressed affect as mediated by the frequency and valence of automatic thoughts and how this model was moderated by neurocognitive function in a cohort of HIV+ men and women. METHODS HIV+ adults (mage=39.8, SD=9.5) provided data for the baseline assessment of a randomized trial that investigated the effects of a cognitive-behavioral stress management intervention. Measures included coping, depressive symptoms, positive (PAT) and negative automatic thoughts (NAT), and HIV-dementia. RESULTS After controlling for covariates, cognitive coping was related to depressed mood as mediated via NAT (β=-.92) and PATs (β=.61), (R(2)=.42, F(7, 325)=33.50, p<.0001). The indirect effect of coping on depressive symptoms via NAT and PAT was moderated by neurocognitive function. LIMITATION Cross-sectional design does not allow for the inference of causation among the variables. CONCLUSION Results support a cognitive vulnerability model for depression whereby HIV-related neurocognitive deficits interfere with the ability to use acceptance and positive reframing strategies to increase the frequency of PAT and decrease NAT in adults living with symptoms of depression.
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Affiliation(s)
- Roger C McIntosh
- Department of Health Psychology, University of Miami, United States.
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Kemppainen J, Bormann JE, Shively M, Kelly A, Becker S, Bone P, Belding W, Gifford AL. Living with HIV: responses to a mantram intervention using the critical incident research method. J Altern Complement Med 2012; 18:76-82. [PMID: 22268972 DOI: 10.1089/acm.2009.0489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The objective of this study was to identify and describe ways that a spiritually based intervention of silently repeating a mantram-sacred word or phrase-was used as a coping strategy for managing human immunodeficiency virus (HIV) disease. DESIGN The design was a qualitative research method, the critical incident technique. SETTINGS/LOCATION The study was conducted at an academically affiliated Veterans Affairs Hospital in southern California. SUBJECTS The subjects were outpatient adults living with HIV (n=32) who were receiving care through HIV clinics, community agencies, and HIV providers. INTERVENTIONS Subjects who participated in the intervention arm of a randomized controlled trial that tested the efficacy of a 5-weekly group mantram intervention were interviewed 2 months postintervention. Follow-up telephone interviews were specifically aimed at identifying instances of mantram use, and also participant perceptions of intervention usefulness or nonusefulness. OUTCOME MEASURES The outcome measures comprised categorization and comparison of the types and frequency of incidents reported, describing ways that the intervention was "helpful" or "not helpful" in managing stressors of HIV disease. RESULTS Participants reported a total of 185 incidents. Analysis and classification of the incidents resulted in eight mutually exclusive categories, including Increasing calm and/or peace, Mastering the technique, Changing my viewpoint, Increasing personal awareness, Adjusting behaviors, Managing physical symptoms, Increasing spirituality, and Enhancing relationships. CONCLUSIONS This study shows support for the benefits of the mantram intervention for adults with HIV. Additionally, the spiritually based mantram repetition intervention was found to be more helpful in providing a convenient, portable tool for managing a wide range of situations related to living with HIV disease.
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White W, Grant JS, Pryor ER, Keltner NL, Vance DE, Raper JL. Do Social Support, Stigma, and Social Problem-Solving Skills Predict Depressive Symptoms in People Living With HIV? A Mediation Analysis. Res Theory Nurs Pract 2012; 26:182-204. [DOI: 10.1891/1541-6577.26.3.182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social support, stigma, and social problem solving may be mediators of the relationship between sign and symptom severity and depressive symptoms in people living with HIV (PLWH). However, no published studies have examined these individual variables as mediators in PLWH. This cross-sectional, correlational study of 150 PLWH examined whether social support, stigma, and social problem solving were mediators of the relationship between HIV-related sign and symptom severity and depressive symptoms. Participants completed self-report questionnaires during their visits at two HIV outpatient clinics in the Southeastern United States. Using multiple regression analyses as a part of mediation testing, social support, stigma, and social problem solving were found to be partial mediators of the relationship between sign and symptom severity and depressive symptoms, considered individually and as a set.
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Simms VM, Higginson IJ, Harding R. What palliative care-related problems do patients experience at HIV diagnosis? A systematic review of the evidence. J Pain Symptom Manage 2011; 42:734-53. [PMID: 21620647 DOI: 10.1016/j.jpainsymman.2011.02.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 02/04/2011] [Accepted: 02/06/2011] [Indexed: 11/21/2022]
Abstract
CONTEXT Palliative care is an essential element of HIV care throughout the disease trajectory, but there is a lack of information to guide clinical care at HIV diagnosis. OBJECTIVES This systematic review aimed to identify and appraise the evidence of palliative care-related problems at HIV diagnosis. METHODS The search strategy combined the term "HIV" with seven key words derived from the World Health Organization definition of multidimensional palliative care, in a systematic search of four databases. Abstracts and papers were screened to identify those recording problems within six months of HIV diagnosis in adults. Sample descriptions, aims, methods, and prevalence findings were extracted from these papers into common tables. RESULTS Of 5443 titles retrieved, 65 met the inclusion criteria and 34 were retained. Papers included 27 original studies and seven secondary analyses of patient's records, with great heterogeneity in design, sample definition, and outcome measures. Physical and psychological symptoms were highly prevalent (pain 11%-76%, weight loss 8%-89%, fever 32%-89%, diarrhea 6%-54%, anxiety 36%-95%, and depression 18%-47%). At HIV diagnosis, well-being was impaired, suicidal thoughts were frequent, and peace and calmness were reduced. Participants lacked emotional support and feared the reaction of their families. Practical problems included hunger, homelessness, reduced ability to work, and need for childcare. Studies had methodological failings such as the use of unvalidated tools and lack of clarity reporting results. CONCLUSION People who have recently been diagnosed with HIV have multidimensional palliative care-related problems. HIV care and support services need to assess and manage problems using integrated palliative care, with referral for complex problems. Patient centeredness must be a principle of HIV clinical research.
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Affiliation(s)
- Victoria M Simms
- King's College London, Cicely Saunders Institute, London, United Kingdom.
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Harding R, Liu L, Catalan J, Sherr L. What is the evidence for effectiveness of interventions to enhance coping among people living with HIV disease? A systematic review. PSYCHOL HEALTH MED 2011; 16:564-87. [DOI: 10.1080/13548506.2011.580352] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bormann JE, Liu L, Thorp SR, Lang AJ. Spiritual Wellbeing Mediates PTSD Change in Veterans with Military-Related PTSD. Int J Behav Med 2011; 19:496-502. [DOI: 10.1007/s12529-011-9186-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bormann J, Warren KA, Regalbuto L, Glaser D, Kelly A, Schnack J, Hinton L. A spiritually based caregiver intervention with telephone delivery for family caregivers of veterans with dementia. FAMILY & COMMUNITY HEALTH 2009; 32:345-353. [PMID: 19752637 DOI: 10.1097/fch.0b013e3181b91fd6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Caring for veterans with dementia is burdensome for family caregivers. This exploratory study tested the efficacy of an innovative, spiritually based mantram caregiver intervention delivered using teleconference calls. A prospective, within-subjects, mixed-methods, and 3-time repeated-measures design with 36-week follow-up telephone interviews was conducted. Sixteen caregivers (94% women, 94% Whites with mean age 69.2 years, SD = 10.35 years) completed the intervention. Significant effects for time and linear terms were found for decreasing caregiver burden, perceived stress, depression, and rumination and for increasing quality of life enjoyment and satisfaction, all with large effect sizes. Findings suggest that teleconference delivery of a spiritually based caregiver intervention is feasible.
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Affiliation(s)
- Jill Bormann
- Veterans Affairs San Diego Healthcare System, 3350 LaJolla Village Dr 111N-1, San Diego, CA 92161, USA.
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Epel E, Daubenmier J, Moskowitz JT, Folkman S, Blackburn E. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Ann N Y Acad Sci 2009; 1172:34-53. [PMID: 19735238 PMCID: PMC3057175 DOI: 10.1111/j.1749-6632.2009.04414.x] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Understanding the malleable determinants of cellular aging is critical to understanding human longevity. Telomeres may provide a pathway for exploring this question. Telomeres are the protective caps at the ends of chromosomes. The length of telomeres offers insight into mitotic cell and possibly organismal longevity. Telomere length has now been linked to chronic stress exposure and depression. This raises the question of mechanism: How might cellular aging be modulated by psychological functioning? We consider two psychological processes or states that are in opposition to one another-threat cognition and mindfulness-and their effects on cellular aging. Psychological stress cognitions, particularly appraisals of threat and ruminative thoughts, can lead to prolonged states of reactivity. In contrast, mindfulness meditation techniques appear to shift cognitive appraisals from threat to challenge, decrease ruminative thought, and reduce stress arousal. Mindfulness may also directly increase positive arousal states. We review data linking telomere length to cognitive stress and stress arousal and present new data linking cognitive appraisal to telomere length. Given the pattern of associations revealed so far, we propose that some forms of meditation may have salutary effects on telomere length by reducing cognitive stress and stress arousal and increasing positive states of mind and hormonal factors that may promote telomere maintenance. Aspects of this model are currently being tested in ongoing trials of mindfulness meditation.
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Affiliation(s)
- Elissa Epel
- University of California San Francisco, Department of Psychiatry, San Francisco, California 94143, USA.
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Heralding the New Publisher: Strategic Alliance and Improved Service. Int J Behav Med 2009; 16:1-2. [DOI: 10.1007/s12529-008-9009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2008] [Indexed: 10/21/2022]
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Effects of psychological interventions on neuroendocrine hormone regulation and immune status in HIV-positive persons: a review of randomized controlled trials. Psychosom Med 2008; 70:575-84. [PMID: 18541907 PMCID: PMC2737587 DOI: 10.1097/psy.0b013e31817a5d30] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We reviewed randomized controlled trials (RCTs) that examined the effects of psychological interventions on HIV disease markers including neuroendocrine hormone regulation and immune status. Utilizing both PubMed and PsycINFO, we searched for RCTs published over the past 20 years (1987-2007). Of the 31 RCTs identified, 14 tested effects of psychological interventions on neuroendocrine regulation or immune status. Despite the fact that there are significant methodological limitations of RCTs that have been conducted to date, psychological interventions for HIV-positive persons have been shown to be efficacious in improving psychological adjustment compared with wait-list or treatment as usual control conditions. However, there is little support for differential efficacy of group-based interventions that have been tested to date, even in comparison with semistructured social support groups. Irrespective of the treatment modality, it seems that interventions that are successful in improving psychological adjustment are more likely to have salutary effects on neuroendocrine regulation and immune status. Psychological interventions represent a viable adjuvant treatment that can assist patients with improving psychological adjustment and potentially enhancing immune status. To inform the development of innovative treatments with potentially superior efficacy, deconstruction trials are necessary to examine the effects of distinct components of multimodal psychological interventions compared with nonspecific social support effects. Effectiveness trials of promising psychological interventions with more representative samples of HIV-positive persons are also needed to provide more definitive information on the clinical utility and potential cost-effectiveness of treatments that have been developed to date.
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