1. Study suggests scent of romantic partner can help lower stress levels

    January 16, 2018 by Ashley

    From the University of British Columbia press release:

    The scent of a romantic partner can help lower stress levels, new psychology research from the University of British Columbia has found.

    The study, published yesterday in the Journal of Personality and Social Psychology, found women feel calmer after being exposed to their male partner’s scent. Conversely, being exposed to a stranger’s scent had the opposite effect and raised levels of the stress hormone, cortisol.

    “Many people wear their partner’s shirt or sleep on their partner’s side of the bed when their partner is away, but may not realize why they engage in these behaviours,” said Marlise Hofer, the study’s lead author and a graduate student in the UBC department of psychology. “Our findings suggest that a partner’s scent alone, even without their physical presence, can be a powerful tool to help reduce stress.”

    For the study, the researchers recruited 96 opposite-sex couples. Men were given a clean T-shirt to wear for 24 hours, and were told to refrain from using deodorant and scented body products, smoking and eating certain foods that could affect their scent. The T-shirts were then frozen to preserve the scent.

    The women were randomly assigned to smell a T-shirt that was either unworn, or had been worn by their partner or a stranger. They were not told which one they had been given. The women underwent a stress test that involved a mock job interview and a mental math task, and also answered questions about their stress levels and provided saliva samples used to measure their cortisol levels.

    The researchers asked women to act as the “smellers” because they tend to have a better sense of smell than men.

    They found that women who had smelled their partner’s shirt felt less stressed both before and after the stress test. Those who both smelled their partner’s shirt and also correctly identified the scent also had lower levels of cortisol, suggesting that the stress-reducing benefits of a partner’s scent are strongest when women know what they’re smelling.

    Meanwhile, women who had smelled a stranger’s scent had higher cortisol levels throughout the stress test.

    The authors speculate that evolutionary factors could influence why the stranger’s scent affected cortisol levels.

    “From a young age, humans fear strangers, especially strange males, so it is possible that a strange male scent triggers the ‘fight or flight’ response that leads to elevated cortisol,” said Hofer. “This could happen without us being fully aware of it.”

    Frances Chen, the study’s senior author and assistant professor in the UBC department of psychology, said the findings could have practical implications to help people cope with stressful situations when they’re away from loved ones.

    “With globalization, people are increasingly traveling for work and moving to new cities,” said Chen. “Our research suggests that something as simple as taking an article of clothing that was worn by your loved one could help lower stress levels when you’re far from home.”


  2. Study finds heightened attention to surprise in veterans with PTSD

    January 5, 2018 by Ashley

    From the Virginia Tech press release:

    Fireworks on nights other than the fourth of July or New Year’s Eve might be nothing more than inconsiderate neighbors, but for veterans with Post Traumatic Stress Disorder (PTSD), the shock of noise and light may trigger a deeply learned expectation of danger.

    Scientists at the Virginia Tech Carilion Research Institute (VTCRI) have found that people with PTSD have an increased learning response to surprising events. While most everyone reacts to surprise, people with PTSD tend to pay even more attention to the unexpected.

    The study was published this week in eLife, an open-access journal published by the Howard Hughes Medical Institute, the Max Planck Society, and the Wellcome Trust.

    “Disproportionate reactions to unexpected stimuli in the environment are a core symptom of PTSD,” said Pearl Chiu, an associate professor at the VTCRI and the lead author on the study. “These results point to a specific disruption in learning that helps to explain why these reactions occur.”

    Chiu and her team used functional MRI to scan the brains of 74 veterans, all of whom had experienced trauma while serving at least one combat tour in Afghanistan or Iraq. Some of the study participants were diagnosed with PTSD, while others were not. In the functional MRI, participants played a gambling game, in which they learned to associate certain choices with monetary gains or losses.

    “Computer science and mathematics have given us new tools to understand how the brain learns. We used these tools to study whether and how learning might play a role in PTSD,” said Chiu, who is also an associate professor of psychology in Virginia Tech’s College of Science. “These results suggest that people with PTSD don’t necessarily have a disrupted response to unexpected outcomes, rather they pay more attention to these surprises,” Chiu said.

    The researchers found that people with PTSD had significantly more activity in the parts of their brains associated with how much attention they paid to surprising events when the learning task threw an unexpected curve ball their way.

    “Fireworks unexpectedly going off after a person has exchanged fire in the field can trigger an over-estimation of danger,” said Brooks King-Casas, an associate professor at the VTCRI who co-led the study. “Particularly for individuals with PTSD, unexpected surprising events — noise or otherwise — could be a matter of life or death. The study shows that while everyone is affected by unexpected events, in PTSD extra attention is given to these surprises.”

    King-Casas is also an associate professor of psychology in Virginia Tech’s College of Science and an associate professor in the Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences.

    Earlier studies have connected greater attention to perceived threats and unexpected events in PTSD, but the mechanistic underpinning of this hypersensitivity to unexpected outcomes have been unclear until now.

    “The work by Brown and colleagues is an important step forward to be able to differentiate the brain and behavioral processes that are affected as a consequence of post-traumatic stress,” said Martin Paulus, a medical doctor and the scientific director and president of the Laureate Institute for Brain Research in Tulsa, Oklahoma. He was not involved in this study. “The finding that individuals with PTSD have difficulty appropriately allocating attention to their environment when it changes has clear implications for the development of novel behavioral interventions.”

    Vanessa Brown, first author on the paper and a graduate student in the department of psychology in Virginia Tech’s College of Science, said that both the behavioral and neural findings show that people with PTSD pay more attention to surprise while learning.

    “This disrupted learning increases with more severe PTSD,” said Brown, who is conducting her dissertation research in Chiu’s laboratory at the VTCRI. “Now that we understand how attention to surprise plays a role in PTSD, we may be able to refine our assessment tools or develop new interventions that target specific learning disruptions in people with PTSD or other psychiatric disorders.”

     


  3. Coloring books make you feel better, but real art therapy much more potent

    December 24, 2017 by Ashley

    From the Drexel University press release:

    A new study shows that while those adult coloring books can reduce stress, they’re still not art therapy.

    Often, the now-ubiquitous adult coloring books will advertise themselves as “art therapy.” But actual art therapists contend that such a claim is misleading, that true art therapy is about growth and relationships and not simply about “feeling better.”

    In light of that, Girija Kaimal, EdD, assistant professor in Drexel University’s College of Nursing and Health Professions led a study that shows that while coloring alone does have some positive effect, it is not nearly as potent as involving an art therapist.

    “The main takeaway is that coloring has some limited benefits like reducing stress and negative mental states,” Kaimal said. “But it does not shift anything else of substance, develop relationships, nor result in any personal development.”

    Kaimal and her Canadian Art Therapy Association Journal study co-authors — Janell Mensinger, PhD, associate research professor in Drexel’s Dornsife School of Public Health, and doctoral students Jessica Drass and Rebekka Dieterich-Hartwell — ran two, separate 40-minute exercises, one consisting of pure coloring and the other involving direct input from an art therapist, to see if one of the other led to significant differences in mood and stress levels.

    The art therapists’ open studio sessions resulted in more empowerment, creativity and improved mood, which are significant for individuals striving to improve their quality of life and make lasting change,” Kaimal said.

    Every participant — of which there were 29, ranging in age from 19 to 67 — took part in each exercise. In the pure coloring exercise, the participants colored in a pattern or design. Although an art therapist was in the room, they did not interact with the person coloring.

    In the other exercise, participants were put in an “open studio” situation, where an art therapist was present and able to facilitate the session, as well as provide guidance and support to process the experience and artwork. The participants were able to make any type of art they wished, whether it involved coloring, sketching, doodling, or working with modeling clay. As the participants worked on their piece, the art therapists created art as well, and were available to assist the participants if they asked for it.

    Each person took standardized surveys before and after their sessions that ranked their stress levels and feelings.

    Perceived stress levels went down by at roughly the same levels for both exercises (10 percent for coloring; 14 percent for open studio). Negative mental states also showed similar decreases in levels (roughly a 7 percent decrease for coloring; 6 percent for open studio).

    But while the coloring exercise didn’t show significant changes for any other effects, the participants displayed an approximate 7 percent increase in self-efficacy, 4 percent increase in creative agency, and a 25 percent increase in positive feelings after their art therapist-aided open studio sessions.

    Many of the outcomes were enabled through the relational support from the art therapist,” Kaimal explained. “The art therapist-facilitated session involves more interpersonal interaction, problem solving around creative choices and expression, empowerment and perhaps more learning about the self and others. That all contributes to the outcomes we saw.”

    So while coloring did help alleviate bad feelings, it didn’t create good feelings in the way that actual art therapy might.

    “Coloring might allow for some reduction in distress or negativity, but since it is a structured task, it might not allow for further creative expression, discovery and exploration which we think is associated with the positive mood improvements we saw in the open studio condition,” Kaimal said.


  4. Study suggests mindful yoga can reduce risky behaviors in troubled youth

    December 18, 2017 by Ashley

    From the University of Cincinnati press release:

    For some young people, dealing with life stressors like exposure to violence and family disruption often means turning to negative, risky behaviors — yet little is known about what can intervene to stop this cycle.

    But one long-term study by the University of Cincinnati looks at the link between stressful life events and an increase in substance abuse, risky sexual behaviors and delinquency in a diverse population of 18- to 24-year-old youths. The research also sheds light on distinct coping strategies that can lead to more positive outcomes.

    As part of a 10-year study looking at risk-taking and decision-making — or the lack thereof — Jacinda Dariotis, UC public health researcher, spent 12 months focusing on early life stressors as a predictor of risky sexual behavior, substance abuse and delinquency for more than 125 at-risk youths. Surprisingly, she found a small number of the youths were already engaging in constructive coping behaviors on their own that will have positive outcomes later in life.

    But what about the majority of troubled youth who cope by engaging in negative, risky and dangerous behaviors?

    Results from the most recent segment of Dariotis’ study were presented at the American Public Health Association conference in Atlanta, under the title,”Stress coping strategies as mediators: Toward a better understanding of sexual, substance and delinquency-related risk-taking among transition-aged youth.”

    The study revealed that in spite of early life stressors, positive coping behaviors, either learned or self-generated, can actually have a protective effect.

    “We found that many of these youths who had endured stressful life events and otherwise would have fallen into the risky behavior trap could actually have positive outcomes later in life because they chose to join in prosocial physical activities, yoga or mindfulness meditation,” says Dariotis.

    Risky outlets

    During the study, Dariotis looked at the disconnect between the youths who had intended to have positive influences in their lives but continually found themselves engaged in behaviors that had negative outcomes. She found a link between stressful life events and increased risky unprotected sex, violence and substance abuse.

    “We took a holistic approach, looking at these issues from a social and biological perspective,” says Dariotis, also director of UC’s College of Education, Criminal Justice and Human Services Evaluation Services Center. “In addition to question-and-answer information, we collected urine samples for drug use confirmation and testosterone levels early in the study to see how hormones played out in negative behaviors.”

    According to Dariotis, testosterone can be influential in dominance and aggressive behaviors, but if directed through prosocial behaviors like sports, yoga or healthy competition it can have very positive outcomes.

    “If you are the star on your sports team you are succeeding,” says Dariotis. “You can also be competitive academically where you succeed by competing with your peers.”

    It’s not that testosterone itself is all bad but it depends on how it is channeled, she adds.

    The right track

    Before joining UC as an associate professor of research, Dariotis spent the last decade at Johns Hopkins University gathering most of the data that includes neuroimaging and weekly questioning for hundreds of youth from all walks of life.

    “I’m particularly interested in teaching at-risk youths to regulate their thoughts, processes and emotions,” says Dariotis. “The neuroimaging allows us to see what’s activated in one’s brain while at rest or performing tasks to help us understand the intersection between hormones, brain structure and activity.”

    Dariotis found that at-risk youth who voluntarily spend their time reading books, playing sports or engaged in avoidance coping behaviors were twice as likely to avoid risky sexual behaviors or substance abuse. An example of avoidance coping behaviors, she says, is not thinking about a bad event that had occurred and instead, thinking about what could be better.

    Dariotis found youths who were unable to develop positive coping strategies were much more likely to turn to greater risk-taking behaviors that included unprotected sex or sex for money, substance abuse, violence and crime.

    Saving time, money and lives

    Participating in weekly mindful yoga intervention programs as part of the current study taught the youths how to take control of their breathing and their emotions and helped them develop healthier long-term coping skills.

    “These findings highlight the importance of implementing positive coping strategies for at-risk youth particularly for reducing illicit drug use and risky sexual behavior,” says Dariotis. “Mindfulness-based yoga programs designed to improve the ability to cope are needed at earlier ages in schools to help vulnerable youths channel their skills more effectively.”

    Given the relative low cost of such programs and easy adaptations to different populations and settings, Dariotis says the return on investment may be substantial especially if they can reduce arrests, repeat offenses and other negative outcomes for risk-taking youth.


  5. Study suggests discrimination harms not just victim but victim’s partner as well

    by Ashley

    From the Michigan State University press release:

    Discrimination not only harms the health and well-being of the victim, but the victim’s romantic partner as well, indicates new research led by a Michigan State University scholar.

    The work, which analyzed a nationally representative sample of nearly 2,000 couples, is the first study to consider how the discrimination experiences of both people in a relationship are associated with their health. The findings are published in the journal Social Psychological and Personality Science.

    “We found that when an individual experiences discrimination, they report worse health and depression. However, that’s not the full story — this stress spills over and affects the health of their partner as well,” said William Chopik, an assistant professor of psychology who conducted the study with current and former MSU students.

    The researchers studied the survey data of 1,949 couples ranging in age from 50 to 94. Survey participants reported on incidents of discrimination, as well as on their health, depression and relationship strain and closeness.

    Chopik said the study found that it didn’t matter where the discrimination came from (e.g., because of race, age, gender or other factors). “What matters is that they felt that they were unfairly treated. That’s what had the biggest impact on the person’s health.”

    And that discrimination had a spillover affect on the person’s spouse or partner. Because people are embedded in relationships, what happens in those relationships affects our health and well-being, Chopik said.

    “We found that a lot of the harmful effects of discrimination on health occurs because it’s so damaging to our relationships,” he said. “When one partner experiences discrimination, they bring that stress home with them and it strains the relationship. So this stress not only negatively affects their own health, but their partner’s as well.”


  6. Study suggests duration of sleep increases and sleeping difficulties decrease after retirement

    December 16, 2017 by Ashley

    From the University of Turku press release:

    When people retire from work life, they sleep approximately 20 minutes longer than before retirement. The quality of sleep also improves, as retired people experience less early morning awakenings or nonrestorative sleep, unlike in their last working years.

    Researchers at the University of Turku, Finland, discovered in collaboration with the Finnish Institution of Occupational Health, University of Helsinki, and University College London Medical School that self-reported duration of sleep increased approximately 20 minutes after retirement, and stayed on the achieved level for years after retirement.

    Duration of sleep increased especially for people who had had sleep difficulties or were heavy alcohol users prior to retirement. The duration of sleep increased the most for people who did not get enough sleep during their employment and they slept 45 minutes longer during their retirement.

    – A sufficient amount of sleep is very important for our health and functioning. Individuals have different needs of sleep, but it is recommended for people over the age of 65 to sleep for 7-8 hours a night. Retiring enables people to sleep longer, as work schedules no longer determine the times for sleeping and waking up, states Doctoral Candidate Saana Myllyntausta from the University of Turku, whose dissertation research is part of the study.

    During their last years of employment, different sleep difficulties were experienced by 30 percent of the people. After retiring, only 26 percent of the people were experiencing sleep difficulties. The researchers discovered that, of different kinds of sleep difficulties, people experienced a decrease especially in early morning awakenings and nonrestorative sleep, where a person experiences tiredness and fatigue after sleeping for a regular duration. Sleep difficulties decreased especially among people who experienced their work as stressful and their health as poor before retirement. Sleep difficulties decreased the most for people who experienced psychological distress before retirement.

    – For example, work-related stress is known to disturb sleep. One reason for the decrease in sleeping difficulties during retirement could be the removal of work-related stress, says Myllyntausta.

    The study followed approximately 5,800 people who participated in the Finnish Public Sector study by the Finnish Institution of Occupational Health and who retired on a statutory basis in 2000-2011. The participants estimated their sleep duration and the prevalence of different kinds of sleep difficulties in surveys before and after retiring. The research was funded by the Academy of Finland, Ministry of Education and Culture, and Juho Vainio Foundation.


  7. Study suggests pregnant women with PTSD have higher levels of stress hormone cortisol

    December 14, 2017 by Ashley

    From the University of Michigan press release:

    Research has shown that a woman’s emotional and physical health during pregnancy impacts a developing fetus. However, less is known about the effect of past stressors and posttraumatic stress disorder on an expectant woman.

    To that end, researchers at the University of Michigan measured the stress hormone cortisol in pregnant women from early pregnancy to when their baby was 6 weeks old. They found that those with a dissociative type of PTSD that’s often related to childhood abuse or trauma had levels up to 10 times higher than their peers.

    These toxic levels of cortisol may contribute to health problems in the next generation, said Julia Seng, professor of nursing and lead author on the study.

    “We know from research on the developmental origins of health and disease that the baby’s first environment in its mother’s body has implications for health across the lifespan,” Seng said. “Higher exposure to cortisol may signal the fetus to adapt in ways that help survival, but don’t help health and longevity. This finding is very useful because it helps us know which women are most likely to exhibit the highest level of stress and stress hormones during pregnancy and postpartum.”

    Cortisol is sometimes called the stress hormone because it’s released in stressful situations as part of the flight-or-fight response. Cortisol levels that stay high are linked to serious health problems such as heart disease and high blood pressure, and can fuel weight gain, depression and anxiety plus a host of other problems. The effect of elevated cortisol on a developing fetus isn’t well understood, but high cortisol and stress also contribute to preterm birth.

    In the study, 395 women expecting their first child were divided into four groups: those without trauma, those with a trauma but no PTSD, those with classic PTSD and those with dissociative PTSD.

    Researchers measured salivary cortisol at different times during the day. Then 111 of those women gave saliva specimens until postpartum. The difference in cortisol was greatest in early pregnancy, when levels were eight times higher in the afternoon and 10 times higher at bedtime for the dissociative group than for other women.

    About 8 percent of pregnant women in the study had PTSD, a disorder that results when symptoms of anxiety and fear persist well after exposure to stressful events. About 14 percent of that group had the more complex dissociative PTSD, which was associated with higher cortisol.

    “It’s been a mystery in our field why cortisol is sometimes high with PTSD and sometimes not,” Seng said. “This finding that in pregnancy it’s only the dissociative subgroup that has high cortisol gives us more to go on for future research.”

    Seng was surprised at how high the cortisol was in the dissociative group. She also said researchers expected women with classic PTSD to experience elevated cortisol as well, and the fact that they didn’t is good news.

    “We can do something for the 1-to-2 out of 100 pregnant women who have this dissociative PTSD,” Seng said. “We can work with them to make pregnancy, maternity care, labor, breastfeeding and early parenting less likely to trigger stress reactions. And we can connect them to mental health services when they are ready to treat their PTSD.”

    Seng and collaborator Mickey Sperlich have developed a PTSD-specific education program for pregnant woman with a childhood trauma called the Survivor Moms’ Companion, which has been piloted in Michigan and is currently being piloted in England.


  8. Study suggests mindfulness meditation can offset the worry of waiting

    December 13, 2017 by Ashley

    From the University of California – Riverside press release:

    Popular music and clichés aren’t the only evidence that the waiting is the hardest part. Research backs it up as well; waiting for potentially bad news can be at least as difficult as receiving the news.

    People try lots of things to mitigate the suffering that comes with waiting for exam scores, hospital test results, or the outcome of a job interview. They try to distract themselves. They try to stay positive. They brace for the worst.

    Past research by UC Riverside “worry and waiting” expert Kate Sweeny has studied the effectiveness of those techniques. None of it works, her research has found. Those tactics not only fail to reduce distress — they can even backfire and make it worse.

    But now, Sweeny’s research finds something that can help: supplementing those ineffective strategies with “mindfulness” meditation. That is, focusing on the present using meditation.

    In the journal Personality and Social Psychology Bulletin, research funded by the National Science Foundation asserts that mindfulness is a sort of antidote to the “curse” of waiting. That curse is a focus on the past or on the future, represented by questions such as “Why did I say that?” and “What if things don’t go my way?”

    “We try to predict our fate and regain a sense of certainty and control over our life,” said Sweeny, who is an associate professor of psychology at UCR. “We know from lots of research that rumination (repetitive thoughts about the past) and worry (repetitive thoughts about the future) are quite unpleasant and even harmful to our health and well-being, so it’s important to seek solutions to this painful form of mental time-travel.”

    Better to focus on the present, Sweeny said, and accept your thoughts and feelings as they arise rather than engage in tactics to avoid them. It means you’ll process your emotions differently and — Sweeny argues — more effectively.

    The study was performed using 150 California law students who had taken the bar exam and were awaiting the exam results. It takes four months after taking the exam before results are posted online. The students completed a series of questionnaires in that four-month waiting period.

    There are few “waiting” scenarios more stressful than the potentially career-killing bar exam. The magnitude of the distress is represented in several sample statements Sweeny and her team collected. Among them:

    I had a nightmare where I couldn’t determine whether I had passed or failed the bar exam and I spent the entire dream trying to find out my results. I have these sort of bar exam nightmares once every couple weeks.

    I got sick, like fever flu sick, and I think it’s because my anxiety levels have slowly been building up to today!! I was constantly thinking and thinking about the results.

    During the four-month waiting period, the students were asked to participate in a 15-minute audio-guided meditation session at least once a week.

    Sweeny found the mindfulness meditation served to postpone the phenomenon of “bracing.” Bracing is essentially preparing for the worst. Previous research by Sweeny and others shows bracing can be an effective technique for managing expectations, but its benefits erode when it occurs too early in the waiting process.

    “Optimism feels good; it just does a poor job of preparing us for the blow of bad news,” Sweeny said. “That’s where bracing comes in. In a perfect world, we’d be optimistic as long as possible to get all the good feelings we can from assuming the best, and then we’d brace for the worst at the moment of truth to make sure we’re prepared for bad news.”

    The benefits of mindfulness meditation have long been asserted, but Sweeny said this is the first research to demonstrate its effectiveness coping with waiting.

    “We know that meditation is a great way to reduce everyday stress, but our study is the first to see if it also makes it easier to wait for personally significant news. This study is also one of the first to identify any strategy that helps people wait better, and it also shows that even brief and infrequent meditation can be helpful,” Sweeny said.

    Best of all, Sweeny said, the mindfulness tactic requires no training, no money, and minimal time and effort.

    “Meditation isn’t for everyone, but our study shows that you don’t have to be a master meditater or go to a silent meditation retreat to benefit from mindfulness,” she said. “Even 15 minutes once a week, which was the average amount of meditation practiced by our participants, was enough to ease the stress of waiting.”


  9. Researchers ‘dismantle’ mindfulness intervention to see how each component works

    by Ashley

    From the Brown University press release:

    As health interventions based on mindfulness have grown in popularity, some of the field’s leading researchers have become concerned that the evidence base for such practices is not yet robust enough. A new study shows how a rigorous approach to studying mindfulness-based interventions can help ensure that claims are backed by science.

    One problem is that mindfulness-based interventions (MBIs) sometimes blend practices, which makes it difficult to measure how each of those practices affects participants. To address that issue, the researchers took a common intervention for mood disorders — mindfulness-based cognitive therapy (MBCT) — and created a controlled study that isolated, or dismantled, its two main ingredients. Those include open monitoring (OM) –– noticing and acknowledging negative feelings without judgment or an emotional secondary reaction to them; and focused attention (FA) — maintaining focus on or shifting it toward a neutral sensation, such as breathing, to disengage from negative emotions or distractions.

    “It has long been hypothesized that focused attention practice improves attentional control while open-monitoring promotes emotional non-reactivity — two aspects of mindfulness thought to contribute its therapeutic effects,” said study lead and corresponding author Willoughby Britton, an assistant professor of psychiatry and human behavior in the Warren Alpert Medical School of Brown University. “However, because these two practices are almost always delivered in combination, it is difficult to assess their purported differential effects. By creating separate, validated, single-ingredient training programs for each practice, the current project provides researchers with a tool to test the individual contributions of each component and mechanism to clinical endpoints.”

    In the study, the researchers randomized more than 100 individuals with mild-to-severe depression, anxiety and stress to take one of three eight-week courses: one set of classes provided a standardized MBCT that incorporated the typical blend of OM and FA. The two other classes each provided an intervention that employed only OM or only FA. In every other respect — time spent in class, time practicing at home, instructor training and skill, participant characteristics, number of handouts — each class was comparable by design.

    At the beginning and end of the classes, the researchers asked the volunteers to answer a variety of standardized questionnaires, including scales that measure their self-reported ability to achieve some of the key skills each practice is assumed to improve. If the researchers saw significant differences between the FA group and the OM group on the skills each was supposed to affect, then there would be evidence that the practices uniquely improve those skills as intervention providers often claim.

    Sure enough, the different practices engaged different skills and mechanisms as predicted. The FA-only group, for example, reported much greater improvement in the ability to willfully shift or focus attention than the OM-only group (but not the MBCT group, which also received FA training). Meanwhile, the OM-only group was significantly more improved than the FA-only group (but not the MBCT group) in the skill of being non-reactive to negative thoughts.

    “If FA practice promotes attentional control, and OM practice promotes emotional non-reactivity, then end users can alter the amount of each practice to fit their individual needs for each skill,” Britton said. “The study created validated single-practice programs that can be used by other researchers or providers for specific populations or conditions. This is the first step to an evidence-based personalized medicine approach to mindfulness.”

    The Science of Behavior Change

    Along with co-author and epidemiology associate professor Eric Loucks, director of Brown University’s Mindfulness Center, Britton is part of the five-university Mindfulness Research Collaborative. The collaborative is one of eight teams in the National Center for Complementary and Integrative Health’s Science of Behavior Change (SOBC) Research Network.

    The new research will appear in print inae February 2018 special issue of the journal Behaviour Research and Therapy titled “An experimental medicine approach to behavior change: The NIH Science Of Behavior Change (SOBC),” which takes a mechanism-focused approach to studying behavioral interventions.

    The Mindfulness Research Collaborative (MRC) consists of 11 mindfulness researchers across five universities, and is one of the eight teams in the SOBC Research Network who are working to advance a mechanism-focused approach to behavioral interventions. The collaborative’s SOBC project “Mindfulness Influences on Self-Regulation: Mental and Physical Health Implications” seeks to identify self-regulation intervention targets that are engaged by MBIs, as well as factors that influence target engagement. The current paper describes the “Dismantling Mindfulness” concurrent clinical trial.

    Britton said the SOBC approach can make mindfulness more effective for people who practice it.

    “Mindfulness research in general could benefit from employing the SOBC experimental medicine approach,” she said. “Little is known about how MBIs work or how they should be modified to maximize effectiveness. The SOBC experimental medicine approach will not only help MBIs become maximally effective, but also provide essential mechanistic information that will help tailor the intervention and instructor training to specific populations and conditions.”


  10. Study suggests surrogate decision makers experience psychological distress

    by Ashley

    From the Regenstrief Institute press release:

    Nearly half of the 13 million older adults hospitalized annually in the United States are unable to make their own medical decisions and rely on surrogates, usually close family members, to make decisions for them. However little is known about how these surrogates respond to the demands put upon them. A new study from the Indiana University Center for Aging Research and the Regenstrief Institute explores predictors and frequency of surrogate decision-maker distress and has found high levels of both anxiety and depression.

    The researchers report that provision of high levels of emotional support to surrogates during their family member’s hospitalization was associated with more effective decisions and lower surrogate anxiety, depression and post-traumatic stress.

    While emotional support (such as, “hospital staff really listened to me when we talked”) was associated with decision quality, surprisingly provision of information (“I [surrogate] received as much detail about my loved one’s care as I needed”) was less important.

    The researchers note that their study provides a detailed look at the relationship between clinician communication and psychological well-being of the family member. While this observational study does not prove causation, it raises the question of whether improved emotional support of surrogates could lead to both better decisions for the patient and better psychological outcomes for the surrogate.

    “Family decision makers face emotional, ethical and communication challenges that differ from personal decision making. It is not enough to provide good information; family members also need emotional support when making difficult decisions,” said corresponding author Alexia Torke, MD, the IU Center for Aging Research associate director, Regenstrief Institute investigator and IU School of Medicine associate professor of medicine, who led the study.

    “As the population ages and more and more family members are thrust into the role of surrogate decision makers, appropriately supporting these family members will become a public health imperative,” she said. Dr. Torke is the associate division chief of general internal medicine and geriatrics at IU School of Medicine and is also affiliated with the IU Health Fairbanks Center for Medical Ethics and Daniel F. Evans Center for Spiritual and Religious Values in Healthcare.

    A total of 364 patient-surrogate pairs from three hospitals were enrolled in the study. The average patient age was 82. Six out of ten patients were female and nearly three out of ten were African-American. Surrogates’ average age was 58 and 71 percent were female. Two thirds of surrogates were the patient’s adult children; 17 percent were the patient’s spouse.

    As many as 15 percent of the surrogate decision makers were found to suffer from clinically high levels of anxiety, depression or post-traumatic stress even six to eight weeks after the family member’s hospitalization. Some of the surrogate distress experienced during the acute illness resolved, but remained high for over 10 percent of surrogates. Surprisingly, anxiety and depression was not significantly higher for those making decisions for ICU patients than for other inpatients.

    “Even though high quality information is associated with overall satisfaction with the hospital stay, information without emotional support may be harmful to surrogates,” said Dr. Torke. “Improved emotional support could lead to both better decisions for the patient and better psychological outcomes for the surrogate. Physicians, nurses, chaplains and social workers can provide emotional support to family members. This study points to the fact that this support is very important.”