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Women with breast cancer experience social disruption during and after treatment. Brief cognitive-behavioral (CBT) and relaxation (RT) interventions may improve social disruption by increasing positive affect. Using the Broaden-and-Build Theory as a framework, this study examined whether short-term CBT- and RT-related increases in positive affect mediate long-term reductions in social disruption in women with breast cancer undergoing treatment (N = 183). This secondary analysis used latent change score and growth models to test 6- and 12-month intervention effects on positive affect and social disruption, respectively; a parallel-process model assessed mediation. RT demonstrated larger reductions in social disruption across 12 months compared to CBT and a health education control. Six-month latent change in positive affect was significant but not driven by condition. There was a significant direct effect linking the latent slopes of positive affect and social disruption but meditation was not observed. These preliminary findings hint at the value of promoting positive affect and inform the development of brief behavioral interventions that aim to augment social functioning among women surviving breast cancer. [ABSTRACT FROM AUTHOR]

Context: Adolescent and young adults (AYAs) with cancer experience significant psychological distress due to cancer treatment that can persist long after treatment. However, little is known regarding optimal interventions to support the psychosocial needs of AYAs with cancer.Objective: The overall objective of this single arm, longitudinal, pilot study was to determine the feasibility of implementing a mindfulness-based music therapy intervention to improve anxiety and stress in AYAs receiving cancer treatment.Methods: AYAs (15 - 39 years old) who were to receive cancer treatment for ≥ eight weeks were recruited from the pediatric, melanoma, sarcoma, breast, lymphoma, and leukemia oncology outpatient centers at Dana-Farber Cancer Institute. The music therapy intervention included four sessions of individual mindfulness-based music therapy in-person or using Zoom over twelve weeks. Prior to-and after the intervention period, participants completed the Patient-Reported Outcomes Measurement Information Anxiety 4a and Perceived Stress Scale. Changes in patient-reported outcomes are compared using Wilcoxon signed-rank tests.Results: Over ∼14 months, 37 of 93 eligible AYAs were enrolled to the study (39.8% consent rate). Overall, 27 of 37 (73%) participants (Median age=32; 56.8% Female) completed at least two music therapy sessions and the baseline measures and end of study measures. Participation in the mindfulness-based music therapy sessions resulted in significant pre-to-posttest improvements in perceived stress (median change: -4.0, P = 0.013) and non-significant changes in anxiety (median change: -1.9, P = 0.20). Satisfaction and acceptability were highly rated.Conclusions: The delivery of a four-session mindfulness-based music therapy intervention to AYAs receiving chemotherapy was feasible and significantly improved perceived stress. These preliminary findings should be confirmed in a randomized controlled trial.Trial Registration: ClinicalTrials.gov Identifier: NCT03709225. [ABSTRACT FROM AUTHOR]

Background: . Cognitive-behavioral therapy and mindfulness-based stress reduction (MBSR) are two prominent evidence-based treatments for social anxiety disorder (SAD). It is not clear, however, whether outcomes of these two treatments are moderated by similar factors. For example, whereas anger suppression and anger expression each predict outcomes in cognitive- behavioral group therapy (CBGT), it is unknown whether they differentially influence outcomes in CBGT versus MBSR.Methods: . One hundred eight participants with SAD were randomized to CBGT, MBSR or Waitlist (WL). WL participants were later randomized to CBGT or MBSR, and their data were combined with data from those originally randomized to CBGT or MBSR. Anger suppression and anger expression were assessed at pre-treatment, and social anxiety was assessed at pre-treatment, post-treatment, and every 3 months throughout a 12-month follow-up period.Results: . From pre- to post-treatment, higher anger suppression was associated with significantly greater reduction in social anxiety in CBGT compared with MBSR. From post-treatment through follow-up, higher anger expression was associated lesser reduction in social anxiety in MBSR but not in CBGT.Limitations: . Data are limited by sole reliance on self-report and it is unclear whether these findings generalize beyond group-based interventions.Conclusions: . Individuals with SAD who are higher in anger suppression and/or expression might be better suited to CBGT than MBSR. [ABSTRACT FROM AUTHOR]

Background: The general aim of the study was to examine the relative effectiveness and mediators of change in standardized mindfulness and compassion interventions.Methods: A sample of 431 participants enrolled in a Mindfulness-Based Stress Reduction program (MBSR = 277) and a Compassion Cultivation Training (CCT = 154). The assessment before and after the program included a set of outcomes and mediators measures. A three-step data analysis plan was followed: ANCOVAs, Reliable Change Index, and mediations (simple and multiple).Results: Both interventions yielded increased mindfulness, decentering, body awareness, and self-compassion. Yet, present-moment awareness improvements (i.e., decentering, and body awareness) were significantly larger in the MBSR than in CCT, whereas socio-emotional changes (i.e., common humanity and empathic concern) were larger in the CCT than in MBSR. The magnitude of effect sizes ranged from medium to large. Furthermore, both mindfulness and compassion interventions yielded similar changes in psychological distress (i.e., stress, anxiety, and depression), maladaptive cognitive processes (i.e., rumination and thought suppression), and well-being. The mediation models showed that although the MBSR program seemingly relies on changes in present-moment awareness mechanisms (i.e., decentering and body awareness) to reduce psychological distress and to improve well-being, the CCT program seemingly achieves the same positive outcomes through changes in socio-emotional mechanisms (i.e., common-humanity and empathy concern).Limitations: Due to our naturalistic design in real-world community setting, it was infeasible to randomly assign participants to conditions.Conclusions: Our results suggest that mindfulness and compassion programs operate through different pathways to reduce psychological distress and to promote well-being. [ABSTRACT FROM AUTHOR]

Much research has demonstrated the beneficial effects of mindfulness-based stress reduction (MBSR) on psychological and physical health, but it is not known whether MBSR may impact cellular aging in healthy populations. Further, little research has evaluated MBSR against an active control condition, which precludes strong conclusions regarding the unique effects of mindfulness on psychological functioning. The present study examined the effects of MBSR versus music therapy-based stress reduction (MTSR) on trait mindfulness, self-compassion, and several psychological health outcomes, as well as leukocyte telomere length (LTL). One hundred and fifty eight Singaporean Chinese adults were recruited and randomly assigned to an eight-week MBSR or MTSR course. Participants provided blood samples and completed a battery of self-report measures pre- and post-intervention. Analyses showed that participants in the MBSR condition demonstrated significantly greater improvements in depressive symptoms, trait mindfulness, and self-compassion compared to the control condition. Treatment condition did not predict changes in LTL, anxiety, stress, or happiness, though there was a trend for duration of home mindfulness practice to predict increases in LTL. Overall, the study demonstrated MBSR's unique effects in reducing depressive symptoms. Improvements in trait mindfulness and self-compassion correspond with theorized mechanisms of change underlying mindfulness training. The lack of intervention effect with regards to LTL suggests that a more intensive intervention may be required for mindfulness to exert noticeable impact on aging at the cellular level, or that the effect may only emerge over a longer term. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the effects of group supportive counseling (SC) on pregnancy-specific stress, general stress, and healthy behavior of pregnant women.Methods: This randomized controlled trial study was conducted on 80 pregnant women in two groups; SC for six sessions, once a week for two hours (n = 40), and antenatal usual care (AUC) (n = 40). All Participants completed questionnaires measuring pregnancy-specific stress, state anxiety, prenatal health behaviors, perceived stress, and provided a saliva sample for measurement of cortisol at pre-intervention and 6-week post-intervention.Results: The post-intervention results indicated that the outcome scores decreased more significantly in group SC than in the AUC for total NuPDQ, for state-anxiety, for PSS-14, and for unhealthy behaviors with a large effect size. Also, healthy behaviors were promoted more significantly in SC group than in AUC. However, salivary cortisol levels did not differ between group SC and AUC groups.Conclusion: Group supportive counselling can promote pregnancy stress and healthy behaviors.Practice Implications: Addition of supportive counseling to prenatal usual care may be suggested for pregnant women with any gestational age who seek methods for improving pregnancy stress and healthy behaviors. [ABSTRACT FROM AUTHOR]

Deaths due to COVID-19 are associated with risk factors which can lead to prolonged grief disorder, post-traumatic stress, and other poor bereavement outcomes among relatives, as well as moral injury and distress in frontline staff. Here we review relevant research evidence and provide evidence-based recommendations and resources for hospital clinicians to mitigate poor bereavement outcomes and support staff. For relatives, bereavement risk factors include dying in an intensive care unit, severe breathlessness, patient isolation or restricted access, significant patient and family emotional distress, and disruption to relatives' social support networks. Recommendations include advance care planning; proactive, sensitive, and regular communication with family members alongside accurate information provision; enabling family members to say goodbye in person where possible; supporting virtual communication; providing excellent symptom management and emotional and spiritual support; and providing and/or sign-posting to bereavement services. To mitigate effects of this emotionally challenging work on staff, we recommend an organizational and systemic approach which includes access to informal and professional support. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to test the efficacy of a Mindfulness-Based Childbirth and Parenting Program (MBCP) in reducing pregnant women's perceived stress and preventing perinatal depression compared to an active control condition.Method: First time pregnant women (n = 197) at risk of perinatal depression were randomized to MBCP or an active control treatment, which consisted of a Lamaze childbirth class. At baseline and post-intervention, participants filled out questionnaires on perceived stress, depressive symptoms, positive states of mind, and five facets of mindfulness.Results: Compared to the active control treatment, MBCP significantly reduced perceived stress (p = 0.038, d = 0.30) and depressive symptoms (p = 0.004, d = 0.42), and increased positive states of mind (p = 0.005, d = 0.41) and self-reported mindfulness (p = 0.039, d = 0.30). Moreover, change in mindfulness possibly mediated the treatment effects of MBCP on stress, depression symptoms, and positive states of mind. The subscales "non-reactivity to inner experience" and "non-judging of experience" seemed to have the strongest mediating effects.Limitations: The outcomes were self-report questionnaires, the participants were not blinded to treatment condition and the condition was confounded by number of sessions.Conclusions: Our results suggest that MBCP is more effective in decreasing perceived stress and risk of perinatal depression compared to a Lamaze childbirth class. The results also contribute to our understanding of the underlying psychological mechanisms through which the reduction of stress and depression symptoms may operate. Thus, this study increases our knowledge about efficient intervention strategies to prevent perinatal depression and promote mental wellbeing among pregnant women. [ABSTRACT FROM AUTHOR]

Objective: Bibliotherapy refers to psychological self-help interventions that utilize treatment books to improve psychological well-being. Research supports bibliotherapy as an efficacious intervention for a variety of mental health problems. Yet, few studies have investigated bibliotherapy in psychosocial oncology. The objective of this randomized controlled trial was to examine the efficacy of the NuCare intervention, delivered as a self-directed workbook, for enhancing empowerment, coping, and quality of life and reducing distress in patients with cancer.Methods: Eighty-nine adult patients with cancer were randomized to receive the workbook for 6 weeks or the control condition, usual care. Participants completed questionnaires at baseline, 6 weeks post-baseline, and 10 weeks post-baseline.Results: The increase of empowerment (main outcome) and quality of life and the decrease of distress in the NuCare group from pre-intervention to follow-up assessment differed significantly from the respective difference scores in the control group.Conclusions: The self-administered NuCare workbook is a potentially cost-effective, minimal intervention addressing psychosocial needs of patients with cancer.Practice Implications: Evidence-based bibliotherapy can empower patients and has the promise of reducing the burden on the healthcare system while enhancing the immediacy of psychosocial support. [ABSTRACT FROM AUTHOR]

Background: Laughter Yoga (LY) is a group-based intervention involving simulated laughter, gentle stretching, rhythmic breathing and meditation. There is some limited evidence that LY reduces depressive symptoms over the short term. However, the quality of previous LY studies is poor and none involved working-aged people with a clinical diagnosis of depression. Therefore, this study aimed to investigate the feasibility and potential efficacy of LY for improving residual mood, anxiety and stress symptoms in adults diagnosed with depression.Methods: Fifty participants were randomised to the group LY intervention (n = 23) consisting of eight sessions over four weeks, or treatment-as-usual (n = 27). Participants completed the Depression Anxiety Stress Scale and the Short Form 12 item Health Survey at baseline (T0), post-intervention (T1) and at 3 months follow-up (T2). LY participants also completed a Client Satisfaction Questionnaire (CSQ8) at T1 and eleven participated in individual qualitative interviews at T2.Results: The LY group had statistically greater decreases in depression and improvements in mental health related quality of life compared to the control group from T0 to T1. The CSQ8 scores indicated a favourable level of satisfaction with the LY intervention. The qualitative interviews highlighted aspects of the intervention that were effective and those requiring modification.Limitations: Limitations include the small sample size and treatment-as-usual control group.Conclusions: A full scale RCT of LY could be feasible if some modifications were made to the protocol/intervention. The intervention may be effective to improve depression and mental health related quality of life immediately post intervention. [ABSTRACT FROM AUTHOR]

Background: Both depression itself and antidepressant medication have been reported to be significantly related to the risk of type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 (GLP-1), a treatment target for T2DM, has a neuroprotective effect. As an enhancer and sensitiser of GLP-1, metformin has been reported to be safe for the neurodevelopment. The present study aimed to determine whether and how GLP-1 mediates antidepressant effects of metformin and exercise in mice.Methods: Male C57BL/6 mice were exposed to chronic unpredictable mild stress (CUMS) for 8 weeks. From the 4th week, CUMS mice were subjected to oral metformin treatment and/or treadmill running. A videocomputerized tracking system was used to record behaviors of mice for a 5-min session. ELISA, western blotting and immunohistochemistry were used to examine serum protein concentrations, protein levels in whole hippocampus, protein distribution and expression in dorsal and ventral hippocampus, respectively.Results: Our results supported the validity of metformin as a useful antidepressant; moreover, treadmill running favored metformin effects on exploratory behaviors and serum corticosterone levels. CUMS reduced GLP-1 protein levels and phosphorylation levels of extracellular signal-regulated kinase 1/2 (ERK1/2), but increased protein levels of B-cell lymphoma 2-associated X-protein (BAX) in mice hippocampus. All these changes were restored by both single and combined treatment with metformin and exercise.Limitations: We did not establish a causal relationship between GLP-1 expression and related signaling, using GLP-1 agonist and antagonist or knockout techniques.Conclusions: Our findings have demonstrated that protein levels of pERK and BAX may be relevant to the role of GLP-1 in antidepressant effects of metformin and exercise, which may provide a novel topic for future clinical research. [ABSTRACT FROM AUTHOR]

Background: Evidence shows high prevalence of depression and anxiety symptoms among university students. This study investigated whether a meditation-based program would help reducing these symptoms in this population.Methods: Non-randomized controlled trial investigating the effects of a six-week focused meditation training on depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) outcomes among university students. Participants were allocated into a meditation or waiting list control group. Assessment occurred pre and post intervention and only for the meditation group at 6 and 12 months follow-up. General linear model for repeated measures evaluated the intervention effect considering group and time factors, controlling for minor psychiatric disorders, gender and absence at meetings.Results: The meditation group presented a reduction in depression and anxiety symptoms after intervention compared to controls. Among the meditation group, depression (at 6 months follow-up) and anxiety (at 6 and 12 months follow-up) scores were lower for those who continued practicing.Limitations: Non-randomization and absence of daily practice record (precluding dose-response gradient evaluation).Conclusion: The meditation training was effective in reducing depression and anxiety symptoms, but the maintanance of these reductions only occurred for those who continued meditating. Permanent meditation programs may be an alternative for promoting mental health for university students. [ABSTRACT FROM AUTHOR]

Extinction learning, which creates new safety associations, is thought to be the mechanism underlying exposure therapy, commonly used for the treatment of anxiety disorders and posttraumatic stress disorder. The relative strength and availability for retrieval of both the fear and safety memories determine the response in a given situation. While the fear memory is often context-independent and may easily generalize, extinction memory is highly context-specific. "Renewal" of the extinguished fear memory might thus occur following a shift in context. The aim of the current work was to create an enhanced and generalized extinction memory to a discrete stimulus using stress exposure before extinction learning, thereby preventing renewal. In our contextual fear conditioning paradigm, 40 healthy men acquired (Day 1), retrieved and extinguished (Day 2) the fear memories, with no differences between the stress and the control group. A significant difference between the groups emerged in the renewal test (Day 3). A renewal effect was seen in the control group (N = 20), confirming the context-dependency of the extinction memory. In contrast, the stress group (N = 20) showed no renewal effect. Fear reduction was generalized to the acquisition context as well, suggesting that stress rendered the extinction memory more context-independent. These results are in line with previous studies that showed contextualization disruption as a result of pre-learning stress, mediated by the rapid effects of glucocorticoids on the hippocampus. Our findings support research investigating the use of glucocorticoids or stress induction in exposure therapy and suggest the right timing of administration in order to optimize their effects. [ABSTRACT FROM AUTHOR]

The high rates of anxiety in college students and the many barriers to accessing evidence-based care in communities and on campuses indicate a clear need to explore ways to increase access to evidence-based treatments. Web-based interventions and preventions are one way to bridge this gap; they hold the potential to decrease mental health disparities and enhance student functioning. The current RCT examined the acceptability and efficacy of a 3-session web-based therapist-assisted acceptance-based behavioral intervention targeting anxiety (Surviving and Thriving During Stress) for college students versus a waitlist (WL) control condition, in a sample of racially and ethnically diverse college students. Overall, participants rated the program as helpful and acceptable. Mixed-effects regression models (MRMs) were run in SPSS to examine the effects of time, condition, and Condition × Time on outcomes and hypothesized mechanisms. Significant Condition × Time interactions for general anxiety, depression, and quality of life (QOL) emerged, suggesting that SATDS participants reported significantly greater changes on these outcomes from pre- to posttreatment versus WL. However, interaction effects were nonsignificant for anxious arousal and social anxiety. MRMs examining hypothesized mechanisms revealed significant Condition × Time interactions for experiential avoidance, decentering, and values-based living. However, interaction effects were nonsignificant for mindfulness. All significant gains were maintained at 1-month follow-up, with the exception of QOL. Results contribute to the growing literature on the acceptability and efficacy of web-based approaches, and suggest these approaches can be effective for diverse college students, and may provide a unique platform to increase access to evidence-based care. [ABSTRACT FROM AUTHOR]

Background: People in reentry from prison or jail (returning citizens) living with HIV and substance use problems often experience numerous stressors and are at high risk for resumed substance use. Interventions are needed to manage stress as a pathway to reduced substance use.Objective: This study explored the effect of a hatha yoga intervention as compared to treatment as usual on stress and substance use among returning citizens living with HIV and substance use problems.Methods: Participants were randomized to either a 12-session, 90-minute weekly yoga intervention or treatment as usual. All participants were clients of a service provider for returning citizens that offered case management, health care, and educational classes. Outcomes included stress as measured by the Perceived Stress Scale at the completion of the yoga intervention (three-months) and substance use as measured by the Timeline Followback at one-month, two-months, and three-months.Results: Seventy-five people were enrolled, two of whom were withdrawn from the study because they did not have HIV. Of the 73 remaining participants, 85% participated in the three-month assessment. At three-months, yoga participants reported less stress than participants in treatment as usual [F (1,59) = 9.24, p < .05]. Yoga participants reported less substance use than participants in treatment as usual at one-month, two-months, and three-months [X2 (1) = 11.13, p < .001].Conclusion: Yoga interventions for returning citizens living with HIV and substance use problems may reduce stress and substance use. This finding is tentative because the control group did not receive an intervention of equal time and intensity. [ABSTRACT FROM AUTHOR]

Highlights • To investigate the mediation effects of perceived stress and the moderation effects of SOC. • A better understanding of the specific interactive mechanisms underlying poor sleep quality and late-life depression. • It is hoped that these findings would offer some clues for prevention of depression in the elderly. Abstract This study aims to investigate a moderated mediation model in the relationship between poor sleep quality, depressive symptoms, perceived stress, sense of coherence. A cross-sectional survey was conducted from May to July 2015 in Liaoning Province, China. 1050 community residents aged ≥60 years were ultimately chosen to participate. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), the Epidemiological Studies Depression Scale(CES-D),the Chinese version Perceived Stress Scale(CPSS), and the Sense of Coherence Scale (SOC) were used to estimate sleep quality, late-life depression, perceived stress, and sense of coherence (SOC) respectively. Pearson's correlations and the PROCESS macro were applied to analyze the data. The results showed that perceived stress partially mediated the association between poor sleep quality and depression symptoms (35% proportion mediated). In addition, the effect of poor sleep quality and the effect of perceived stress on late-life depression was moderated by SOC.The current findings indicates that the impact of poor sleep quality on late-life depression through perceived stress can be buffered when the elderly individuals have a high SOC. Interventions should therefore target individuals who are classified as poor sleepers but only have a lower SOC score. However, longitudinal studies should be conducted in future to substantiate these findings. Importantly, this research provides a useful theoretical and methodological approach for prevention of depression among the elderly in urban China. [ABSTRACT FROM AUTHOR]

Abstract Arts-based programming has increasingly been offered to youth experiencing homelessness in various service settings, often grounded in the belief that this type of programming can promote mental wellness and recovery, social inclusion, and life skills. Despite the ubiquity of such programs, there is limited research on the impacts and value of arts creation for youth who are homeless. Drawing on 23 in-depth interviews with youth experiencing homelessness and staff at a large youth homeless shelter, this study explores the importance, meanings, roles, and effects of art creation and art-based programming in the lives of youth who are homeless. Analysis identified five key ways that youth experiencing homelessness use the arts to cope with adversity and create meaning, including to: manage mental health challenges; cope with stress and homelessness; recover from trauma and create ‘safe spaces’; explore, express, and discover themselves; and develop positive self-esteem and hopefulness for the future. Findings revealed the complex and highly personal ways through which youth strategically use art creation as a self-care and health-promoting practice. These findings demonstrate the importance of developing arts-based interventions that employ a positive youth development approach and support youth's own self-care and meaning-making practices. Implications for practice and policy are discussed, including the need for art programs to build upon the positive arts-based practices youth are already employing in their efforts to improve their health, pursue their goals, and empower themselves. Highlights • Youth experiencing homelessness strategically employ art creation as a self-care and health-promoting practice. • Arts-based programs assist youth in managing homelessness, trauma, and stress. • Art programs should build on youth's self-care and meaning-making practices. [ABSTRACT FROM AUTHOR]

Stress is deeply rooted in the society and women are frequently exposed to psychological, physical and physiological stressors. Psychological stress disturbs reproductive health by inducing generation of reactive oxygen species (ROS) and thereby oxidative stress (OS). The increased OS may affect physiology of ovary, oocyte quality and cause female reproductive health disorders. To overcome stress-mediated reproductive health disorders in women, shatavari ( Asparagus racemosus ) is frequently recommended in Ayurvedic system of medicine. Although shatavari is one of the major health tonics and most popular rasayana drugs to treat reproductive ailments of women, underlying mechanism of shatavari action at the level of ovary remains poorly understood. Based on the existing studies, we propose that shatavari may improve female reproductive health complications including hormonal imbalance, polycystic ovarian syndrome (PCOS), follicular growth and development, oocyte quality and infertility possibly by reducing OS level and increasing antioxidants level in the body. Further studies are required to elucidate the mechanism of shatavari actions at the level of ovary and oocyte that directly impacts the reproductive health of women. [ABSTRACT FROM AUTHOR]

Objective: To investigate the views of a range of hospital based health professionals and health care staff involved in the management of stillbirth.Study Design: A qualitative pilot study informed by grounded theory conducted in three hospital trusts in the North East of England. In total, 21 consultant obstetricians, 3 trainees (including 1 senior trainee), 29 midwives, 3 midwife sonographers and 4 chaplains took part in six focus groups and two semi-structured interviews.Results: Two different approaches in stillbirth management could be detected in our study. One approach emphasised the existing evidence-base and patient directed choice whilst the other emphasised tradition and profession-directed care. These differences were particularly apparent in choices over mode of delivery, and the location of women as well as the time interval between diagnosis of an IUD and delivery. The existence of these two approaches was underscored by a lack of high quality evidence.Conclusion: Robust, high quality evidence is needed regarding the longer term psychological and emotional sequelae of different modes of delivery and varying time intervals and locations of women between diagnosis and delivery in stillbirth. If the competing discourses demonstrated here are found elsewhere then such need to be considered in any future policy development, evidence implementation and training programmes. [ABSTRACT FROM AUTHOR]

Background: Stress-induced failed resilience of brain plasticity can contribute to the onset and recurrence of depression. Chronic stress has been reported to open windows of epigenetic plasticity in hippocampus. However, how hippocampal plasticity underlies depression-like behaviors and how it adapts in response to stress has not been addressed. The present study aimed to investigate the signaling mechanisms of CUMS affecting hippocampal plasticity-related proteins expression and the regulation of swimming exercise in mice.Methods: Male C57BL/6 mice were subjected to chronic unpredictable mild stress (CUMS) for 7 weeks. From the 4th week, CUMS mice were trained in a moderate swimming program for a total of 4 weeks. A videocomputerized tracking system was used to record behaviors of animals for a 5-min session. Real-time PCR and Western Blotting were used to examine gene expression in mouse hippocampus.Results: Our results demonstrated that CUMS induced depression-like behaviors, which were reversed by swimming exercise. Moreover, the behavioral changes induced by CUMS and exercise were correlated with hippocampal plasticity-related proteins expression of growth-associated protein-43 (GAP-43) and synaptophysin (SYN). The molecular mechanisms regulating this plasticity may include SIRT1/mircoRNA, CREB/BDNF, and AKT/GSK-3β signaling pathways.Limitations: We did not establish a correlation between depression-like behaviors induced by chronic stress and epigenetic changes of hippocampal plasticity, either a causal molecular signaling underling this plasticity.Conclusions: Our findings have identified swimming exercise effects on CUMS-induced changes in depression-like behaviors and hippocampal plasticity-related proteins, which provide a framework for developing new strategies to treat stress-induced depression. [ABSTRACT FROM AUTHOR]

Cross-sectional methods were utilized to investigate if greenspace (GS) exposure predicts stress, a known factor affecting health outcomes. Data included publicly accessible Community Statistical Area (CSA) level information and survey (mailed and online) results of residents in Baltimore, Maryland. The convenience sample was recruited in spring 2013 using random (by CSA) and snowball techniques. The survey included demographic information, GS exposure, recent stressful life events, and the validated Perceived Stress Scale (PSS). Individuals reported (hours per week, type) where they see (visual exposure) or spend time in (physical exposure) GS around their home, work and/or school, and during recreation. Duration of GS exposure was defined as hours of visual exposure, hours of physical exposure, and total hours of exposure (both visual and physical). Multivariable linear regression assessed the effect of GS on perceived stress. Respondents (N = 323) reported a mean 25.5 total hours/week exposed to GS. Mean PSS scores were 15.75 for females and 13.45 for males. Controlling for all covariates, there was a statistically significant reduction in PSS score (0.049, p = 0.007) for every hour/week exposed to GS. This means that an individual who spent 25.5 h/week exposed to GS would have a PSS score 3.1% lower than those who were not exposed to GS. Total hours/week exposed to GS, and the individual effects of visual and physical exposure were all statistically significant. These findings indicate the stress reducing effects of GS exposure may be part of complex set of factors behind the relationship between GS and health outcomes. [ABSTRACT FROM AUTHOR]

Background: Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress.Methods: This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5-19 and/or Generalised Anxiety Disorder; GAD-7 score: 5-14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation.Results: 182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N=17, 53%). Twenty-five patients were randomised to the supported (N=18) or unsupported arm (N=7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred.Conclusion: Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible. ClinicalTrials.gov Identifier: NCT02352870. [ABSTRACT FROM AUTHOR]

Adolescents face barriers to mental health services and value confidentiality when seeking help. Kids Help Phone (KHP) is Canada's only free and confidential service for adolescents seeking help over the Internet. 188 participants responded to questionnaires to determine the client characteristics in terms of gender, age, culture, generational status, and socioeconomic status (SES), as well as their risk levels and types of presenting problems. Efficacy of service was also evaluated. Clients' posts were analyzed qualitatively for symptomology indicative of the Youth Self Report (YSR) syndromes, as well as for the level of risk and topics discussed. Level of distress, level of difficulty of the problem, and self-efficacy were evaluated using client self-report scales and found to improve after counselling. A non-significant positive trend was found in clients' self-efficacy after counselling. Distributions of demographic characteristics are presented alongside youths' reasons for choosing the Internet instead of the telephone. Implications for service delivery are discussed. [ABSTRACT FROM AUTHOR]

Theacrine (l,3,7,9-tetramethyluric acid), a purine alkaloid from Camellia assamica var . kucha , has diverse pharmacological properties, including sedative and hypnotic activities, anti-inflammatory and analgesic activities, antidepressant effects, and a protective effect against stress-provoked liver damage. The present study aims to investigate the possible mechanism of the hypnotic activity of theacrine. The results revealed that theacrine significantly enhanced pentobarbital-induced sleep at a dose of 3.0 mg/kg (i.g.) in mice. Sleep parameter analysis by EEG and EMG showed that theacrine obviously shortened wake time and increased NREM sleep time and that theacrine almost had no effect on REM sleep. Meanwhile, theacrine markedly attenuated caffeine (a nonselective antagonist of adenosine receptor)-induced insomnia. In pretreatment with the adenosine A 1 receptor antagonist DPCPX and the A 2A receptor antagonist SCH 58261, theacrine significantly reversed the decrease in sleeping time in pentobarbital-treated mice. In addition, theacrine also markedly increased the adenosine content in the hippocampus of rats. These results suggested that theacrine might mediate the adenosine system to augment pentobarbital-induced sleep. [ABSTRACT FROM AUTHOR]

In modern society stress is a major problem, causing lack of mental and social well-being as well as potential vulnerability to problems at work. Previous studies have found natural environments to be relaxing. In this intervention study, performed in Northern Sweden, the hypothesis was that an outdoor forest environment would be more relaxing than an indoor handicraft environment. Forty-six participants with high stress levels (PSQ ≥ 0.4) (33 women, 13 men, average age 48 years) were randomly assigned to visit either the forest environment (n = 27) or the handicraft environment (n = 19). The participants visited their assigned environment twice a week during three months, either in autumn or spring. During each visit they spent two hours performing, simple and undemanding activities. Psychological health outcomes were measured by the questionnaires CIS, PSQ, SCQ, SMBQ, SF-36 before and after the three months interventions. Sleeping patterns were monitored by an Actiwatch and sleep diary. The participants’ mood before and after each visit were estimated by a questionnaire. The results show that the participants’ health had improved after the interventions in both the forest and handicraft environments. The sleep latency increased slightly among participants in the handicraft environment. For participants in both environments the levels of fatigue, stress and burnout were all lower. They felt less limitation due to physical problems and did not feel so tired. Also their mental health had improved. From start to end of a visit to either environments the participants’ mood was improved, and they felt more relaxed, alert, happy, harmonious, peaceful and clearheaded. Over time during the intervention, they also felt significantly more clearheaded. We conclude that the health of all participants improved, irrespective of the environment visited. [ABSTRACT FROM AUTHOR]

Purpose: Radiation therapy (RT) is associated with high stress levels. The role of music therapy (MT) for patients receiving RT is not well described. This study evaluates the impact of MT on anxiety and distress during simulation in patients with newly diagnosed head and neck or breast cancer.Methods and Materials: This institutional review board-approved randomized trial of MT versus no MT at the time of simulation included the pre-State-Trait Anxiety Inventory (STAI-S Anxiety) questionnaire and Symptom Distress Thermometer (SDT). Patients randomized to MT received a consultation with a music therapist, during which music of the patients' choice to be played during simulation was selected. The no-MT patients did not receive the MT consultation, nor did they hear prerecorded music during simulation. Subsequent to the simulation, all patients repeated the STAI-S Anxiety questionnaire and the SDT.Results: Of the 78 patients enrolled (39 in MT group and 39 in no-MT group), 38 had breast cancer and 40 had head and neck cancer. The male-female ratio was 27:51. The overall mean pre- and post-simulation STAI-S scores were 38.7 (range, 20-60) and 35.2 (range, 20-72), respectively. The overall mean pre- and post-simulation SDT scores were 3.2 (range, 0-10) and 2.5 (range, 0-10), respectively. The MT group had mean pre- and post-simulation STAI-S scores of 39.1 and 31.0, respectively (P<.0001), and the mean SDT scores before and after simulation were 3.2 and 1.7, respectively (P<.0001). The no-MT group's mean pre- and post-simulation STAI-S scores were 38.3 and 39.5, respectively (P=.46), and the mean SDT scores were 3 and 3.2, respectively (P=.51).Conclusions: MT significantly lowered patient anxiety and distress during the simulation procedure on the basis of the STAI-S questionnaire and SDT. Incorporating culturally centered individualized MT may be an effective intervention to reduce stressors. Continued research defining the role of MT intervention in improving the patient experience by reducing anxiety is warranted. [ABSTRACT FROM AUTHOR]

Accumulating evidence strongly suggest that impaired glucocorticoid receptor (GR) signaling is involved in stress-related mood disorders, and nominate GR as a potential target for antidepressants (ADs). It is known that different classes of ADs affects the GR action via modifying its phosphorylation, while the mechanism through which ADs alter GR phosphorylation targeted by GSK3β, a kinase modulated via serotonin neurotransmission, are unclear. On this basis, we investigated whether GSK3β-GR signaling could be a convergence point of fluoxetine action on brain function and behavior, by examining its effect on GSK3β targeted-GR phosphorylation on threonine 171 (pGR171), and expression of GR-regulated genes in the hippocampus of female and male rats exposed to chronic isolation stress. Stress induced sex-specific GSK3β-targeted phosphorylation of pGR171 in the nucleus of the hippocampus of stressed animals. Namely, while in females stress triggered coupled action of GSK3β-pGR171 signaling, in males changes in pGR171 levels did not correspond to GSK3β activity. On the other hand, fluoxetine managed to up-regulate this pathway in sex-unbiased manner. Furthermore, fluoxetine reverted stress-induced changes in most of the analyzed genes in males, CRH, 5-HT1a and p11, while in females its effect was limited to CRH. These data further suggest that pGR171 signaling affects cellular localization of GR in response to chronic stress and fluoxetine in both sexes. Collectively, our results describe a novel convergence point between GR signaling and GSK3β pathway in rat hippocampus in response to stress and fluoxetine in both sexes and its involvement in fluoxetine-regulated brain function in males. [ABSTRACT FROM AUTHOR]

The Adverse Childhood Experiences' (ACEs) research provided groundbreaking evidence that events that occur early in life can impede core life capabilities and lead to significant negative social, behavioral, and physical outcomes. While the research is widely known, the translation and application for use with families has been lacking. In response to this gap, Lemonade for Life was developed to help professionals who work directly with families understand how to use the ACEs research as a tool to build hope and resilience. A developmental evaluation was conducted to learn about how Lemonade for Life participants integrate ACEs in their work with families, as well as whether and how the Lemonade for Life training and materials influenced their work. Focus group and survey data were collected from 24 home visitors and parent educators and parent educators, who participated in a Lemonade for Life training. Findings indicate that Lemonade for Life may be a useful tool for translating ACEs research into practice with families. Participants perceived that following the integration of what they learned through Lemonade for Life into their work, the families they served were more engaged in services and better able to understand their past experiences and current life circumstances. Results suggest a continued need to assess and focus on the hope and mindset of professionals who work directly with families to optimize opportunities for change. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of listening to music on pain, anxiety, or stress during a urodynamic study (UDS).Materials and Methods: A total of 74 female and 74 male patients who underwent UDS between March 2013 and October 2013 were prospectively randomized. The patients were divided into 2 groups according to gender (female, n = 74 vs male, n = 74) and into 2 subgroups according to whether they listened to music or not. Music group subjects played their preferred music during UDS. Before and after UDS, all subjects completed the State-Trait Anxiety Inventory (STAI) form and their degree of pain, anxiety, and satisfaction during examination were assessed by the visual analog scale (VAS, 0-10). Basic vital signs were also checked before and after the procedure.Results: In the analysis of anxiety, pain, and stress scores, the mean shame, discomfort, and satisfaction scores (VAS) were significantly higher in female patients, whereas the mean score of willingness to retry the procedure was higher in male patients whether listening to music or not (P < .001). In the analysis of differences of STAI total, state anxiety, and trait anxiety, there were no statistical significances between the music group and the no-music group in either gender.Conclusion: In our study, music during UDS did not reduce anxiety, pain, and stress in either gender. In the analysis focusing on gender difference, female patients showed statistically higher levels of pain, anxiety, and stress scores than male patients whether listening to music or not. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although humans have developed abundant strategies to down regulate their own negative emotions, at times of distress they frequently turn to significant others to seek comfort. In the present study we use a novel performance-based paradigm to evaluate the effectiveness of this interaction.Methods: Forty-seven couples in a long-term relationship volunteered to participate in the study. In each couple the two partners were randomly assigned as either target or regulator. The target viewed pictures with negative valance. In response to each picture he/she was then instructed to choose and apply a regulatory strategy (i.e., intrapersonal emotion regulation) or to apply a regulatory strategy chosen by his/her partner, the regulator (i.e., interpersonal emotion regulation).Results: We found that the outside perspective of the regulator helped reducing distress more effectively than intrapersonal emotion regulation. Moreover, the cognitive, but not the emotional, empathy of the regulator predicted the added value of interpersonal emotion regulation. Specifically, regulators with a better ability to understand their partners' point of view, selected regulatory strategies that reduced levels of distress more effectively.Limitations: While the present study examined possible effects of depression, anxiety and the ability to identify and describe feelings, a larger sample is needed in order to optimally address their potential moderating effect.Conclusions: The results illuminate the value of non-professional interventions and the importance of cognitive empathy in reducing distress. The study has significant clinical implications, providing a simple behavioral tool that can be used to decrease and prevent psychopathology. [ABSTRACT FROM AUTHOR]

Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate the feasibility and effects of an internet-based information and self-help program with therapist contact for parents of children and adolescents with burns. The program aimed to reduce parents' symptoms of general and posttraumatic stress.Methods: Participants were parents of children treated for burns between 2009-2013 at either of the two specialized Swedish Burn centers. Sixty-two parents were included in a two-armed, randomized controlled trial with a six-week intervention group and a wait-list control group, including a pre and post-assessment, as well as a 3 and 12-month follow-up. The intervention contained psychoeducation, exercises and homework assignments, and the intervention group received weekly written feedback from a therapist. The main outcome was stress (post-traumatic stress, general stress and parental stress).Results: The program had a beneficial effect on posttraumatic stress in the short term, but did not affect general stress or parental stress. The parents rated the program as being informative and meaningful, but some of them thought it was time-consuming.Conclusion: The program has the potential to support parents of children with burns. The intervention is easily accessible, cost-effective and could be implemented in burn care rehabilitation. [ABSTRACT FROM AUTHOR]

Because it induces a state of reduced awareness and deep relaxation, hypnosis is thought to be efficient at relieving stress and anxiety. This study examined whether hypnosis may alter the pattern and time evolution of maternal and fetal stress. Here we report a 23-yrs-old primigravida woman at 31-weeks' gestation who underwent daily sessions of hypnosis during one week. An A (baseline)-B (intervention) - A' (return to baseline) design was used. Each study phase lasted one week. The State Anxiety Inventory (SAI) was completed daily. Uterine contractions as well as maternal and fetal heart rate were recorded over 24-h periods in each of the study phase. Uterine contractions and maternal systolic blood pressure showed clear reductions during the hypnosis phase. In addition, a statistically significant declining trend in anxiety scores was observed during the hypnosis phase, and anxiety re-increased in the return-to-baseline phase (p<0.05). Coefficient of variation of maternal heart rate was found to be considerably lower during the hypnosis phase. Our results suggest that a short-lived hypnosis intervention (combined with standard care) holds sufficient promise for antenatal stress relief to justify testing its efficacy in larger groups of pregnant women. [ABSTRACT FROM AUTHOR]

Major depression is the leading cause of disability worldwide, which is associated with diverse alterations in brain such as neuro-inflammation, synaptic dysfunction, and cognitive deficit. Accumulating evidences suggest sirtuins (SIRTs) are involved in brain developmental disorders, metabolic diseases and play a key role in cognition and synaptic plasticity, yet the role in mood regulation remains controversial. Hence, Western blotting and RT-qPCR were used to investigate whether SIRTs (SIRT1–7) expression levels were altered in the hippocampus of rats, which followed 5 weeks of chronic unpredictable mild stress (CUMS) treatment, the results showed depressive-like behaviors: like body weight, forced swim test and sucrose preference test and SIRT6 was a significant increase in the hippocampal of CUMS rats. Furthermore, via a lentivirus-mediated transfection in hippocampal neurons, we aimed to detect how SIRT6 influence the function of hippocampus. The SIRT6 overexpression significantly inhibited expressions of proteins and/or phosphoproteins (e.g AKT, p-AKT, P-GSK3β), decreased the ratios of p-GSK3β/GSK3β and p-Akt/Akt in the primary hippocampus neurons. Thus, our data indicates that SIRT6 is involved in the modulation of depressive-like behaviors and affects the survival and synaptic plasticity of hippocampal neuron via inhibitory activation of Akt-GSK3β signaling. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effect of mindfulness meditation on occupational functioning in individuals with Generalized anxiety disorder (GAD).Methods: Fifty-seven individuals with GAD (mean (SD) age=39 (13); 56% women) participated in an 8-week clinical trial in which they were randomized to mindfulness-based stress reduction (MBSR) or an attention control class. In this secondary analysis, absenteeism, entire workdays missed, partial workdays missed, and healthcare utilization patterns were assessed before and after treatment.Results: Compared to the attention control class, participation in MBSR was associated with a significantly greater decrease in partial work days missed for adults with GAD (t=2.734, df=51, p=0.009). Interestingly, a dose effect was observed during the 24-week post-treatment follow-up period: among MBSR participants, greater home mindfulness meditation practice was associated with less work loss and with fewer mental health professional visits.Conclusion: Mindfulness meditation training may improve occupational functioning and decrease healthcare utilization in adults with GAD. [ABSTRACT FROM AUTHOR]

We review evidence for training programmes that manipulate autobiographical processing in order to treat mood, anxiety, and stress-related disorders, using the GRADE criteria to judge evidence quality. We also position the current status of this research within the UK Medical Research Council's (2000, 2008) framework for the development of novel interventions. A literature search according to PRISMA guidelines identified 15 studies that compared an autobiographical episodic memory-based training (AET) programme to a control condition, in samples with a clinician-derived diagnosis. Identified AET programmes included Memory Specificity Training (Raes, Williams, & Hermans, 2009), concreteness training (Watkins, Baeyens, & Read, 2009), Competitive Memory Training (Korrelboom, van der Weele, Gjaltema, & Hoogstraten, 2009), imagery-based training of future autobiographical episodes (Blackwell & Holmes, 2010), and life review/reminiscence therapy (Arean et al., 1993). Cohen's d was calculated for between-group differences in symptom change from pre- to post-intervention and to follow-up. We also completed meta-analyses for programmes evaluated across multiple studies, and for the overall effect of AET as a treatment approach. Results demonstrated promising evidence for AET in the treatment of depression ( d = 0.32), however effect sizes varied substantially (from − 0.18 to 1.91) across the different training protocols. Currently, research on AET for the treatment of anxiety and stress-related disorders is not yet at a stage to draw firm conclusions regarding efficacy as there were only a very small number of studies which met inclusion criteria. AET offers a potential avenue through which low-intensity treatment for affective disturbance might be offered. [ABSTRACT FROM AUTHOR]

We studied the interaction between mGlu7 and α 1 -adrenergic receptors in heterologous expression systems, brain slices, and living animals. L-2-Amino-4-phosphonobutanoate (L-AP4), and l -serine- O -phosphate (L-SOP), which activate group III mGlu receptors, restrained the stimulation of polyphosphoinositide (PI) hydrolysis induced by the α 1 -adrenergic receptor agonist, phenylephrine, in HEK 293 cells co-expressing α 1 -adrenergic and mGlu7 receptors. The inibitory action of L-AP4 was abrogated by (i) the mGlu7 receptor antagonist, XAP044; (ii) the C-terminal portion of type-2 G protein coupled receptor kinase; and (iii) the MAP kinase inhibitors, UO126 and PD98059. This suggests that the functional interaction between mGlu7 and α 1 -adrenergic receptors was mediated by the βγ-subunits of the G i protein and required the activation of the MAP kinase pathway. Remarkably, activation of neither mGlu2 nor mGlu4 receptors reduced α 1 -adrenergic receptor-mediated PI hydrolysis. In mouse cortical slices, both L-AP4 and L-SOP were able to attenuate norepinephrine- and phenylephrine-stimulated PI hydrolysis at concentrations consistent with the activation of mGlu7 receptors. L-AP4 failed to affect norepinephrine-stimulated PI hydrolysis in cortical slices from mGlu7 −/− mice, but retained its inhibitory activity in slices from mGlu4 −/− mice. At behavioural level, i.c.v. injection of phenylephrine produced antidepressant-like effects in the forced swim test. The action of phenylephrine was attenuated by L-SOP, which was inactive per se . Finally, both phenylephrine and L-SOP increased corticosterone levels in mice, but the increase was halved when the two drugs were administered in combination. Our data demonstrate that α 1 -adrenergic and mGlu7 receptors functionally interact and suggest that this interaction might be targeted in the treatment of stress-related disorders. [ABSTRACT FROM AUTHOR]

It is well established that stress plays a major role in the pathogenesis of neuropsychiatric diseases. Stress-induced alteration of synaptic plasticity has been hypothesized to underlie the morphological changes observed by neuroimaging in psychiatric patients in key regions such as hippocampus and prefrontal cortex (PFC). We have recently shown that a single acute stress exposure produces significant short-term alterations of structural plasticity within medial PFC. These alterations were partially prevented by previous treatment with chronic desipramine (DMI). In the present study we evaluated the effects of acute Foot-shock (FS)-stress and pre-treatment with the traditional antidepressant DMI on the gene expression of key regulators of synaptic plasticity and structure. Expression of Homer, Shank, Spinophilin, Densin-180 , and the small RhoGTPase related gene Rac1 and downstream target genes, Limk1 , Cofilin1 and Rock1 were investigated 1 day (1 d), 7 d and 14 d after FS-stress exposure. We found that DMI specifically increases the short-term expression of Spinophilin , as well as Homer and Shank family genes, and that both acute stress and DMI exert significant long-term effects on mRNA levels of genes involved in spine plasticity. These findings support the knowledge that acute FS stress and antidepressant treatment induce both rapid and sustained time-dependent alterations in structural components of synaptic plasticity in rodent medial PFC. [ABSTRACT FROM AUTHOR]

Context: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.Objectives: The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.Methods: Three hundred twenty-two Stage 0-III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models of factor analysis and structural equation modeling.Results: Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.Conclusion: Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.Trial Registration: Name and URL of Registry: ClinicalTrials.gov. Registration number: NCT01177124. [ABSTRACT FROM AUTHOR]

Heart rate variability biofeedback (HRV-BF) is frequently used for stress management. Recently, virtual reality technology has gained attention for delivery, promising higher immersion, motivation, and attention than classical screens. However, the effects of different technologies and breathing techniques are not yet understood. In this study, 107 healthy participants completed a session in one of four conditions: HRV-BF on a desktop screen, HRV-BF via head-mounted display (HMD), standardised paced breathing without feedback (sPB) on a screen, or sPB via HMD. All setups significantly reduced perceived stress and increased heart rate variability (HRV). Practising HRV-BF, however, led to significantly greater increases in the low frequency band of HRV and cardiac coherence than sPB, and using an HMD rather than a screen also led to greater increases in cardiac coherence. As for user experience, immersion adaptation and interface quality were higher for HMDs and facilitating conditions were better for screens. While all technique and technology combinations are feasible and effective for stress management, immersing oneself in virtual reality with an HMD for HRV-BF might yield increased benefits in terms of HRV target outcomes and several user experience measures. Future research is necessary to confirm any long-term effects of such a mode of delivery. • Heart rate variability biofeedback in virtual reality reduces psychological stress. • Biofeedback increases low-frequency power more than standardised paced breathing. • Using a head-mounted display increases cardiac coherence more than a desktop screen. • Immersion adaptation is higher for head-mounted displays than for desktop screens. [ABSTRACT FROM AUTHOR]

Objectives: Research has shown the effectiveness of mindfulness-based interventions for a variety of emotional problems in different samples, but it is unknown which factors influence this effectiveness. Therefore, the aim of the current study was: which factors (demographic, personality, and baseline levels of mindfulness skills) moderate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT)?Methods: Outpatients with diabetes (type 1 or type 2; N=139) and an elevated level of emotional distress participated in the Diabetes and Mindfulness (DiaMind) trial. They were randomized into MBCT (N=70) or a control group (N=69) that received treatment as usual and that was offered the intervention 6months later. Primary outcomes were anxiety, depressive symptoms, and perceived stress at post-intervention and at 6-month follow-up.Results: Mixed models analyses showed that sex, extraversion, and baseline acting with awareness were significant moderators of effectiveness. In the MBCT group, women showed larger decreases in anxiety and depression across time (large effects) compared to men (medium to small effects). For extraversion divided into quartiles, the three lowest quartiles generally exhibited large decreases in symptoms, whereas the high extraversion group showed medium (perceived stress) to small (depression) decreases.Conclusion: MBCT seems to be effective to decrease symptoms of anxiety, depression, and perceived stress for a broad range of person characteristics in patients with diabetes. However, men and those high in extraversion showed considerably lower effectiveness compared to the other groups. The small effect in high extraverts may be due to the large dropout in this subgroup. [ABSTRACT FROM AUTHOR]

Background: Preterm birth causes parenting stress and increases the risk of developmental disorders in children. Our objective was to assess the impact of an early psychological intervention, Triadic parent-infant Relationship Therapy (TRT), on parenting stress, parental mental health and preterm infant development in the motor, language, social, behavioral and emotional domains at a corrected age of 18months.Methods: Sixty-five families of preterm infants were randomly assigned to the intervention group (n=33) or the control group (n=32). Families of full-term children (n=24) were also recruited. Intervention focused on the triadic relationship and aimed to improve parenting stress by supporting parental mental health to promote infant development. The main outcome was assessed with the Parenting Stress Index Short Form (PSI-SF).Results: Highly significant differences at 18months were observed for the mother and father in overall PSI-SF scores, with 16.6, and 11.7 points, respectively, in favor of the intervention group. Children in the intervention group demonstrated higher full-scale developmental quotients than the preterm controls (an 8.7-point difference) along with lower scores on behavioral tests (a 5.8-point difference at 18months). At 18months, results for children in the intervention group showed no significant differences compared to the full-term group or were even better.Conclusions: Our study provides sound evidence for the efficiency of the TRT program to reduce parenting stress and improve parental mental health for both parents, thus fostering the infant's overall development. [ABSTRACT FROM AUTHOR]

Introduction Psychological stress has long been a silent killer, impairing normal physiological functions and leading to a variety of diseased conditions. However, the existing animal models for studying psychological stress have been marred by their inherent limitations warranting further research in their development and optimization. Methods In this study 2 5 full factorial design was utilized for the development and optimization of psychological stress model in mice by applying different stressors viz. , slanted cage(X 1 ), restraint(X 2 ), no bedding(X 3 ), dirty bedding(X 4 ) and isolation(X 5 ) at two time duration levels of 30 and 60 min. The development of behavioral changes like depression, anxiety and anhedonia was taken as criteria for development of stress. These responses were analyzed using Design Expert 7.1.6. (Stat-Ease, Inc., USA). The maximum effective responses obtained were taken as a criterion for optimization. The optimized model was applied to measure the change in serum cortisol level to confirm the stress development. Results The statistical data showed that a quadratic model was fitted to the data obtained. All the factors were found to have a significant role in the development of stress among which restraint, slanted cage and dirty bedding were found to be more causal (p < 0.05). Serum cortisol level was increased significantly in the stressed mice of optimized model (p < 0.05). Discussion Utilizing the magnitude of responses from the quadratic equations, it can be concluded that slanted cage, restraint and dirty bedding stressors should be applied for longer duration than other stressors for psychological stress development in mice. The study could lay a strong platform for the use of quality by design approach in the development of robust, efficient and resourceful animal models. [ABSTRACT FROM AUTHOR]

Kineococcus radiotolerans is a Gram-positive, radio-resistant bacterium isolated from a radioactive environment. The small noncoding RNAs (sRNAs) in bacteria are reported to play roles in the immediate response to stress and/or the recovery from stress. The analysis of K. radiotolerans transcriptome sequencing results can identify these sRNAs in a genome-wide detection, using RNA sequencing (RNA-seq) by the deep sequencing technique. In this study, the raw data of radiation-exposed samples (RS) and control samples (CS) were acquired separately from the sequencing platform. There were 217 common sRNA candidates in the two samples screened in the genome-wide scale by bioinformatics analysis. There were 43 differentially expressed sRNA candidates, including 28 up-regulated and 15 down-regulated ones. The down-regulated sRNAs were selected for the sRNA target prediction, of which 12 sRNAs that may modulate the genes related to the transcription regulation and DNA repair were considered as the candidates involved in the radio-resistance regulation system. [ABSTRACT FROM AUTHOR]

Nucleus accumbens (NAc) plays an essential role in morphine sensitization and suppression of pain. Repeated exposure to stress and morphine increases dopamine release in the NAc and may lead to morphine sensitization. This study was carried out in order to investigate the effect of forced swim stress (FSS), as a predominantly physical stressor and morphine on the development of morphine sensitization; focusing on the function of D1 / D2-like dopamine receptors in the NAc in morphine sensitization. Eighty-five adult male Wistar rats were bilaterally implanted with cannulae in the NAc and various doses of SCH-23390 (0.125, 0.25, 1 and 4 μg/0.5 μl/NAc) as a D1 receptor antagonist and sulpiride (0.25, 1 and 4 μg/0.5 μl/NAc) as a D2 receptor antagonist were microinjected into the NAc, during a sensitization period of 3 days, 5 min before the induction of FSS. After 10 min, animals received subcutaneous morphine injection (1 mg/kg). The procedure was followed by 5 days free of antagonist, morphine and stress; thereafter on the 9th day, the nociceptive response was evaluated by tail-flick test. The results revealed that the microinjection of sulpiride (at 1 and 4 μg/0.5 μl/NAc) or SCH-23390 (at 0.25, 1 and 4 μg/0.5 μl/NAc) prior to FSS and morphine disrupts the antinociceptive effects of morphine and morphine sensitization. Our findings suggest that FSS can potentiate the effect of morphine and causes morphine sensitization which induces antinociception. [ABSTRACT FROM AUTHOR]

Our group has recently provided novel insights into a poorly understood component of intercommunication between the brain and the immune system by showing that psychological stress can modify lymphocytes in a manner that may boost resilience to psychological stress. To demonstrate the influence of the adaptive immune system on mood states, we previously showed that cells from lymph nodes of socially defeated mice, but not from unstressed mice, conferred anxiolytic and antidepressant-like effects and elevated hippocampal cell proliferation when transferred into naïve lymphopenic Rag2 −/− mice. In the present study, we asked whether similar transfer could be anxiolytic and antidepressant when done in animals that had been rendered anxious and depressed by chronic psychological stress. First, we demonstrated that lymphopenic Rag2 −/− mice and their wild-type C57BL/6 mouse counterparts had similar levels of affect normally. Second, we found that following chronic (14 days) restraint stress, both groups displayed an anxious and depressive-like phenotype and decreased hippocampal cell proliferation. Third, we showed that behavior in the open field test and light/dark box was normalized in the restraint-stressed Rag2 −/− mice following adoptive transfer of lymph node cells from green fluorescent protein (GFP) expressing donor mice previously exposed to chronic (14 days) of social defeat stress. Cells transferred from unstressed donor mice had no effect on behavior. Immunolabeling of GFP+ cells confirmed that tissue engraftment had occurred at 14 days after transfer. We found GFP+ lymphocytes in the spleen, lymph nodes, blood, choroid plexus, and meninges of the recipient Rag2 −/− mice. The findings suggest that the adaptive immune system may play a key role in promoting recovery from chronic stress. The data support using lymphocytes as a novel therapeutic target for anxiety states. [ABSTRACT FROM AUTHOR]

Background: Compared to the general population, drug users are at increased risk of both poor mental health and HIV infection. The aim of this study was to determine the prevalence and correlates of high psychological distress among drug users in Cambodia.Methods: In April 2014, a two-stage cluster sampling method was used to randomly select 169 drug users from hotspots in Phnom Penh. Psychological distress was measured using General Health Questionnaire (GHQ-12). Bivariate and multivariable analyses were conducted to identify factors associated with levels of psychological distress among this population.Results: Our study found high prevalence of attempted suicide (15.3%), drug related arrests (46.2%), and incarceration (31.4%). Of the 169 participants, 42.0% were found to have high levels of psychological distress, indicating poor mental health. After adjustment, high levels of psychological distress were independently associated with suicidal ideation (p<0.001), higher frequency of drug use (p=0.02), sharing of needles or syringes (p=0.005), and having been sent to a rehabilitation centre (p=0.02). In addition, participants who perceived their overall health as being poor or very poor were more likely to have high levels of psychological distress (p=0.002).Conclusion: Integration of mental health within HIV and needle and syringe exchange programmes is required to address psychological distress among drug users in Cambodia. Health system interventions, such as screening, referral, and training of health providers, need to be strengthened. In addition, interventions addressing social determinants of mental health and mitigation of frequent arrests and improving conditions in rehabilitation centres are required. [ABSTRACT FROM AUTHOR]

Aims: To test the efficacy of a community health worker (CHW) delivered stress management (SM) intervention on psychosocial, glycemic, and cortisol outcomes among U.S. Latinos with type 2 diabetes.Methods: A randomized, controlled trial compared CHW-delivered diabetes education (DE; one group session) to DE plus CHW-delivered SM (DE+SM; 8 group sessions). Psychosocial variables and urinary cortisol were measured at baseline and posttreatment. HbA1c was measured at baseline, posttreatment, and 3-month follow-up.Results: In intent to treat analysis, compared to DE (n=46), DE+SM (n=61) showed significantly improved symptoms of depression, anxiety, and self-reported health status. There were no significant group effects for HbA1c, diabetes distress, or urinary cortisol. However, there was a dose response effect for HbA1c and diabetes distress; increasing attendance at SM sessions was associated with greater improvements in HbA1c and diabetes distress.Conclusions: This is the first randomized, controlled trial demonstrating that CHWs can improve psychological symptoms and self-reported health among Latinos with type 2 diabetes. Efforts to increase intervention attendance may improve HbA1c and diabetes distress. [ABSTRACT FROM AUTHOR]

Background: The present randomized controlled trial aimed to examine whether a newly developed psychoeducational information website on stress and depression was effective in improving depressive symptoms at one- and four-month follow-ups among workers in Japan.Methods: Participants were recruited from registered members of a web survey site in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to intervention or control groups. Immediately after the baseline survey, the intervention group was invited to access a psychoeducational website named the "UTSMed" within 4 months after the baseline survey. Depressive symptoms (Beck Depression Inventory II; BDI-II) were assessed as a primary outcome, at baseline, and one- and four-month follow-ups for both intervention and control groups. The analyses were conducted separately by the three subgroups (high-risk, moderate-risk, and low-risk).Results: A total of 1236 workers completed the baseline survey. Participants were randomly allocated to an intervention or control group (N=618 for each), with the subgroups of high-risk (7-8%), moderate-risk (47%) and low-risk (45-46%) in each group. A significant intervention effect on improving depressive symptoms (t=-2.35, P =0.02, d=-0.57) was observed at 1-month follow-up only in the high-risk subgroup.Limitations: The present study did not use a stratified permuted-block randomization.Conclusions: A web-based psychoeducation approach may not be effective enough in improving depressive symptoms in a general population of workers, while it may be effective for workers who had recently sought help for mental health. [ABSTRACT FROM AUTHOR]