Publications by authors named "Susan Gaylord"

50 Publications

Enhancing stress reactivity and wellbeing in early schizophrenia: A randomized controlled trial of Integrated Coping Awareness Therapy (I-CAT).

Schizophr Res 2021 Jul 28;235:91-101. Epub 2021 Jul 28.

Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America; School of Behavioural and Health Sciences, Australian Catholic University, Australia.

Individuals with schizophrenia spectrum disorders (SSD) are at heightened risk for exposure to stressful life events which can lead to increased sensitivity to stress and a dysregulated stress response, which are in turn associated with poor long-term functioning. Stress reactivity is thus a promising treatment target in the early stages of SSD. Integrated-Coping Awareness Therapy (I-CAT) is a manualized intervention integrating mindfulness and positive psychology to target a dysregulated stress response in SSD. The current study is a preliminary randomized-controlled trial (RCT) comparing I-CAT (n = 18) with treatment as usual (TAU; n = 18) in individuals in the early stages of SSD. I-CAT was hypothesized to be more effective than TAU on primary outcomes: increasing positive emotions, decreasing negative emotions, reducing stress, and improving functioning and quality of life; and secondary outcomes: reducing symptoms, increasing mindfulness, and improving overall well-being. Excellent therapy attendance rates, low study attrition, and positive participant feedback demonstrated that I-CAT was a feasible and well-tolerated psychosocial intervention. Results suggest I-CAT led to greater reduction in symptoms (i.e., overall, negative, and disorganized symptoms), increased observational mindfulness, increased endorsement of a sense of purpose in life, and preservation of work abilities and school social functioning compared with TAU. Future work should replicate and extend these findings in a larger-scale RCT.
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http://dx.doi.org/10.1016/j.schres.2021.07.022DOI Listing
July 2021

Methodology for altering omega-3 EPA+DHA and omega-6 linoleic acid as controlled variables in a dietary trial.

Clin Nutr 2021 Jun 12;40(6):3859-3867. Epub 2021 May 12.

Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background & Aims: Increasing dietary intake of n-3 EPA+DHA and lowering dietary n-6 LA is under investigation as a therapeutic diet for improving chronic pain syndromes as well as other health outcomes. Herein we describe the diet methodology used to modulate intake of n-3 and n-6 PUFA in a free living migraine headache population and report on nutrient intake, BMI and diet acceptability achieved at week 16 of the intensive diet intervention and week 22 follow-up time-point.

Methods: A total of 178 participants were randomized and began one of three diet interventions: 1) a high n-3 PUFA, average n-6 PUFA (H3) diet targeting 1500 mg EPA+DHA/day and 7% of energy (en%) from n-6 linoleic acid (LA), 2) a high-n-3 PUFA, low-n-6 PUFA (H3L6) targeting 1500 mg EPA+DHA/day and <1.8 en% n-6 LA or 3) a Control diet with typical American intakes of both EPA+DHA (<150 mg/day) and 7 en% from n-6 LA. Methods used to achieve diet change to week 16 include diet education, diet counseling, supply of specially prepared foods, self-monitoring and access to online diet materials. Only study oils and website materials were provided for the follow-up week 16 to week 22 periods. Diet adherence was assessed by multiple 24 h recalls administered throughout the trial. Diet acceptability was assessed in a subset of participants at 4 time points by questionnaire.

Results: At week 16 H3 and H3L6 diet groups significantly increased median n-3 EPA+DHA intake from 48 mg/2000 kcals at baseline to 1484 mg/2000 kcals (p < 0.0001) and from 44 mg/2000 kcals to 1341 mg/2000 kcals (p < 0.0001), respectively. In the Control group, EPA+DHA intake remained below the typical American intake with baseline median at 60 mg/2000 kcals and 80 mg/2000 kcals (p = 0.6) at week 16. As desired, LA intake was maintained in the H3 and Control group with baseline median of 6.5 en% to 7.1 en% (p = 0.4) at week 16 and from 6.5 en% to 6.8 en% (p = 1.0) at week 16, respectively. In the H3L6 group, n-6 LA decreased from 6.3 en% at baseline to 3.2 en% (p < 0.0001) at week 16. There were no significant changes in BMI or diet acceptability throughout the trial or between diet groups.

Conclusions: We find this diet method to be acceptable to research participants and successful in altering dietary n-3 EPA+DHA with and without concurrent decreases in n-6 LA. If n-6 LA of less than 3 en% is desired, additional techniques to limit LA may need to be employed.
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http://dx.doi.org/10.1016/j.clnu.2021.04.050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293619PMC
June 2021

Feasibility of Implementation Mapping for Integrative Medical Group Visits.

J Altern Complement Med 2021 Mar;27(S1):S71-S80

School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Implementation science is key to translating complementary and integrative health intervention research into practice as it can increase accessibility and affordability while maximizing patient health outcomes. The authors describe using implementation mapping to (1) identify barriers and facilitators impacting the implementation of an Integrative Medical Group Visit (IMGV) intervention in an outpatient setting with a high burden of patients with chronic pain and (2) select and develop implementation strategies utilizing theory and stakeholder input to address those barriers and facilitators. The authors selected a packaged, evidence-based, integrative pain management intervention, the IMGV, to implement in an outpatient clinic with a high burden of patients with chronic pain. The authors used implementation mapping to identify implementation strategies for IMGV, considering theory and stakeholder input. Stakeholder interviews with clinic staff, faculty, and administrators ( = 15) were guided by the Consolidated Framework for Implementation Research. Based on interview data, the authors identified administrators, physicians, nursing staff, and scheduling staff as key stakeholders involved in implementation. Barriers and facilitators focused on knowledge, buy-in, and operational procedures needed to successfully implement IMGV. The implementation team identified three cognitive influences on behavior that would impact performance: knowledge, outcome expectations, and self-efficacy; and three theoretical change methods: cue to participate, communication, and mobilization. Implementation strategies identified included identifying and preparing champions, participation in ongoing training, developing and distributing educational materials, and organizing clinician implementation team meetings. This study provides an example of the application of implementation mapping to identify theory-driven implementation strategies for IMGV. Implementation mapping is a feasible method that may be useful in providing a guiding structure for implementation teams as they employ implementation frameworks and select implementation strategies for integrative health interventions.
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http://dx.doi.org/10.1089/acm.2020.0393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035918PMC
March 2021

Effects of Mindfulness-Based Stress Reduction on Experimental Pain Sensitivity and Cortisol Responses in Women With Early Life Abuse: A Randomized Controlled Trial.

Psychosom Med 2021 Jul-Aug 01;83(6):515-527

From the Department of Psychiatry (Andersen, Geiger, Schiller, Bluth, Xia, Tauseef, Leserman, Girdler), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychiatry and Behavioral Sciences (Watkins), Duke University, Durham; and Departments of Biostatistics (Zhang) and Physical Medicine and Rehabilitation (Gaylord), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Objective: Early life abuse (ELAb) initiates pathophysiological cascades resulting in long-term maladaptive stress responsivity, hyperalgesia, and an increased risk of psychopathology. Mindfulness-based stress reduction (MBSR) is effective in modifying psychological and somatic symptoms; thus, we predicted that MBSR would be particularly efficacious for women with ELAb.

Method: Medically healthy women (mean age = 31 years) with or without a history of early (≤13 years) physical or sexual abuse provided self-report measures and were tested in the laboratory before and after randomization to standard MBSR (n = 52) or social support (SSG) (n = 60) for 8 weeks. The laboratory procedure involved pain testing using the cold pressor and temporal summation of heat pain (indexing central sensitization) procedures, and exposure to the Trier Social Stress Test. Plasma cortisol in response to the experimental protocol was assessed as area under the curve (AUC).

Results: The interventions differentially impacted pain sensitivity and cortisol AUC for women with ELAb, as MBSR increased the temporal summation of heat pain intensity ratings (p = .024) and reduced cortisol AUC (p = .004). For women without ELAb, MBSR decreased cold pressor tolerance (p = .045) and decreased the temporal summation of heat pain intensity ratings relative to SSG (p = .024). Both MBSR and SSG improved depression symptoms and emotion regulation abilities (p values < .001); however, MBSR was associated with greater benefits in describing emotions (p = .008) and impulse control (p = .017) for women with ELAb.

Conclusions: Women with ELAb benefited from MBSR-specific improvements in central sensitization, mindfulness skills, and emotion regulation abilities. This is the first study to examine the efficacy of MBSR in modifying affective and somatic symptoms based on ELAb status and provides evidence for considering ELAb in tailoring treatment approaches.Trial Registration: ClinicalTrials.gov Identifier: NCT01995916; https://clinicaltrials.gov/ct2/show/NCT01995916.
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http://dx.doi.org/10.1097/PSY.0000000000000889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164640PMC
January 2022

Feasibility and Acceptability of an Abbreviated, Four-Week Mindfulness Program for Chronic Pain Management.

Pain Med 2020 11;21(11):2799-2810

Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.

Objective: The Mindfulness-Based Stress Reduction program is effective at improving chronic pain outcomes, but the time demand hinders participation. This preliminary study evaluated the feasibility, acceptability, and potential effects of providing an abbreviated mindfulness program for patients with chronic pain.

Design: A single-arm, mixed-methods, pre-post intervention study.

Setting: An outpatient rehabilitation clinic at an academic medical center.

Subjects: Participants were N = 23 adults with chronic pain who were new to mindfulness practice.

Methods: Mindfulness-based Stress Reduction was adapted to shorten the program to four weekly 90-minute sessions and to focus content on pain management. Three cohorts of six to nine participants completed baseline and post-treatment measures of 1) patient-reported outcomes, including pain intensity, pain interference, physical functioning, depressive/anxiety symptoms, positive affect and well-being, and sleep disturbance; 2) pain medication dosages; 3) psychosocial variables including pain acceptance, pain catastrophizing, and perceived stress; 4) dispositional mindfulness, as well as postintervention structured interviews about their experiences.

Results: Acceptable rates of retention and attendance and high ratings of satisfaction indicated that the intervention was feasible and acceptable. In interviews, participants found the program acceptable and beneficial and provided suggestions to improve it. From pre- to post-treatment, significant improvements were reported in all measures except physical functioning and anxiety.

Conclusions: In adults with chronic pain, a four-week mindfulness program is feasible and acceptable, addresses the barrier of a lengthy program, and may improve quality of life and psychological functioning. An appropriately powered randomized controlled trial with a comparison group is needed to assess the intervention's effectiveness.
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http://dx.doi.org/10.1093/pm/pnaa208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685688PMC
November 2020

Comparing prospective headache diary and retrospective four-week headache questionnaire over 20 weeks: Secondary data analysis from a randomized controlled trial.

Cephalalgia 2020 11 16;40(13):1523-1531. Epub 2020 Aug 16.

Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: Headache diaries and recall questionnaires are frequently used to assess headache frequency and severity in clinical and research settings.

Methods: Using 20 weeks of data from an intervention trial with 182 participants, we evaluated concordance between an electronic headache diary administered on a daily basis and designed to capture the presence and severity of headaches on an hourly basis (the headache diary) and a recall questionnaire, with retrospective estimation of the number of headache days assessed on a monthly basis. We further examined whether the duration or severity of headaches assessed by the electronic diary impacted concordance between these two measures.

Results: Over the course of four 28-day periods, people with migraine participating in a dietary intervention reported an average of 13.7 and 11.1 headache days in the headache diary and recall questionnaire, respectively.

Conclusion: Over time, the concordance between headache days reported in these two measures tended to increase; however, the recall questionnaire headache estimates were lower than the diary measures in all four periods. When analysis was restricted to headaches lasting 8 hours or more, the number of headache days was more closely aligned with days reported in the recall questionnaire, indicating that the accuracy of recall estimates is likely to be influenced by headache duration. Restriction of analyses to moderate-to-severe headaches did not change results as much as headache duration. The findings indicate that recall questionnaires administered on a monthly basis may underestimate headache frequency and therefore should not be used interchangeably with headache diaries.: NCT02012790.
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http://dx.doi.org/10.1177/0333102420949180DOI Listing
November 2020

Use of complementary and alternative medicine in children with ADHD: Results from the 2012 and 2017 National Health Interview Survey.

Complement Ther Med 2020 Mar 19;49:102352. Epub 2020 Feb 19.

University of North Carolina at Chapel Hill, Department of Physical Medicine & Rehabilitation, Chapel Hill, NC, 27516, USA. Electronic address:

Objective: To examine the prevalence, patterns, and factors associated with CAM use among children with ADHD.

Method: We used data from the 2012 and 2017 National Health Interview Survey. Descriptive statistics, Wald F chi-square test, and multivariable logistic regression were performed.

Results: Approximately 8.4 % of U.S. children had ADHD in 2017. Children with ADHD had greater CAM use than those without (p < 0.05). Meditation (10.8 %), yoga (9.6 %), and deep breathing (7.3 %) were the most commonly used mind-body CAM modalities in ADHD children in 2017, with their use increased 468 %, 433 %, and 192 %, respectively, since 2012. Nearly all children experiencing ADHD (91.9 %) have comorbid psychiatric disorders, and they are more likely to use CAM than those without comorbidities (p < .0001). Less than one-third of the respondents disclosed children's CAM use to their medical doctors. Among children with ADHD, CAM use is generally not correlated with conventional medical care use, except for a significant inverse relationship between CAM use and use of prescription medication for more than three months.

Conclusion: The use of mind-body CAM modalities has substantially increased among children with ADHD, compared to those without ADHD, from 2012 to 2017. Parents' reasons for the use of CAM among their children with ADHD included their unique function in reducing ADHD symptoms and their lack of unwanted side-effects. It is imperative to improve effective communication between health care providers and ADHD patients and their parents, in order to understand patients' values and preferences for using CAM therapies as a natural holistic therapy for ADHD.
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http://dx.doi.org/10.1016/j.ctim.2020.102352DOI Listing
March 2020

Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis.

JAMA Intern Med 2020 Jan;180(1):91-105

Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina.

Importance: Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.

Objective: To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.

Data Sources: For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.

Study Selection: Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain.

Data Extraction And Synthesis: Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs.

Main Outcomes And Measures: The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function.

Results: Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = -0.51; 95% CI, -0.76 to -0.26) and reduced opioid dose (Cohen d = -0.26; 95% CI, -0.44 to -0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70), hypnosis (Cohen d = -0.54), suggestion (Cohen d = -0.68), and cognitive behavioral therapy (Cohen d = -0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias.

Conclusions And Relevance: The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.
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http://dx.doi.org/10.1001/jamainternmed.2019.4917DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830441PMC
January 2020

Didgeridoo Sound Meditation for Stress Reduction and Mood Enhancement in Undergraduates: A Randomized Controlled Trial.

Glob Adv Health Med 2019 30;8:2164956119879367. Epub 2019 Sep 30.

Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Background: College students report feeling frequently stressed, which adversely impacts health. Meditation is one effective method for reducing stress, but program length and required effort are potential obstacles. Research on sound meditation, involving focused listening to sounds, is nascent but may appeal to undergraduates. The effects of listening to didgeridoo, an Australian wind instrument producing a low, resonant, droning sound, have not been studied.

Objective: This study compared the effect of a 30-minute didgeridoo sound meditation versus silent meditation with focus on one's breath on acute self-perceived stress and mood in undergraduates without prior meditation experience.

Methods: Seventy-four undergraduates were randomized to 2 interventions: (1) didgeridoo meditation (n = 40) performed live by a musician or (2) silent meditation (n = 34) taught by a meditation instructor. Immediate pre-post effects of the session were examined using the 4-Dimension Mood Scale and an item assessing acute self-perceived stress. Intervention acceptability was assessed postintervention.

Results: Two-way mixed analyses of variance were performed. Both groups reported significantly increased relaxation after meditation (Group D,  = .0001 and Group S,  = .0005). Both groups reported decreased negative arousal (Group D,  = .02 and Group S,  = .02), energy (Group D,  = .0001 and Group S,  = .003), tiredness (Group D,  = .0001 and Group S,  = .005), and acute stress (Group D,  = .0001 and Group S,  = .0007). Group Didgeridoo experienced significantly more relaxation ( = .01) and less acute stress ( = .03) than Group Silent. Fifty-three percent of silent participants and 80% of didgeridoo participants agreed that they would attend that type of meditation again. Forty-seven percent of silent participants and 80% of didgeridoo participants enjoyed the meditation.

Conclusion: Didgeridoo sound meditation is as effective as silent meditation for decreasing self-perceived negative arousal, tiredness, and energy and more effective than silent meditation for relaxation and acute stress in undergraduates. Didgeridoo meditation participants reported higher levels of enjoyment and higher likelihood of attending another session. Further investigation into didgeridoo and sound meditation is warranted.
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http://dx.doi.org/10.1177/2164956119879367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769210PMC
September 2019

Adapting Mindfulness Training for Military Service Members With Chronic Pain.

Mil Med 2020 03;185(3-4):385-393

University of North Carolina School of Medicine, 321 S. Columbia St, Chapel Hill, NC 27516.

Introduction: Rates of chronic pain in military personnel are disproportionately high. Chronic pain is often associated with mental health and substance use disorders as comorbid conditions, making treatment of chronic pain complex. Mindfulness-based interventions (MBIs) are a promising behavioral approach to managing chronic pain and psychosocial sequelae. The unique nature of the military context may require adaptations to original MBIs for successful delivery in active-duty military populations. This study adapted the mindfulness-based stress reduction (MBSR) program to create a mindfulness training program that was relevant to active-duty Army personnel experiencing chronic pain. This article delineates the adaptation process employed to modify the MBSR program to the military context and discusses the resulting training program.

Materials And Methods: The adaptation process consisted of three iterative stages: 1) Drafting the preliminary intervention protocol with recommendations from stakeholders, including military healthcare providers; 2) Refining the preliminary protocol after pretesting the sessions with research team members and a military Veteran advisory committee; and 3) Delivering the preliminary protocol to one cohort of active-duty Soldiers with chronic pain, collecting feedback, and further refining the intervention protocol.

Results: Military-related adaptations to MBSR addressed three areas: military culture, language and terminology, and practical and logistical factors relevant to implementation in the military setting. This adaptation process resulted in a live, online program with six, weekly, sessions. Feedback from a military Veteran advisory committee resulted in modifications, including increasing military-relevant examples; preliminary testing with the target population resulted in additional modifications, including shortening the sessions to 75 min and structuring discussions more efficiently.

Conclusions: The adaptation process was successful in generating an engaging mindfulness training program that was highly relevant to the military context. Obtaining input from stakeholders, such as military healthcare providers and active-duty soldiers, and iterative feedback and modification, were key to the process. Moreover, the program was designed to maintain the integrity and core elements of MBIs while adapting to military culture. A future randomized controlled trial design will be used to evaluate the effectiveness of the intervention in improving chronic pain in military personnel. This program is responsive to the military's call for nonpharmacologic treatments for chronic pain that are easily accessible. If effective, the mindfulness program has the potential for widespread dissemination to complement standard care for Service Members experiencing chronic pain.
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http://dx.doi.org/10.1093/milmed/usz312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134381PMC
March 2020

A Mixed-Methods, Randomized Clinical Trial to Examine Feasibility of a Mindfulness-Based Stress Management and Diabetes Risk Reduction Intervention for African Americans with Prediabetes.

Evid Based Complement Alternat Med 2019 14;2019:3962623. Epub 2019 Aug 14.

Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA.

African Americans have disproportionately high rates of stress-related conditions, including diabetes and diabetes-related morbidity. Psychological stress may negatively influence engagement in risk-reducing lifestyle changes (physical activity and healthy eating) and stress-related physiology that increase diabetes risk. This study examined the feasibility of conducting a randomized trial comparing a novel mindfulness-based stress management program combined with diabetes risk-reduction education versus a conventional diabetes risk-reduction education program among African American adults with prediabetes and self-reported life stress. Participants were recruited in collaboration with community partners and randomized to the mindfulness-based diabetes risk-reduction education program for prediabetes (MPD;  = 38) or the conventional diabetes risk-reduction education program for prediabetes (CPD;  = 30). The mindfulness components were adapted from the Mindfulness-based Stress Reduction Program. The diabetes risk-reduction components were adapted from the Program and the . Groups met for eight weeks for 2.5 hours, with a half-day retreat and six-monthly boosters. . Psychological, behavioral, and metabolic data were collected before the intervention and at three and six months postintervention to examine within-group change and feasibility of collecting such data in future clinical efficacy research. Participants reported acceptability, credibility, and cultural relevance of the intervention components. Enrollment of eligible participants (79%), intervention session attendance (76.5%), retention (90%), and postintervention data collection attendance (83%, 82%, and 78%, respectively) demonstrated feasibility, and qualitative data provided information to further enhance feasibility in future studies. Both groups exhibited an A1C reduction. MPD participants had reductions in perceived stress, BMI, calorie, carbohydrate and fat intake, and increases in spiritual well-being. Considering the high prevalence of diabetes and diabetes-related complications in African Americans, these novel findings provide promising guidance to develop a larger trial powered to examine efficacy of a mindfulness-based stress management and diabetes risk-reduction education program for African Americans with prediabetes.
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http://dx.doi.org/10.1155/2019/3962623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710811PMC
August 2019

Wang et al. Respond.

Am J Public Health 2019 09;109(9):e5-e6

Claudia (Chunyun) Wang and Susan Gaylord are with the Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill. Claudia (Chunyun) Wang is also with the School of Physical Education, Pingdingshan University, Pingdingshan. Kaigang Li is with the Department of Health and Exercise Science, Colorado State University, Fort Collins.

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http://dx.doi.org/10.2105/AJPH.2019.305239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687258PMC
September 2019

Prevalence, patterns, and predictors of meditation use among U.S. children: Results from the National Health Interview Survey.

Complement Ther Med 2019 Apr 8;43:271-276. Epub 2019 Feb 8.

University of North Carolina at Chapel Hill, Department of Physical Medicine & Rehabilitation, Chapel Hill, NC 27516, USA.

Objectives: The purpose of the study is to examine the characteristics of various types of meditation use (i.e., mantra, mindful, and spiritual meditation) among U.S. children.

Methods: Using 2017 National Health Interview Survey, we examined the prevalence, patterns, and potential predictors of meditation use among U.S. children aged 4 to 17 years. Descriptive statistics, Wald F chi-square test, and multivariable logistic regression were used for data analysis (n = 6925).

Results: Overall meditation use has increased substantially from 1.6% in 2012 to 7.4% in 2017 among children in the US. Children with chronic medical conditions were more likely to use mindful meditation (Adjusted Odds Ratio (AOR) = 1.9-3.6, 95% CI [1.0-7.4]). Regularly taking prescription medication had an inverse relation with mantra meditation use (AOR = 0.4, 95% CI [0.2-0.9]). Children with delayed medical care due to access difficulties were more likely to use spiritual meditation, compared to those who did not (AOR = 1.7, 95% CI [1.1-2.6]).

Conclusions: Meditation use has rapidly increased among U.S. children within the past few years. Future studies should explore the underlying reasons for this increase and its potential benefits for pediatric meditators.
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http://dx.doi.org/10.1016/j.ctim.2019.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502253PMC
April 2019

Trends in Yoga, Tai Chi, and Qigong Use Among US Adults, 2002-2017.

Am J Public Health 2019 05 21;109(5):755-761. Epub 2019 Mar 21.

Claudia (Chunyun) Wang is with the Department of Health and Human Development, Western Washington University, Bellingham and the School of Physical Education, Pingdingshan University, Pingdingshan, Henan Province, China. Kaigang Li is with the Department of Health and Exercise Science, Colorado State University, Fort Collins. Arkopal Choudhury is with the Department of Biostatistics, University of North Carolina at Chapel Hill. Susan Gaylord is with the Department of Physical Medicine & Rehabilitation, University of North Carolina at Chapel Hill.

Objectives: To examine the characteristics and temporal trends of yoga, tai chi, and qigong (YTQ) use among US adults.

Methods: Using the 2002, 2007, 2012, and 2017 National Health Interview Surveys, we examined the prevalence, patterns, and predicting factors of YTQ use by Taylor series linear regression, the Wald F χ test, and multivariable logistic regression models (n = 116 404).

Results: YTQ use increased from 5.8% in 2002 to 14.5% in 2017 (P ≤ .001). Only 6.6% of YTQ users were referred by their medical doctors, and approximately one third disclosed their use of YTQ to medical professionals. Reasons for using YTQ included (1) YTQ was beneficial, (2) YTQ focused on the whole person, and (3) YTQ was natural. Acute and chronic pain, arthritis, and depression were the top 3 medical conditions for which people used YTQ the most.

Conclusions: YTQ use is increasing substantially, mainly because of its natural and holistic healing approach toward health and chronic diseases. Future studies aiming to explore how to best integrate YTQ into the current health care system are warranted.
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http://dx.doi.org/10.2105/AJPH.2019.304998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459666PMC
May 2019

Enhancing stress reactivity and wellbeing in early schizophrenia: A pilot study of individual coping awareness therapy (I-CAT).

Schizophr Res 2018 11 4;201:413-414. Epub 2018 May 4.

The Department of Psychology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Australian Catholic University, School of Psychology, Melbourne, VIC, Australia.

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http://dx.doi.org/10.1016/j.schres.2018.04.039DOI Listing
November 2018

A sixteen-week three-armed, randomized, controlled trial investigating clinical and biochemical effects of targeted alterations in dietary linoleic acid and n-3 EPA+DHA in adults with episodic migraine: Study protocol.

Prostaglandins Leukot Essent Fatty Acids 2018 01 16;128:41-52. Epub 2017 Nov 16.

Lipid Mediators, Inflammation, and Pain Unit, Laboratory of Clinical Investigation, National Institute on Aging, NIH, 251 Bayview Blvd., Baltimore, MD 21224, United States; Intramural Program of the National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, United States; Department of Physical Medicine and Rehabilitation, UNC School of Medicine, 171 Wing D, C.B.#7200, 170 Manning Drive, Chapel Hill, NC 27599, United States. Electronic address:

Migraine is a prevalent neurological disorder, affecting over 16% of adult women and 7% of adult men in the U.S., causing significant pain, disability, and medical expense, with incomplete benefits from conventional medical management. Migraine, as a chronic pain syndrome, provides a practical model for investigating the impact of dietary modifications in omega-3 (n-3) and omega-6 (n-6) fatty acids. This paper reports the protocol of a trial to assess whether targeted dietary modifications designed to increase n-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with or without concurrent reduction in n-6 linoleic acid (LA), will alter nociceptive lipid mediators and mediate decreases in frequency and severity of migraine. This prospective, randomized, controlled trial in 153 male and female adult subjects, ages 18-99, with diagnosed and actively managed episodic migraine tests the efficacy, safety, and biochemical effects of targeted, controlled alterations in dietary omega-3 and omega-6 fatty acids. Participants are masked to diet hypotheses and all assessors are masked to treatment assignment. Following a four-week baseline period, participants with migraine headache frequency of 5-20 per month are randomized to one of three intensive dietary regimens for 16 additional weeks followed by a less intensive observation period. Dietary intervention arms include: 1) increased n-3 EPA+DHA with low n-6 linoleic acid (H3 L6); 2) increased n-3 EPA+DHA with usual US dietary intake of n-6 linoleic acid (H3 H6); and 3) usual US dietary content of n-3 and n-6 fatty acids (L3 H6). During the actual intervention, subjects receive content-specific study oils and foods sufficient for two meals and two snacks per day, as well as dietary counseling. Biochemical and clinical outcome measures are performed at intervals throughout this period. This randomized controlled trial is designed to determine whether targeted alterations in dietary n-3 and n-6 fatty acids can alter nociceptive lipid mediators in a manner that decreases headache pain and enhances quality of life and function in adults with frequent migraines.

Trial Registration: NCT02012790.
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http://dx.doi.org/10.1016/j.plefa.2017.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6269096PMC
January 2018

Literature Review of Research on Chronic Pain and Yoga in Military Populations.

Medicines (Basel) 2017 Sep 1;4(3). Epub 2017 Sep 1.

Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310, USA.

Although yoga is increasingly being provided to active duty soldiers and veterans, studies with military populations are limited and effects on chronic pain are largely unknown. We reviewed the existing body of literature and provide recommendations for future research. We conducted a literature review of electronic databases (PubMed, PsychINFO, Web of Science, Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index-Science, and Conference Proceedings Citation Index-Social Science & Humanities). The studies were reviewed for characteristics such as mean age of participants, sample size, yoga type, and study design. Only peer-reviewed studies were included in the review. The search yielded only six studies that examined pain as an outcome of yoga for military populations. With one exception, studies were with veteran populations. Only one study was conducted with Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) veterans. One study was a randomized controlled trial (RCT). Four of the five studies remaining used pre/post design, while the last study used a post-only design. Studies on the use of yoga to treat chronic pain in military populations are in their infancy. Methodological weaknesses include small sample sizes, a lack of studies with key groups (active duty, OEF/IEF veterans), and use of single group uncontrolled designs (pre/post; post only) for all but one study. Future research is needed to address these methodological limitations and build on this small body of literature.
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http://dx.doi.org/10.3390/medicines4030064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622399PMC
September 2017

Comparative Benefits and Harms of Complementary and Alternative Medicine Therapies for Initial Treatment of Major Depressive Disorder: Systematic Review and Meta-Analysis.

J Altern Complement Med 2017 Dec 12;23(12):907-919. Epub 2017 Jul 12.

2 RTI International, Research Triangle Park , NC.

Objectives: To report the comparative benefits and harms of exercise and complementary and alternative medicine (CAM) treatments with second-generation antidepressants (SGA) for major depressive disorder (MDD).

Design: Systematic review and meta-analysis.

Settings: Outpatient clinics.

Subjects: Adults, aged 18 years and older, with MDD receiving an initial treatment attempt with SGA.

Interventions: Any CAM or exercise intervention compared with an SGA.

Outcome Measures: Treatment response, remission, change in depression rating, adverse events, treatment discontinuation, and treatment discontinuation due to adverse events.

Results: We found 22 randomized controlled trials for direct comparisons and 127 trials for network meta-analyses, including trials of acupuncture, omega-3 fatty acids, S-adenosyl methionine, St. John's wort, and exercise. For most treatment comparisons, we found no differences between treatment groups for response and remission. However, the risk of bias of these studies led us to conclude that the strength of evidence for these findings was either low or insufficient. The risk of treatment harms and treatment discontinuation attributed to adverse events was higher for selective serotonin receptor inhibitors than for St. John's wort.

Conclusions: Although we found little difference in the comparative efficacy of most CAM therapies or exercise and SGAs, the overall poor quality of the available evidence base tempers any conclusions that we might draw from those trials. Future trials should incorporate patient-oriented outcomes, treatment expectancy, depressive severity, and harms assessments into their designs; antidepressants should be administered over their full dosage ranges; and larger trials using methods to reduce sampling bias are needed.
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http://dx.doi.org/10.1089/acm.2016.0261DOI Listing
December 2017

A mindful self-compassion videoconference intervention for nationally recruited posttreatment young adult cancer survivors: feasibility, acceptability, and psychosocial outcomes.

Support Care Cancer 2017 06 19;25(6):1759-1768. Epub 2017 Jan 19.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.

Purpose: Young adult (YA) cancer survivors report substantial distress, social isolation, and body image concerns that can impede successful reintegration into life years after treatment completion. Mindful Self-Compassion (MSC) interventions focus on developing mindfulness and self-compassion for managing distress, hardships, and perceived personal inadequacies. An MSC intervention would be beneficial in supporting YA survivors' management of psychosocial challenges that arise in survivorship; however, a telehealth intervention modality is essential for reaching this geographically dispersed population. We conducted a single-arm feasibility study of an MSC 8-week videoconference intervention for nationally recruited YA survivors (ages 18-29).

Methods: The MSC intervention was group-based, 90-minute videoconference sessions, held weekly over 8 weeks, with audio-supplemented home practice. Feasibility and acceptability were assessed via attendance rate and an intervention satisfaction scale. Baseline to post-intervention changes in psychosocial outcomes (body image, anxiety, depression, social isolation, posttraumatic growth, resilience, self-compassion, mindfulness) were assessed using paired t tests and Cohen's d effect sizes.

Results: Thirty-four participants were consented and 25 attended a videoconference group. Feasibility was established with 84% attending at least six of the eight sessions, and intervention acceptability was high (M = 4.36, SD = 0.40, score range = 1-5). All psychosocial outcomes, except for resilience, demonstrated significant changes (p < 0.002), with medium to large effect sizes (Cohen's d > 0.5).

Conclusion: YA survivors are interested in receiving an MSC videoconference intervention. Feasibility, acceptance, and potential psychosocial benefits of the intervention were demonstrated. Findings can be applied toward the design of an efficacy randomized controlled trial to improve quality of life for YA survivors in transition after cancer treatment.
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http://dx.doi.org/10.1007/s00520-017-3586-yDOI Listing
June 2017

Age and Gender Differences in the Associations of Self-Compassion and Emotional Well-being in A Large Adolescent Sample.

J Youth Adolesc 2017 04 15;46(4):840-853. Epub 2016 Sep 15.

Department of Physical Medicine and Rehabilitation, CB 7200, School of Medicine, University of North Carolina-Chapel Hill, 27599, USA.

Adolescence is a challenging developmental period marked with declines in emotional well-being; however, self-compassion has been suggested as a protective factor. This cross-sectional survey study (N = 765, grades 7th to 12th; 53 % female; 4 % Hispanic ethnicity; 64 % White and 21 % Black) examined whether adolescents' self-compassion differed by age and gender, and secondly, whether its associations with emotional well-being (perceived stress, life satisfaction, distress intolerance, depressive symptoms, and anxiety) also differed by age and gender. The findings indicated that older females had the lowest self-compassion levels compared to younger females or all-age males. Self-compassion was associated with all emotional well-being measures, and gender and/or age moderated the associations with anxiety and depressive symptoms. Among older adolescents, self-compassion had a greater protective effect on anxiety for boys than for girls. Additionally, older adolescents with low and average self-compassion had greater levels of depressive symptoms than those with high self-compassion. These results may inform for whom and at what age self-compassion interventions may be implemented to protect adolescents from further declines in emotional well-being.
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http://dx.doi.org/10.1007/s10964-016-0567-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346326PMC
April 2017

Making Friends With Yourself: A Mixed Methods Pilot Study of a Mindful Self-Compassion Program for Adolescents.

Mindfulness (N Y) 2016 Mar 19;7(2):479-492. Epub 2015 Dec 19.

University of California-San Diego Center for Mindfulness, University of California at San Diego; San Diego, CA, USA.

The aims of this mixed-method pilot study were to determine the feasibility, acceptability, and preliminary psychosocial outcomes of "Making Friends with Yourself: A Mindful Self-Compassion Program for Teens" (MFY), an adaptation of the adult Mindful Self-Compassion program. Thirty-four students age 14-17 enrolled in this waitlist controlled crossover study. Participants were randomized to either the waitlist or intervention group and administered online surveys at baseline, after the first cohort participated in the intervention, and after the waitlist crossovers participated in the intervention. Attendance and retention data were collected to determine feasibility, and audiorecordings of the 6-week class were analyzed to determine acceptability of the program. Findings indicated that MFY is a feasible and acceptable program for adolescents. Compared to the waitlist control, the intervention group had significantly greater self-compassion and life satisfaction and significantly lower depression than the waitlist control, with trends for greater mindfulness, greater social connectedness and lower anxiety. When waitlist crossovers results were combined with that of the first intervention group, findings indicated significantly greater mindfulness and self-compassion, and significantly less anxiety, depression, perceived stress and negative affect post-intervention. Additionally, regression results demonstrated that self-compassion and mindfulness predicted decreases in anxiety, depression, perceived stress, and increases in life satisfaction post-intervention. MFY shows promise as a program to increase psychosocial wellbeing in adolescents through increasing mindfulness and self-compassion. Further testing is needed to substantiate the findings.
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http://dx.doi.org/10.1007/s12671-015-0476-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838201PMC
March 2016

Weathering the seasons of cancer survivorship: mind-body therapy use and reported reasons and outcomes by stages of cancer survivorship.

Support Care Cancer 2016 09 6;24(9):3783-91. Epub 2016 Apr 6.

Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, CB# 7200, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.

Purpose: Mind-body therapies (MBTs), a subset of complementary and alternative medicine (CAM), are used by cancer survivors to manage symptoms related to their cancer experience. MBT use may differ by cancer survivorship stage (i.e., acute, short-term, long-term) because each stage presents varying intensities of medical activities, associated emotions, and treatment effects. We examined the relationship between MBT use and survivorship stage (acute <1 year; short-term 1 to 5 years; long-term >5 years since diagnosis) using the CAM supplement of the 2012 National Health Interview Survey. We also examined reported reasons for and outcomes of MBT use and frequency of MBT types.

Methods: The sample included cancer survivors (N = 3076) and non-cancer controls (N = 31,387). Logistic regression tested the relationship of MBT use and survivorship stage. Weighted percentages were calculated by survivorship stage for reported reasons and outcomes of use and frequency of MBT types.

Results: MBT use varied by cancer survivorship stage (p = 0.02): acute (8.3 %), short-term (15.4 %), long-term (11.7 %) survivorship and non-cancer controls (13.2 %). In the adjusted model, short-term survivors had 35 % greater odds of MBT use than did controls (95 % CI 1.00, 1.83). Reasons for and outcomes of MBT use varied among the survivorship stages, with more acute survivors reporting medical-related reasons and more short-term survivors reporting to manage symptoms.

Conclusions: MBT may fulfill different symptom management needs at varying stages of survivorship. These findings can help inform supportive care services of survivors' use of MBT for symptom burden at each stage and the allocation of these services.
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http://dx.doi.org/10.1007/s00520-016-3200-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967379PMC
September 2016

Does Self-compassion Protect Adolescents from Stress?

J Child Fam Stud 2016 Apr 23;25(4):1098-1109. Epub 2015 Oct 23.

University of North Carolina-Chapel Hill, Chapel Hill, NC.

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http://dx.doi.org/10.1007/s10826-015-0307-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793986PMC
April 2016

Comparative Benefits and Harms of Antidepressant, Psychological, Complementary, and Exercise Treatments for Major Depression: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians.

Ann Intern Med 2016 Mar 8;164(5):331-41. Epub 2015 Dec 8.

Background: Primary care patients and clinicians may prefer options other than second-generation antidepressants for the treatment of major depressive disorder (MDD). The comparative benefits and harms of antidepressants and alternative treatments are unclear.

Purpose: To compare the benefits and harms of second-generation antidepressants and psychological, complementary and alternative medicine (CAM), and exercise treatments as first- and second-step interventions for adults with acute MDD.

Data Sources: English-, German-, and Italian-language studies from multiple electronic databases (January 1990 to September 2015); trial registries and gray-literature databases were used to identify unpublished research.

Study Selection: Two investigators independently selected comparative randomized trials of at least 6 weeks' duration on health outcomes of adult outpatients; nonrandomized studies were eligible for harms.

Data Extraction: Reviewers abstracted data on study design, participants, interventions, and outcomes; rated the risk of bias; and graded the strength of evidence. A senior reviewer confirmed data and ratings.

Data Synthesis: 45 trials met inclusion criteria. On the basis of moderate-strength evidence, cognitive behavioral therapy (CBT) and antidepressants led to similar response rates (relative risk [RR], 0.90 [95% CI, 0.76 to 1.07]) and remission rates (RR, 0.98 [CI, 0.73 to 1.32]). In trials, antidepressants had higher risks for adverse events than most other treatment options; no information from nonrandomized studies was available. The evidence was too limited to make firm conclusions about differences in the benefits and harms of antidepressants compared with other treatment options as first-step therapies for acute MDD. For second-step therapies, different switching and augmentation strategies provided similar symptom relief.

Limitation: High dropout rates, dosing inequalities, small sample sizes, and poor assessment of adverse events limit confidence in the evidence.

Conclusion: Given their similar efficacy, CBT and antidepressants are both viable choices for initial treatment of MDD.

Primary Funding Source: Agency for Healthcare Research and Quality.
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http://dx.doi.org/10.7326/M15-1813DOI Listing
March 2016

Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.

BMJ 2015 Dec 8;351:h6019. Epub 2015 Dec 8.

RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.

Study Question: What are the benefits and harms of second generation antidepressants and cognitive behavioral therapies (CBTs) in the initial treatment of a current episode of major depressive disorder in adults?

Methods: This was a systematic review including qualitative assessment and meta-analyses using random and fixed effects models. Medline, Embase, the Cochrane Library, the Allied and Complementary Medicine Database, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature were searched from January 1990 through January 2015. The 11 randomized controlled trials included compared a second generation antidepressant CBT. Ten trials compared antidepressant monotherapy with CBT alone; three compared antidepressant monotherapy with antidepressant plus CBT.

Summary Answer And Limitations: Meta-analyses found no statistically significant difference in effectiveness between second generation antidepressants and CBT for response (risk ratio 0.91, 0.77 to 1.07), remission (0.98, 0.73 to 1.32), or change in 17 item Hamilton Rating Scale for Depression score (weighted mean difference, -0.38, -2.87 to 2.10). Similarly, no significant differences were found in rates of overall study discontinuation (risk ratio 0.90, 0.49 to 1.65) or discontinuation attributable to lack of efficacy (0.40, 0.05 to 2.91). Although more patients treated with a second generation antidepressant than receiving CBT withdrew from studies because of adverse events, the difference was not statistically significant (risk ratio 3.29, 0.42 to 25.72). No conclusions could be drawn about other outcomes because of lack of evidence. Results should be interpreted cautiously given the low strength of evidence for most outcomes. The scope of this review was limited to trials that enrolled adult patients with major depressive disorder and compared a second generation antidepressant with CBT, and many of the included trials had methodological shortcomings that may limit confidence in some of the findings.

What This Study Adds: Second generation antidepressants and CBT have evidence bases of benefits and harms in major depressive disorder. Available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences. Funding, competing interests, data sharing This project was funded under contract from the Agency for Healthcare Research and Quality by the RTI-UNC Evidence-based Practice Center. Detailed methods and additional information are available in the full report, available at http://effectivehealthcare.ahrq.gov/.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673103PMC
http://dx.doi.org/10.1136/bmj.h6019DOI Listing
December 2015

Mindfulness-based Stress Reduction as a Promising Intervention for Amelioration of Premenstrual Dysphoric Disorder Symptoms.

Mindfulness (N Y) 2015 Dec 3;6(6):1292-1302. Epub 2015 Apr 3.

Department of Psychiatry, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC.

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http://dx.doi.org/10.1007/s12671-015-0397-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651211PMC
December 2015

A Pilot Study of a Mindfulness Intervention for Adolescents and the Potential Role of Self-Compassion in Reducing Stress.

Explore (NY) 2015 Jul-Aug;11(4):292-5. Epub 2015 Apr 28.

Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, CB 7200, Chapel Hill, NC 27599.

Objective: In this pilot study, we sought to investigate the effects of a mindfulness intervention for adolescents on a community sample of teens. Specifically, we explored the effects of mindfulness training on emotional well-being outcomes. Also, we examined the relationship between mindfulness and self-compassion at baseline-predicted outcome measures.

Design: This design was a pre-/post-pilot intervention study. Paired t-tests were conducted to examine change in outcome measures before and after the mindfulness intervention. Multiple regression was also conducted to investigate the influence of baseline mindfulness and self-compassion on outcome measures.

Setting: The study took place after school in a classroom at a local university.

Participants: Overall 28 adolescents age 10-18 years from two different cohorts participated in this study.

Intervention: Learning to BREATHE, a mindfulness curriculum designed specifically for adolescents and taught in six 1.5h sessions, was implemented.

Main Outcome Measures: The outcome measures, life satisfaction and perceived stress, were included in an online survey before and after the mindfulness intervention.

Results: Results indicated that mindfulness, self-compassion, perceived stress, and life satisfaction improved from pre-intervention to post-intervention. Further, self-compassion (taught within the mindfulness intervention) was negatively related to perceived stress post-intervention while controlling for baseline stress. These findings suggest that mindfulness may be an effective intervention for improving indicators of emotional well-being among an adolescent population. Additionally, self-compassion may be a pathway through which youth can lower stress. Future research should examine self-compassion as a potential factor in promoting emotional well-being.
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http://dx.doi.org/10.1016/j.explore.2015.04.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457455PMC
April 2016

From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness.

Pers Individ Dif 2015 Jul;81:41-46

University of North Carolina at Chapel Hill, Chapel Hill, NC.

Theory suggests that heightening mindfulness in meditation practice over time increases mindfulness, which benefits psychological health. We prospectively examined individual trajectories of state mindfulness in meditation during a mindfulness-based intervention in relation to changes in trait mindfulness and psychological distress. Each week during the eight-week intervention, participants reported their state mindfulness in meditation after a brief mindfulness meditation. Participants also completed pre- and post-intervention measures of trait mindfulness and psychological symptoms. Tests of combined latent growth and path models suggested that individuals varied significantly in their rates of change in state mindfulness in meditation during the intervention, and that these individual trajectories predicted pre-post intervention changes in trait mindfulness and distress. These findings support that increasing state mindfulness over repeated meditation sessions may contribute to a more mindful and less distressed disposition. However, individuals' trajectories of change may vary and warrant further investigation.
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http://dx.doi.org/10.1016/j.paid.2014.12.044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404745PMC
July 2015
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