Quality Stress Management Course

The Well Being Way Stress Management Program

What you'll learn in the book is as follows: The Secret Formula I use every day to gain maximum happiness. Over 101 Ways To Reduce Stress. How To Use Your Body to Maximise Your Happiness. The one thing I did in 2010 which made a huge difference to my life which I didn't use for the 2 previous years. How To Deal With Challenging Emotions. The key to building a Joyful Life that if you implement will make huge changes. How To Turn Stressful Situations Around When Things Arent Going Your Way. Revealed. The best Spiritual Advice I've Ever Received. Affirmations. How To Make Affirmations Work For You. The Cornerstone of Maintaining Joy In Your Life. The One Technique To Cope With Huge Workloads in An American Fortune 500 Company. The 2 things that you need to start doing to overcome modern day stress in your life. Read more here...

The Well Being Way Stress Management Program Summary

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Author: Piers Cross
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Stressful Life Events

Numerous twin investigations have examined the heritability of stressful life events using checklists or other inventories of diverse life stressors. Among studies that included a score reflecting the sum of all recently experienced events, Kendler and Baker (2007) report a mean heritability of 28 for total life events, when weighted for variation in sample sizes. A distinction is also commonly made between events that could be dependent, in part, on actions of the individual experiencing them (e.g., financial problems marital discord, separation, or divorce legal difficulties) and those that are truly adventitious (e.g., illness or death of a relative natural disasters). When dependent (or controllable) events are examined separately, genetic influences account for an estimated 31 of the variation in their occurrence, whereas independent (or uncontrollable) events are much less heritable, with a weighted average heritability of 17 . Some life event scales include items that are...

Project Title Stress Reduction And Atherosclerotic Cvd In Blacks

Summary The President's Racial and Ethnic Health Disparities Initiative of 1998 emphasizes that African Americans suffer from disproportionately high rates of cardiovascular disease (CVD) morbidity and mortality compared to white Americans. Numerous controlled studies suggest that this disparity is associated with chronic psychosocial and environmental stress. For these reasons, the NHLBI Working Group on Research in Coronary Heart Disease in Blacks has mandated behavior and prevention in this minority population as a national research priority. Our research team has previously demonstrated in NHLBI-supported randomized controlled trials that hypertension can be effectively treated in high risk African Americans with stress reduction using the Transcendental Meditation (TM) program compared to control procedures. These and other studies have also reported clinically significant improvements in other CVD risk factors, psychosocial stress, myocardial ischemia, left ventricular mass and...

Does CBCA Differentiate between Liars and Truth Tellers

Which give the test psychological meaning and make interpretation possible (Kline, 1993). An intelligence test is a standardised test. If a person obtains a score of 130, then we know that they are very intelligent and also that they are more intelligent than someone who obtains a score of 70. This is not the case for CBCA assessments. A child with a low CBCA score is not necessarily fabricating. Other factors (for example, low mental capability of the child) may have influenced the CBCA outcome. Similarly, a child with a high CBCA score is not necessarily telling the truth (for example, the child might have been well coached by a parent, especially one who knows about CBCA). Without any norms at all the meaning of a test score is impossible to gauge. Therefore, standardisation of a test is essential. In an effort to standardise CBCA assessments, the validity checklist has been developed (Steller, 1989). This contains a set of topics which SVA experts address (such as 'cognitive...

Ultrasonic vocalizations in rats

The first description of these calls comes from a study where rats were allowed to copulate until exhaustion (Brown, 1979). When approaching the fifth ejaculation males began to emit these calls. The appearance of the 22 kHz calls coincided with an increase in the number of mounts without intromission. The males actually mounted more but intromitted less. An analysis of the behavior of the female partner showed that this was caused by a lessened tendency to display lordosis in response to male mounting. Furthermore, the females showed more aggressive responses (turning away, kicking and boxing) when pursued by the male. This is most interesting since aggressive encounters are another situation associated with emission of 22 kHz calls (Lore et al., 1976). Thus, it is quite possible that the pre-ejaculatory calls are unrelated to copulatory behavior. Instead, they may be a simple side effect of aggressive behaviors on the part of the female. It can also be...

The Determinants of Positive Well Being

Positive well-being has multiple determinants at the individual, social, and ecological levels, and these have been extensively studied by a variety of social scientists ranging from personality psychologists to economists (Diener et al, 1999 Dolan et al, 2008). There is good evidence that positive affect is moderately heritable (Lykken and Tellegen, 1996), and this association may be mediated through temperamental dispositions such as high extraversion, low neuroticism, and optimism. Positive well-being is strongly related to satisfying social relationships and social engagement, though the causal sequence can be difficult to disentangle (Lyubomirsky et al, 2005). The issues of causation and reverse causation also bedevil analyses of the relationship between positive well-being and income or wealth. There is evidence, on one hand, that changes in income stimulate changes in well-being and, on the other hand, that high positive well-being predicts future increases in income and...

Health Maintenance And Disease Prevention

Even in old age, there are many things that can be done to maintain a reasonably healthy state and consequently continue to enjoy life. Among the recommendations for adding both years to life and life to years are to maintain physical fitness and positive wellness by proper exercise, nutritional awareness, effective stress management, and refraining from or reducing cigarette

Coping Interventions for Disease Populations

Antoni and his colleagues developed a 10-week cognitive behavioral stress management intervention involving relaxation, cognitive restructuring, and coping skills training for women being treated for non-metastatic breast cancer. This intervention led to improved psychosocial outcomes (Antoni et al, 2006a, b). It also led to greater reductions in cortisol levels through a 12-month follow-up, compared with a control group (Phillips et al, 2008), and Another research team tested a year-long intervention (4 months of weekly sessions and 8 monthly sessions), which trained breast cancer patients strategies to reduce stress, improve mood, and maintain treatment adherence. This intervention improved symptoms and functional status, compared to a control group (Andersen et al, 2007). A recent report indicated that it even increased survival rates (Andersen et al, 2008). This is a particularly encouraging result, given the considerable controversy about whether such interventions can influence...

Mechanisms Linking Social Networks to Health Outcomes

Cohen and Wills (1985) distinguished between two models to explain the mechanisms by which social relationships influence health outcomes (a) the main effects model and (b) the stress-buffering model. According to the stress-buffering model, social ties influence health outcomes only for individuals who happen to be experiencing stress - in other words, social resources buffer the individual against the deleterious effects of stress - whereas the main effects model posits that social relationships are beneficial regardless of the presence of stress. While these two models are not mutually exclusive, the emerging consensus in the field is that social networks operate via the main effects model, whereas social support is mobilized (and is most effective in promoting well-being) under stressful circumstances.

Stress and Personality

Reactions to stressful situations are a function not only of the severity of the event but also of the physical and psychological makeup of the affected individual. In a longitudinal study of men who had been psychologically examined as college students, those who were diagnosed as poorly adjusted were much more likely to become seriously ill and die in middle adulthood than those who had been diagnosed as well adjusted (Valliant, 1979). These findings led Valliant to conclude that personality adjustment in young adulthood influences a person's physical health in midlife. Good adjustment and positive mental health appear to slow the physical decline that begins in midlife, whereas poor adjustment hastens it. Another cognitive model of coping is Folkman and Lazarus's (1980) distinction between problem-focused and emotion-focused strategies. A problem-focused strategy consists of obtaining additional information to actively change a stressful situation, whereas an emotion-focused...

Project Title Effects Of Meditation On Mechanisms Of Chd

Summary Coronary heart disease (CHD) is the leading cause of death, disability, and health care costs in the US. The majority of CHD patients continue to have acute cardiac events, many sudden and unexpected, despite identification and treatment of their disease and attention to the traditional risk factors. The pathophysiologic bases of these cardiac events are not fully established, but substantial evidence indicates that psychosocial stress and resulting sympathetic nervous system imbalance are major contributors. Evidence indicates that psychosocial stress and a hyperresponsive sympathetic nervous system have adverse effects on both vasomotor function and long-term autonomic balance. Recent advances in our understanding of the pathophysiology of acute cardiac events-specifically, identification of the roles that arterial vasomotor dysfunction and autonomic nervous system imbalances play in the interplay of psychosomatic stress and CHD. Preliminary evidence further suggests that...

Age Differences in Coping Strategies

In their study of coping strategies in young, middle-aged, and older adults, Folkman et al. (1987) found that older adults were less likely than young and middle-aged adults to employ confrontation and aggression. Rather than becoming highly emotional when faced with stressful circumstances, older adults tended to cope by using denial, repression, and other passive strategies (Felton & Revenson, 1987 Folkman et al., 1987). As they become older, most adults relinquish coping strategies that, though presumably appropriate in young adulthood, have now outlived their usefulness. Confronting stress with detachment and humor is more characteristic of older than younger adults (Valliant, 1977). Lazarus and his colleagues (DeLongis, Coynce, Dakof, Folkman, & Lazarus, 1982 Lazarus & Folkman, 1984) also found that the reported number of stressful life events declined from middle to older adulthood. However, this does not necessarily mean that older adults experience less stress than...

Methods for the Study of Bats

There are several techniques for capturing bats, and success with any requires knowledge of the roosting and foraging behavior of bats, as well as their emergence and dispersal patterns (Kunz and Kurta, 1988). Regardless of technique, three critical pieces of equipment for capturing bats are a light source, gloves, and ''bat bags.'' Because bats are nocturnal, most capture sessions take place at dusk or at night when they emerge for foraging. Headlamps with halogen bulbs and battery packs are ideal for this work as they are reliable and keep a researcher's hands free for handling bats and manipulating equipment. Leather gloves should be used when handling bats to prevent bites and reduce stress to the animal. Lightweight leather gloves (e.g., baseball batter gloves) can be used for juveniles and smaller species, but heavier leather will be necessary for larger and more aggressive species, especially vampire bats and the large megachiroptera. The gloves should be soft and pliable to...

Gene Stress Correlation

Is there evidence of gene-environment correlation for environments definable as stressors, and if so, how pervasively do genetic factors influence exposure to stressors These questions have been investigated extensively in twin and adoption studies of the past 2 decades, and much of this literature was evaluated recently in a systematic review by Kendler and Baker (2007). The short answer is that gene-environment correlation is now well documented and that genetic variation typically accounts for a small to moderate proportion of individual differences in environmental exposures, including stressful life events, traumatic experiences, interpersonal relationships, parenting and family environments, and stress-related appraisals. We briefly summarize these associations in the following sections. It should be noted that while genetic analyses reported in this literature can detect heritable influences on measures of stressor exposure or appraisal, generally they cannot discriminate among...

Traumatic Experiences

Total posttraumatic stress disorder (PTSD) symptoms (with individual symptom categories showing slightly lower heritabilities reexperiencing 36 , avoidance 28 , numbing 36 , and hyperarousal 29 ). Although it is reasonable to think that etiologic factors affecting the likelihood of traumatic exposures might differ from those influencing PTSD symptomatology after the occurrence of a traumatic event, additive genetic effects on the experience of assaultive trauma correlated highly with genetic variance in PTSD symptoms (all r's > 0.70). These results suggest that liability to both trauma and PTSD symptomatology involves overlapping genetic influences. Finally, other research on this sample has shown personality variables, particularly adult and juvenile antisocial traits, to account for a significant proportion of the genetic variance in assaultive trauma (Jang et al, 2003). Like the literature on stressful life events, then, heritable personality characteristics and associated...

Perceived Stress and Social Support

Social support, perceived or tangible, represents an important resource for dealing with stressful life experiences, and so also, for appraising one's ability to cope (secondary appraisal) (Lazarus and Folkman, 1984). Framing social support as a resource encourages its interpretation as an environmental asset that promotes adaptation or ameliorates the impact of a stressor. Sources of support are not acquired fortuitously, though. They are embedded in interpersonal relationships that require effort to establish and maintain (e.g., the parents' admonition, to have a friend, be a friend), which may, in turn, depend on the heritable attributes of individuals. For instance, 59 of the variance in levels of social support indexed by one common support measure, the Interpersonal Support Evaluation List, was accounted for by genetic factors in a study of young adult MZ and DZ twins (Raynor et al, 2002). In the same investigation, participants having the least support reported a more hostile...

Summary of Gene Stress Correlation

In sum, biometric family studies document heritable variation in the likelihood of experiencing environmental stressors and do so across nearly all categories of stressors examined in this research. These associations include self-reported stressful life events (especially those that may be construed as controllable to some extent by the individual), exposure to traumatic (life-threatening) events, adverse parenting environments (particularly family conflict and absence of parental warmth), personal appraisals of recent life stress and some dimensions of perceived chronic stress, as well as resources for coping with stressors, such as confidants and engagement in social networks. The genetic variance in these environmental measures is relatively consistent across the several

Prenatal Antecedents of Allergies and Asthma

At birth others emerged as the infant monkey developed across the first year of life. For example, the infants established atypical profiles of gut bacteria, with lower concentrations of beneficial Lactobacilli and Bifidobacteria, when generated from stressed pregnancies (Bailey et al, 2004). In turn, with reduced numbers of the protective microbiota, the infants were more vulnerable to enteric pathogens like Shigella and Campylobacter, two diarrhea-causing bacteria, especially during the subsequent stressful event of weaning (Bailey and Coe, 1999).

Challenges to Fetal Wellbeing Maternal Stress

The likelihood that psychological stressors by themselves can result in premature delivery and obstetrical complications are less clear. Domestic violence, which sadly has been reported to occur in 4-8 of pregnancies, and up to 26 in some surveys, has been linked with increased morbidity, including a greater likelihood of hypertensive conditions like eclampsia and need for assisted deliveries (Cokkinides et al, 1999 Gazmararian et al, 1996 Newberger et al, 1992 Petersen et al, 1997). But the level of risk following other types of stressful events is more variable and nuanced (Hedegaard et al, 1996). For example, following an earthquake in southern California, a shortened gestation was more likely when the earthquake occurred during the first trimester, but it was less stress-inducing without deleterious consequences for women when they were further along in the pregnancy (Glynn et al, 2001). In contrast, pregnant women were found to have a slightly longer gestation if they lived or...

Childhood Socioeconomic Status

The point of departure for the model is low childhood SES. Low childhood SES has been related to exposure to a broad array of early stressful events. These include neighborhood conflict, violence exposure, noise, poor housing, exposure to pathogens, and other chronic stressors (Adler et al, 1999). Substantial research also

Chronic Negative Affect

Links between negative emotional states and health outcomes may result from chronic or recurring engagement of biological stress regulatory systems. Negative emotional states have been tied to heightened biological stress responses, including evidence of stronger autonomic response to stressful circumstances (e.g., Matthews et al, 1996) and stronger hypothalamic-pituitary-adrenocortical (HPA) responses to stress (e.g., Chorpita and Barlow, 1998 Flinn and England, 1997). Studies also suggest links between negative emotions and reduced heart rate variability (e.g., Kawachi et al, 1995), implicating potential compromises in parasympathetic functioning in these relations. Intense, chronic, or recurring biological responses to stress may, thus, represent one pathway by which a harsh early environment exerts adverse effects on adult health outcomes (McEwen, 1998 Repetti et al, 2002), effects that may be mediated, at least in part, by negative emotional states.

Impact of Early Environment on Biological Stress Responses

The neural regulation of responses to threat ultimately affects downstream biological stress regulatory systems. What are these systems During times of stress, the body releases the catecholamines epinephrine and norepinephrine with concomitant sympathetic nervous system arousal. Stress may also engage the HPA (hypothalamic-pituitary-adrenocortical) axis, involving the release of corticosteroids including cortisol. These responses have short-term protective effects under stressful circumstances, because they mobilize the body to meet the demands of pressing situations. However, with

Estrogen Deprivation Increases Risk for Depression and Medical Illness

While the most common symptoms associated with progressive ovarian failure and estrogen deprivation during the menopause transition are vasomotor (e.g., hot flushes), perimenopausal women are also at increased risk for clinical depression. While most women will not suffer from clinically significant depressive symptoms during the menopausal transition, longitudinal studies in community samples have consistently documented an increased risk for clinically significant depressive symptoms or major depressive episodes during the menopause transition, with odds ratios generally ranging from 1.3 to 4.0 (e.g., Cohen et al, 2006 Freeman et al, 2009). That the fluctuations in hormones during the menopause transition contribute to the development of depression in vulnerable women is supported by the work of Freeman (2006) who showed that greater variability in estra-diol levels, and not the estradiol levels per se, was associated with both higher depressive symptoms and diagnosed major...

Mortality and Morbidity

Nevertheless, although many behavioral factors have an impact on health in later life, the relative impact of social environment, affective state, and lifestyle behaviors on health might shift due to changes in behavioral factors during aging (as mentioned in Section 2), due to aging-related biological changes, or as a result of selective survival. There are some indications that in terms of psychological predisposition, older adults may be less vulnerable than younger adults. Although stressful life events still appear to increase the risk for adverse health outcomes in old age, the relationship between life events and health outcomes may actually be less strong in older than in younger adults. Older individuals have had the opportunity to learn how to cope with stressful circumstances and how to adjust their expectations so as to have fewer feelings of failure. On the basis of age and experience, older persons may have developed more effective skills with which to manage stressful...

Cardiovascular Measures

A variety of ambulatory heart rate monitors are now available that can be programmed either to record heart rate averaged into short epochs of 15-30 s or to complete beat by beat information. The latter is valuable, since it permits heart rate variability measures to be derived (see Chapter 47). Still more detail is provided by Holter monitors (named after their inventor) that record the complete electrocardiographic (EKG) signal these can be analyzed for EKG markers of cardiac pathology such as ST segment changes and the long Q syndrome. Recent advances have led to the development of small wireless devices that require only two or three electrodes and can therefore be worn more comfortably under clothing (e.g., Actiheart, MetriSense Inc.). An example comes from a study by Pieper and colleagues (2007) who recorded ambulatory heart rate and heart rate variability in 73 male and female teachers for 4 days, during which time participants also kept an hourly computerized diary of worry...

Sampling Framework Is Specific to the Biological Outcomes

The measurement of salivary cortisol, for example, presents a specific challenge in terms of the proper sampling interval because there is a latency ( 20 min) between the stressful event and the release of cortisol therefore, the researcher has to map out the measurement intervals carefully. Thus, a saliva sample for assessment of cortisol might be obtained 20 min after stressor offset. If the interval is mis-specified, the effect of the manipulation may be missed entirely.

Analysis Of Stress Transcriptome From Other Plant Species

None of the classical enzymes involved in antioxidant defense, including catalase, ascorbate peroxidase and superoxide dismutase showed altered transcript levels. This was explained on the basis that candidates like aldehyde dehydrogenase and metallothionins might be fulfilling the role as antioxidant defense. Another gene which has been found to be highly up-regulated is cysteine proteases which have also been reported previously to be induced under both salt and drought stress (Koizumi et al. 1993). Thellungiella halophila is a closely-related to A. thaliana. In sharp contrast with Arabidopsis, Thellungiella tolerates extreme cold, drought, and salinity (Bressan et al. 2001 Inan et al. 2004 Taji et al. 2004, Amtmann et al. 2005). It has been noted that this naturally-occurring wild plant remains always ready to handle stress by keeping, in anticipation, the levels of stress responsive transcripts higher which are otherwise induced by stress signal in A. thaliana (Amtmann et...

Long TermCare Facilities

The negative perception that society, and older adults in particular, have of nursing homes is due in part to the desire of older adults to remain with their families in familiar surroundings rather than being placed in an unfamiliar environment to be tended by strangers and await death. Accounts of unsanitary and unsafe conditions and inadequate treatment of patients by nursing home staff during the 1970s and 1980s prompted a number of investigations of the entire nursing home industry. One result of these investigations and the attendant publicity was passage of the Nursing Home Reform Act of 1987, containing a set of regulations that apply to all nursing home facilities. This legislation resulted in the gradual phasing out of the distinction between nursing homes and intermediate care facilities, and, more importantly, to a greater respect for patients' rights. Nursing home patients are now more likely to be treated as individuals who merit respect and should be permitted and...

Reactivation of Latent Herpes Viruses

It was known anecdotally for many years that stressful periods were associated with increased recurrences of latent viral infections, such as HSV-1, HSV-2, as well as VZV (Cohen et al, 1999 Schmader et al, 1990). The mechanisms leading to reactivation during stressful situations were unknown, but it was known that for latent herpes virus infections, cellular immune competence was a critical factor in controlling the primary herpes virus infections and maintaining latency (Glaser and Gottleib-Stematsky 1982). Moreover, it was recognized that when cellular immunity was decreased, the humoral antibody response to the latent virus was significantly increased (Glaser and Gottleib-Stematsky 1982). Thus, the finding that many different types of stressors, such as academic stress in medical students and the stress of caring for a family member with Alzheimer's disease, resulted in significant elevations in antibody levels to EBV suggested that cellular immunity to the

Experimental Infection and Vaccination

Immune responsiveness to microbial challenge can also be studied by administering vaccines to participants, and many studies have shown that cell-mediated and humoral immunity to vaccines can be significantly modified by psychosocial factors. This was first realized in medical students vaccinated with the recombinant hepatitis B vaccine series (Glaser et al, 1992). Approximately 21 of the students developed a protective antibody response to the vaccine after the initial exposure, with the remaining students producing a protective antibody response after the second exposure. Importantly, the 21 of the students that seroconverted 1 month after the primary exposure had lower Profile of Mood State (POMS) anxiety scores. Similarly, students with lower levels of anxiety also had stronger T lymphocyte proliferative responses to purified hepatitis B antigens (Glaser et al, 1992). This study suggested that mood could significantly change responsiveness to vaccination, with subsequent studies...

Etiology and Pathogenesis

Polymorphisms in the promoter region of the serotonin transporter gene (5-HTTLPR) may play a role in the pathogenesis and course of depression and anxiety (Hariri et al., 2003 Sen et al., 2004 Taylor et al., 2005). Geneotype has been related to hippocampal volumes (Taylor et al., 2005) and to amygdala reactivity to environmental stimuli (Hariri et al., 2005). These findings may be related to interactions between the serotonergic system and neurotrophic factors or cortisol response to stresses and may bias an individual's reactivity to stressful life experiences (Hariri et al., 2005 Taylor et al., 2005). Some studies report that genotype significantly predicts the development of depression after stressful life events (Lenze et al., 2005), although others did not find an association (Gillespie et al., 2005). Several studies have suggested that response to antidepressant therapy may be related to serotonin transporter genotype (Murphy et al., 2004). The short (S) allele was associated...

Overview of Brain Changes inMDD

The cognitive model of depression (Beck, 1961) posits that stressful life events activate cognitive vulnerability and the depressive state develops, resulting in the depressive phenotype that is characterized by increased negative emotion processing (i.e., negative bias) and impaired emotional control (e.g., emotional responses that are too intense or prolonged). Extensive behavioral evidence supports this model, revealing that depressed individuals (1) focus more on negative stimuli and less on positive stimuli (Mogg et al, 1995 Scher et al, 2005), (2) are less easily distracted from negative emotion processing (Ellenbogen et al, 2002 Lyubomirsky et al, 1998 Siegle et al, 2002 Wenzlaff and Bates, 1998), (3) show heightened stress hormone levels such as cortisol that may have deleterious effects on the brain (Sapolsky, 2000), and (4)

Psychotherapeutic procedures

The fourth phase is behavioral training. This phase consists of assertion training, communication training, stress reduction interventions and drive induction, among other things. Of particular interest is the drive induction. Patients are encouraged to go to movies with sexual content, read books with sexual content and to watch pornographic videos. They are also assigned tasks including expressions of physical affection, like hugging, kissing and patting. This kind of behavior is usually infrequent among patients suffering from low sexual desire, because they fear that the partner might interpret such behaviors as invitations to sexual activity, which they want to avoid.

Social Anxiety In Children And Adolescents

An intervention called Social Effectiveness Therapy for children (SET-C) has been developed to treat socially anxious preadolescent children (ages 8 to 12) (Beidel, Turner & Morris, 1996). It was adapted from the adult SET programme (Turner et al., 1994b) and comprises separate group social skills training and individual exposure sessions for 12 weeks. A unique aspect of this treatment is that each child is paired with a non-anxious peer helper to assist in interactions in age-appropriate social outings. Parent involvement is limited to assistance with conducting the structured interaction homework assignments. Cognitive restructuring is not a fixed component of SET-C because the authors believe that children in Piaget's concrete operational stage may not endorse catastrophic negative thoughts during socially stressful situations.

Statistical Power and Trial Design

Smaller trials with similar designs may have sufficient power to compare both active interventions to the control condition, but not to compare the active treatments to each other. This was the case, for example, in our recent trial of treatments for depression in patients with a recent history of CABG surgery. There was adequate power to compare the cognitive-behavioral and stress management interventions to the EUC control condition, but not enough to compare the interventions to each other (Freedland et al, 2009).

Psychosocial Behavioral Intervention in Hivaids

(median 10), in a group format, and used cognitive re-appraisal cognitive restructuring (N 15), coping skills training (N 14), stress management skills training (N 11), or social support (N 7). Reported effect sizes ranged from 0.30 to 1.00 for anxiety and depression. Findings varied as a function of the techniques used in the interventions, with significant effects on depression and anxiety found only in studies providing stress management and in those having at least 10 intervention sessions. Since medication adherence training (MAT) programs had been shown to be effective in improving adherence (e.g., Safren et al, 2006) we examined whether combining CBT with relaxation training (Cognitive behavior stress management CBSM) would provide added value to pharmacist-delivered MAT. In a trial with HIV-positive men who have sex with men comparing the combination of CBSM + MAT to MAT alone, an analysis utilizing all participants showed no intervention-related changes in viral load (Antoni...

Psychosocial Factors and Disease Progression

Require psychological intervention (Holland et al, 1998). Approximately 30 of oncology patients show significant levels of distress that warrant psychological treatment (e.g., Zabora et al, 2001). Such responses vary according to cancer site and stage. Patients experiencing advanced cancer in sites that show poor treatment response outcomes, such as lung, brain, and pancreas, report the greatest levels of psychological distress and need for treatment. Studying psychological responses to cancer diagnosis and treatment has received significant attention, because a growing number of studies have suggested that there is a significant association between psychosocial processes and health outcome in cancer. For example, in a recent review of 165 studies examining the contribution of psychosocial factors to cancer incidence and survival, Chida and colleagues (2008) showed that factors such as stressful life experiences, maladaptive coping styles, and depression are associated with greater...

Conclusionsthe Way Forward

To conclude, workplace stress is not going to be eliminated merely by passing legislation or having workable policies in the organisation. A thorough analysis of the sources of stress- and evidence-based stress management interventions will help to alleviate this problem in the workplace.

Psychosocial Interventions Optimizing Health Survival and Improving Quality of Life

In work targeting prostate cancer survivors about 1-year post-treatment, Penedo and colleagues (2006) adapted a CBSM intervention to be delivered among men who had been treated with radical prostatectomy or radiation therapy for localized disease. Men were randomized either into a group-based 10-week CBSM intervention that targeted areas such as coping and communication skills, social support and relaxation training, and provided health information related to prostate cancer and sexual functioning or a 1-day stress management seminar where the techniques covered in the intervention were provided in a classroom format with no group process. Findings showed that relative to men randomized to the 1-day seminar, patients in the CBSM condition showed significant improvements in QOL and benefit finding. Additionally, the acquisition of stress management skills (e.g., mobilizing social networks, ability to cognitively reframe negative stressor appraisals or engage in relaxation training)...

Project Title Cardiovascular Health Studyechocardiography

Summary The Cardiovascular Health Study is a population-based, longitudinal study of risk factors for the development and progression of coronary heart disease and stroke in adults over the age of 65 years. Both risk factors established in middle-aged population and suspected risk factors are examined and include hypercholesterolemia, hypertension, glucose intolerance and diabetes, and cigarette smoking. Since atherosclerosis is prevalent in the elderly, the study focuses on factors thought to induce clinically overt disease. It does so in two ways (1) It assesses the prediction of clinical disease from non-invasive measure of preclinical disease, such as carotid atherosclerosis, left ventricular impairment, and arrhythmias of episodes of myocardial ischemia. (2) Since cardiovascular events may occur in elderly people as a result of health or life circumstances which may have changed in the months preceding the event, the study contacts participants at frequent intervals to evaluate...

Theoretical Formulations

At its most ambitious the overall goal of therapy is to bring about a fundamental shift in coping from an essentially passive, worried, inhibited reaction to potential threat to an active, problem-solving approach in which stressful events and emotional reactions are accepted and managed. For those GAD sufferers who accept worry and tension as an unchangeable aspect of their personality and have only limited insight into the maladaptive nature of the disorder, therapists face a considerable change in bringing about active engagement with the demands of therapy. Motivational issues are frequently complicated by the presence of comorbid disorders and effective therapy is likely to depend crucially on the collaborative development of a formulation that emphasises the central role of worry and tension in maintaining the problems perceived to be most distressing. Treatment gains following CBT may, therefore, be less enduring than had been assumed from clinical trials with six- to 12-month...

Representations Create a Context for Management

So far, our focus has been on the nitty gritty of the CSM - the details involved in creating structures for performance in a specific place and time. The CSM postulates a second, executive level of strategies involved in evaluating and protecting the self-system, testing and choosing among illness representations, screening and selecting procedures for management, and selecting targets for evaluating outcomes. The model mirrors gerontological views of age-related change (Baltes and Baltes, 1990) and overlaps with psychological models focusing on properties of the self, such as self-efficacy (Bandura, 1998), coping and stress management (Carver et al, 1989 Lazarus, 1993), and procedures involved in cognitive behavioral therapy (e.g., Friedman et al, 2003). The CSM has examined, in detail, the procedures involved in global self-assessments of health (e.g., Mora et al, 2008) and the executive level coping strategies for protecting and enhancing the self, conservation of resources (i.e.,...

Psychosocial Behavioral Interventions with Acute Coronary Syndrome Patients

Several meta-analyses have examined randomized psychosocial-behavioral interventions in patients with CHD (Clark et al, 2005 Dusseldorp et al, 1999 Linden et al, 1996, 2007). Most of the studies that were analyzed compared a psychosocial-behavioral intervention with usual care. The meta-analysis by Dusseldorp and colleagues examined the effects of health education and stress management in 37 studies and found a 34 reduction in cardiovascular mortality, a 29 reduction in MI recurrence and significant positive effects for blood pressure, cholesterol, body weight, smoking, physical exercise, and eating habits. In a subsequent RCT, Jones and West (1996) randomized 2,328 post-MI patients into either an intervention condition receiving seven weekly psychological counseling and therapy, relaxation, and stress management sessions (some in a group format) or a usual care condition. Other components of rehabilitation dealing with smoking, diet, weight control, or exercise were not included in...

Gene Stress Interaction Life Events and Other Natural Stressors

The second sizable literature on gene-stress interactions derives from a widely publicized study in which childhood maltreatment and recent stressful life events predicted depression Stressful life events likewise warrant consideration as an environmental pathogen due to abundant evidence that they predict depression onset, particularly first episodes (Kendler et al, 2000 Uher and McGuffin, 2008) and, in twin research, have been found to do so in interaction with genetic liability (Kendler et al, 1995). A 30-year literature indicates that life events most germane to depression are those that occur abruptly and within 3-6 months preceding onset, that are impactful and directly affect the respondent, and that commonly involve situations of As noted previously, the sentinel study in this literature (Caspi et al, 2003) reported that both childhood maltreatment and life events predicted depression in interaction with 5-HTTLPR variation. The interval of event reporting in this study was 5...

Michael Feuerstein

As implied earlier, the field can also benefit from innovative models related to positive aspects of cancer survivorship. The chapter on a model of well-being was included as an example. State-of-the-art information regarding health behavior change (diet, activity, weight management, smoking, stress reduction) so important in optimal survivorship is also included. Consideration of prevalent symptom management of fatigue, pain, emotional distress, and relationships are also covered. Advanced cancer is not always covered in books on cancer survivorship. Chapters addressing adaptation, survivor, and provider perspectives of advanced cancer are covered to better inform research and practice in this area. Also, a chapter on survivors' view of quality care is included in the book. This is intended to give a voice to concerns that are often not heard as often as it needs to be given the exigencies of the moment. A chapter on approaches to cancer survivorship around the world was included to...

Modes of Assessment

Several interviewer and process characteristics tend to increase the quality of sexual behavior data obtained. Assessment of behavior should occur after a respondent and interviewer have established rapport and the interviewer has assured the respondent of confidentiality. Sexual history interviews should always begin with an appropriate introduction for the respondent. During this time the reasons for asking questions about sexual and other socially sensitive behaviors should be provided. For example, one might explain the purpose of the research and how it will benefit the interviewee or the larger community. It can be helpful to contextualize sexual behavior as an important health behavior, just as one might discuss smoking, exercise, or stress management strategies. If biological specimens are to be collected, these can be likened to taking blood pressure or collecting serum for cholesterol levels (i.e., frame the assessment as

Selfreport

Distress (Schwarz and Kowalski, 1992) or they fail to perceive that some symptoms are related to a stressful event (Solomon and Canino, 1990). This situation points to the simplicity of decision rules that employ dichotomous categories or cut-off scores because there may be numerous reasons why an individual may report a symptom in a particular way (Rogers, 1997b). Until there is a substantive increase in cross-validation studies, there is little evidence to guide interpretation of reporting patterns and one should be careful about placing excessive emphasis on detection strategies based on single studies.

Hsps As Biomarkers

The significance of anti-HSP in the body is unclear, though, like the proteins themselves, anti-HSP levels are affected by disease (Chiba et al., 2006 Child et al., 2006 Pockley et al., 2000 Schett et al., 1995 Wright et al., 2000a Xu et al., 1993). Like HSP, anti-HSP also have the potential for use as clinical markers. We recently published findings of increased anti-Hsp72 antibodies in pregnant women who gave birth to babies with birth defects, suggesting a prior increase in Hsp72 due to a stressful event (Child et al., 2006). Hsp72 may have buffering roles in evolution as shown for Hsp90 (Queitsch et al., 2002) and this may be a mechanism whereby stress in pregnancy exposes undesirable phenotypes due to Hsp72 being relocated in response to stress (Child et al., 2006).

Interventions

Bishop et al (2005) conducted a randomized clinical trial in 58 male patients who had undergone coronary bypass surgery in which patients were randomized to either a six-session cognitive-behavioral stress-coping skills intervention using the Williams LifeSkills Workshop (Williams and Williams, 1998) or a 1-h lecture on stress and the heart with tips on how to manage stress better. It is important to note that there were no selection criteria for this study -all patients were eligible and asked to participate in a study to determine whether stress coping skills training (in short or long formats) helps patients do better after coronary bypass surgery. Compared to those receiving only the 1-h lecture on stress, the patients randomized to the LifeSkills workshop showed significantly larger improvements in trait anger, depression, satisfaction with social support, satisfaction with life, resting systolic blood pressure and heart rate, as well as systolic blood pressure and heart rate...

Exercise

It is a well-known fact that regular exercise can reduce the severity of system disorders (Hill, Storandt, & Malley, 1993). Oxygen consumption, ventilation capacity, cardiac output, blood flow, muscle tonus, muscle strength, and the flexibility of the joints can all be increased by exercises such as walking, swimming, calisthenics, jogging, and other moderate aerobic exercises (Blumentahl et al., 1991). Exercise also results in reduced body fats, poisons, blood pressure, the response times of body cells and organs, and nervous tension. Regular physical exercise also enhances one's sense of well-being, feelings of self-efficacy and control, the ability to cope with psychologically stressful situations, and general psychological health (King, Taylor, Haskell, & DeBusk, 1989). It can also have beneficial effects on depression,

Biological Pathways

A major thrust of research efforts in recent decades has been the identification of biological mechanisms which may explain observed links between social support and physical health outcomes, including cardiovascular, endocrine, and immune pathways, which play a role in disease and disability. An impressive body of evidence is accumulating that greater social support is associated with more positive profiles of physiological functioning, as well as more positive patterns of physiological reactivity to stressor experience (see Uchino, 2006 Uchino et al, 1996). Consistent with a focus on cardiovascular health outcomes in the social support literature, the majority of studies examining physiological correlates of social support have examined indicators of cardiovascular functioning. In a comprehensive review, Uchino and colleagues (1996) documented that structural and functional social relationship measures show similar associations with indicators of cardiovascular functioning,...

Study design

Epidemiological studies, the only notable concern is the timing of the approach to the case, which requires a balance between imposing on subjects at the stressful time of diagnosis, with the concern that case mortality or extreme morbidity may impact on the representativeness of the cases included in the study.

Depression

Patients with malignant gliomas often develop progressive neurobehavioral deficits caused by the disease itself as well as treatments such as radiation and chemotherapy (19). Depression in brain tumor patients can be related to the stress of the diagnosis, treatment, loss of function, or medications. Almost all patients faced with a potentially terminal diagnosis will experience, at minimum, temporary grief and anxiety. Patients may benefit from counseling, psychotherapy, or medication. Some patients may resist but studies have shown that patients have an improvement in overall QOL when emotional distress is treated. One recent study showed that patients wanted and expected more support than they were receiving, especially psychological support. They wanted someone to talk to them and spend more time with them (21). A combination of drugs is often necessary and should not be withheld but neither should they replace compassionate care (22). Stress reduction is essential. Cautious use...

Shelley ETaylor

Both animal and human research conclusively documents that warm, nurturant contact early in life exerts permanent beneficial effects on the functioning of biological stress regulatory systems and on socioemotional skills that affect responses to stress across the life span (Francis et al, 1999 Liu et al, 1997 Repetti et al, 2002, 2007). When this contact is lacking, both biological stress regulatory systems and behavioral skills for managing stress are compromised. Adverse downstream consequences include problems in emotion regulation, social skills deficits, poor health habits, and exacerbation of biological stress responses prognostic for poor mental and physical health.

Emotion Regulation

Emotionally charged circumstances, understanding of emotions, and abilities to regulate their emotions (Repetti et al, 2002). Offspring from harsh family environments may overreact to threatening circumstances, responding aggressively to situations that are only modestly stressful (Reid and Crisafulli, 1990), but may also tune out or avoid stressful circumstances, as through behavioral escape avoidance or substance abuse (Johnson and Pandina, 1991 O'Brien et al, 1991 Valentiner et al, 1994). Deficits in emotion regulation skills related to early family environment may appear in early childhood and compromise the development and use of socioemotional skills in adulthood (Repetti et al, 2002).

Unsettled Questions

Psychosocial Equated to the presence of depressive symptoms de Jonge wrote that ''Subjects experiencing depressive symptoms before the onset of a somatic event may have fewer resources to deal with a stressful event Depressive symptoms reported before by elderly people may thus signal psychosocial frailty'' (de Jonge et al., 2004) Katz elaborated upon this and stated that ''(late-life) depression is a state associated with cognitive dysfunctions that interfere with coping, adaptation, and resilience'' (Katz, 2004).

Course

Trauma may lead to worsening, but in a detailed controlled study no significant associations were found between any form of trauma and an increased frequency of attacks (200). Similarly, surgery and anesthesia do not appear to aggravate the condition, despite earlier suggestions to the contrary (199,201). A recent review by a committee of the American Academy of Neurology concluded that physical trauma was not associated with MS exacerbation (202). However, the group found that evidence about the relationship to psychological stress was inconclusive. In a recent meta-analysis of 14 studies, Mohr et al. (203) did find a significant increase in the risk of exacerbations after stressful life events. However, they were not able to identify specific stressors.

Hypertension

The impact of antihypertensive medication on coronary heart disease has been less than expected, however, most likely because of the influence of adverse side effects and poor compliance. There has led to renewed interest in the non-pharmacological management of hypertension, with the aim of reducing stress by focusing on cognitive and behavioural stress coping strategies and reducing sympathetic arousal. Psychological interventions to date have tended to focus on either one or a combination of biofeedback, relaxation and stress-management techniques. An early meta-analysis purporting to assess the efficacy of cognitive behavioural techniques for hypertension included biofeedback, meditation and relaxation as forms of CB therapies, concluding that there was a lack of support for such interventions (Eisenberg et al., 1993). However, Linden and colleagues have suggested that there is such a varied interpretation of the term 'stress management', ranging from transcendental meditation to...

Massage Therapy

Massage therapy involves the use of a therapist's hands and sometimes elbows and knees or in some cases hand-held wooden thumbs or rocks along with special ointments and aromas that are directly applied to the body's muscles and soft tissues (5). Its origins date back to over 4000 years as a form of TCM therapy to promote health and prevent disease. It is also a primary treatment in the Ayurvedic system. Similar to acupuncture theory, the direct manipulation of the body tissues is thought to activate the immune system, clear waste products from the lymphatic system, increase endorphin production, and restore chi flow. Though massage therapy is not a proven therapy specifically for PD, the potential benefits often reported include stress reduction, emotional calmness, reduced muscle stiffness and associated pain, along with increased range of motion of the limbs, neck, and trunk and increased energy levels. These benefits are often immediate and relatively short lasting thus, similar...

Ayurvedic Medicine

Ayurvedic medicine is the traditional medical system in India, which has existed for over 5000 years. The term Ayurveda literally means science of life or life knowledge. PD is documented to have existed in ancient India and was called Kampavata. Similar to the TCM system, physical illness is thought to result from emotional imbalance, unhealthy lifestyle, and toxins that ultimately upset the balance of the three doshas or regulatory systems of a person (5). These three doshas are vata, which symbolizes physical movement, pitta, which represents heat, metabolism, and energy, and kapha, which stands for physical structure and balance. Although all three systems may be affected in PD, therapy focuses heavily upon treatment of the vata disturbance through oleation with massage along with enemas and ingestion of oils. Proper harmony of the three doshas is achieved by specific diet and nutrition, a number of herbs, meditation, breathing exercises, massage, and yoga poses. Stress reduction...

When Stress Is Over Your Head

When Stress Is Over Your Head

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