•While oxytocin showed similar patterns,cortisol levels showed different patterns of change during stress than during arousal.•Greater cortisol stress reactivity predicted higher oxytocin levels ...after the stressor.•Greater oxytocin arousal reactivity predicted attenuated post-arousal reductions in cortisol.•Individual differences in women’s reactivity to sexual arousal did not predict their reactivity to psychological stress.
Previous research suggests a dynamic regulatory relationship between oxytocin and cortisol, but the specific nature of this relationship and its context-specificity have not been fully specified. In the present study, we repeatedly assessed both salivary oxytocin and salivary cortisol during two experimental sessions (one inducing sexual arousal and one inducing psychological stress), conducted two weeks apart with the same group of 63 female participants. Baseline cortisol and baseline oxytocin were significantly correlated in both sessions. Cortisol levels showed significantly different patterns of change during the stress assessment than during the sexual arousal assessment, but oxytocin showed similar patterns of change across both assessments. Greater cortisol stress reactivity predicted higher oxytocin levels immediately after the stressor, but a different pattern emerged during the arousal assessment: Greater oxytocin arousal reactivity predicted attenuated post-arousal reductions in cortisol. For both cortisol and oxytocin, individual differences in women’s reactivity to sexual arousal did not predict their reactivity to psychological stress. These findings contribute new insights regarding associations between cortisol and oxytocin reactivity and recovery in different psychological contexts.
Life history theory and the adaptive calibration model state that characteristics of one’s early environment influence individual differences in both neuroendocrine reactivity to stress and sexual ...risk-taking behavior. However, few studies have directly examined the relationship between neuroendocrine reactivity to stress and risky sexual behavior. This study used multilevel modeling to test whether cortisol reactivity and recovery in response to laboratory stress were associated with women’s history of sexual behavior and their sexual arousability in response to laboratory sexual stimuli. Participants were 65 women (35% heterosexual, 44% bisexual, and 21% lesbian) who completed two laboratory sessions, two weeks apart. Women’s self-reported sexual arousability to sexual stimuli interacted with their sexual abuse history to predict their trajectories of cortisol stress reactivity and recovery. Cortisol reactivity and recovery were not associated with women’s sexual risk taking, such as the age of sexual debut, sociosexuality, or lifetime number of sexual partners.
Abstract Objective Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind–body interventions may be ...beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind–body intervention, mind–body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans. Methods This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions were conducted in two sessions, once per week. Patient-reported outcomes included the following: primary—Medical Outcomes Study (MOS) Sleep Survey, MOS Short Form-36V; secondary—Center for Epidemiological Studies–Depression, PTSD Check List–Military, Five-Factor Mindfulness Questionnaire. Results At both Week 1 (1 week after the first session) and post-intervention assessments, while sleep disturbance decreased in both groups, MBB performed significantly better than did the control group. Furthermore, self-reported PTSD symptoms improved in MBB, while they remained unchanged in the control. Overall mindfulness increased in MBB, while it remained unchanged in the control. Conclusions This study provides preliminary evidence that a brief sleep-focused MBB could be a promising intervention for sleep and potentially other comorbid symptoms (e.g., PTSD). MBB could help patients develop awareness skills to deal with sleep-related symptoms. Integration of MBB into primary care settings may enhance care of patients with sleep disturbance and co-morbid symptoms.
This document reports the consensus of an interdisciplinary panel of research and clinical experts charged with reviewing the use of opioids for chronic noncancer pain (CNCP) and formulating ...guidelines for future research. Prescribing opioids for chronic noncancer pain has recently escalated in the United States. Contrasting with increasing opioid use are: 1) The lack of evidence supporting long-term effectiveness; 2) Escalating misuse of prescription opioids including abuse and diversion; and 3) Uncertainty about the incidence and clinical salience of multiple, poorly characterized adverse drug events (ADEs) including endocrine dysfunction, immunosuppression and infectious disease, opioid-induced hyperalgesia and xerostomia, overdose, falls and fractures, and psychosocial complications. Chief among the limitations of current evidence are: 1) Sparse evidence on long-term opioid effectiveness in chronic pain patients due to the short-term time frame of clinical trials; 2) Insufficiently comprehensive outcome assessment; and 3) Incomplete identification and quantification of ADEs. The panel called for a strategic interdisciplinary approach to the problem domain in which basic scientists and clinicians cooperate to resolve urgent issues and generate a comprehensive evidence base. It offered 4 recommendations in 3 areas: 1) A research strategy for studying the effectiveness of long-term opioid pharmacotherapy; 2) Improvements in evidence-generation methodology; and 3) Potential research topics for generating new evidence.
Prescribing opioids for CNCP has outpaced the growth of scientific evidence bearing on the benefits and harms of these interventions. The need for a strong evidence base is urgent. This guideline offers a strategic approach to creating a comprehensive evidence base to guide safe and effective management of CNCP.
Summary Objective The main aim of this exploratory study was to assess whether salivary α-amylase (sAA) and salivary cortisol levels would be positively modulated by sleep-focused mind–body ...interventions in female and male cancer survivors. Methods We conducted a randomized controlled trial in which 57 cancer survivors with self-reported sleep disturbance received either a Sleep Hygiene Education (SHE; n = 18) control, or one of two experimental mind–body interventions, namely, Mind–Body Bridging (MBB; n = 19) or Mindfulness Meditation (MM; n = 20). Interventions were three sessions each conducted once per week for three consecutive weeks. Saliva cortisol and sAA were measured at baseline and 1 week after the last session. Participants also completed a sleep scale at the same time points when saliva was collected for biomarker measurement. Results Our study revealed that at post-intervention assessment, mean sAA levels upon awakening (“Waking” sample) declined in MBB compared with that of SHE. Mean Waking cortisol levels did not differ among treatment groups but declined slightly in SHE. Self-reported sleep improved across the three interventions at Post-assessment, with largest improvements in the MBB intervention. Conclusion In this exploratory study, sleep focused mind–body intervention (MBB) attenuated Waking sAA levels, suggesting positive influences of a mind–body intervention on sympathetic activity in cancer survivors with sleep disturbance.
Purpose
After completing treatment, cancer survivors may suffer from a multitude of physical and mental health impairments, resulting in compromised quality of life. This exploratory study ...investigated whether two mind–body interventions, i.e., Mind–Body Bridging (MBB) and Mindfulness Meditation (MM), could improve posttreatment cancer survivors’ self-reported sleep disturbance and comorbid symptoms, as compared to sleep hygiene education (SHE) as an active control.
Methods
This randomized controlled trial examined 57 cancer survivors with clinically significant self-reported sleep disturbance, randomly assigned to receive MBB, MM, or SHE. All interventions were conducted in three sessions, once per week. Patient-reported outcomes were assessed via the Medical Outcomes Study Sleep Scale and other indicators of psychosocial functioning relevant to quality of life, stress, depression, mindfulness, self-compassion, and well-being.
Results
Mixed effects model analysis revealed that mean sleep disturbance symptoms in the MBB (
p
= .0029) and MM (
p
= .0499) groups were lower than in the SHE group, indicating that both mind–body interventions improved sleep. In addition, compared with the SHE group, the MBB group showed reductions in self-reported depression symptoms (
p
= .040) and improvements in overall levels of mindfulness (
p
= .018), self-compassion (
p
= .028), and well-being (
p
= .019) at postintervention.
Conclusions
This study provides preliminary evidence that brief sleep-focused MBB and MM are promising interventions for sleep disturbance in cancer survivors. Integrating MBB or MM into posttreatment supportive plans should enhance care of cancer survivors with sleep disturbance. Because MBB produced additional secondary benefits, MBB may serve as a promising multipurpose intervention for posttreatment cancer survivors suffering from sleep disturbance and other comorbid symptoms.
Implications for Cancer Survivors
Two brief sleep-focused mind–body interventions investigated in the study were effective in reducing sleep disturbance and one of them further improved other psychosocial aspects of the cancer survivors’ life. Management of sleep problems in survivors is a high priority issue that demands more attention in cancer survivorship.
Built environments can induce contemplative states, but direct evidence for their impact on the brain is lacking. This exploratory work investigated brain correlates of internal states elicited by ...architecture designed for contemplative experience. Functional MRI and self-reports of 12 architects were assessed to study their responses to photographs of ordinary and contemplative architectures. Images of contemplative buildings： （1） induced attentive, receptive, and absorbing experiences and diminished internal dialogue; （2） involved decreased engagement of prefrontal cortex; and （3） activated the occipital lobe, precentra gyrus, and inferior parietal lobule. They suggest that viewing buildings designed for contemplation may evoke experiential and brain signatures that consistently differ from those induced by buildings that serve everyday functions. The depth of such externally induced states was inversely correlated with the engagement of the Default Mode Network. Our study points toward a novel avenue for investigating how contemplation can be cultivated in the human brain/mind.
Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems ...and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated (a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and (b) the effects of 2 sleep-focused mind–body interventions, mind–body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months’ duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self-compassion were observed in the MBB group compared with those in SHE. The findings in this exploratory study suggest that sOT may be a reliable biological measure over time that may provide insight into the effects of mind–body interventions on health outcomes in cancer survivors.
Dynamic Reflexivity in Action Cheek, Julianne; Lipschitz, David L.; Abrams, Elizabeth M. ...
Qualitative health research,
06/2015, Letnik:
25, Številka:
6
Journal Article
Recenzirano
Dynamic reflexivity is central to enabling flexible and emergent qualitatively driven inductive mixed-method and multiple methods research designs. Yet too often, such reflexivity, and how it is used ...at various points of a study, is absent when we write our research reports. Instead, reports of mixed-method and multiple methods research focus on what was done rather than how it came to be done. This article seeks to redress this absence of emphasis on the reflexive thinking underpinning the way that mixed- and multiple methods, qualitatively driven research approaches are thought about and subsequently used throughout a project. Using Morse’s notion of an armchair walkthrough, we excavate and explore the layers of decisions we made about how, and why, to use qualitatively driven mixed-method and multiple methods research in a study of mindfulness training (MT) in schoolchildren.
In contemporary education, there is increasing interest in the potential of mindfulness-based training to improve mental health, behavior, and school performance, as part of fostering contemplative ...pedagogy that can positively impact the lives of young children. However, practice-based knowledge is lacking about how to implement mindfulness-based training effectively at schools. Thus, the key question motivating our study was how we can create school-based educational programs that cultivate mindfulness in young people. The study, a retrospective, qualitative analysis of 188 letters written by 112 elementary students who participated in a classroom-based mindfulness-based training curriculum in the mid-1990s, provided an unique opportunity for gaining important insights into ways in which the students viewed the mindfulness-based training curriculum, themselves, and each other when undertaking that training. Applying the principles of qualitative analysis, each letter was coded, and codes were constantly compared, and from this five thematic categories emerged about central aspects of the process and implementation of that mindfulness-based training. They were: (1) Importance of a sense of place; (2) We are more of a community; (3) Actively taking it on; (4) How I relate to others; and (5) Getting in touch with the inner self. A key finding is that the mindfulness-based training program was a sustained process facilitating the cultivation of a range of students’ skillsets, and not simply reduced to attentional techniques acquired in a finite time slot in an otherwise unchanging classroom. This finding has important implications for the way mindfulness-based training is conceptualized and implemented in contemporary school settings.
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