Biofeedback is a form of treatment that has no adverse effects and can be provided by physician extenders. The therapy relies on patients' ability to learn how to influence their bodily functions through dedicated machinery and teaching. This Review provides a comprehensive overview of all potential therapeutic applications of biofeedback for functional constipation, fecal incontinence, functional anorectal pain, IBS, functional dyspepsia, and aerophagia. Practical clinical applications of biofeedback therapy supported by randomized, controlled trials (RCTs) are limited to fecal incontinence and dyssynergic defecation. For fecal incontinence, RCTs suggest that biofeedback combining strength training and sensory discrimination training is effective in approximately 75% of patients and is more effective than placebo. However, verbal feedback provided by a therapist during extended digital examination may be equally effective, and children whose fecal incontinence is associated with constipation plus fecal impaction do no better with biofeedback than medical management. For dyssynergic defecation, RCTs show that biofeedback combining pelvic floor muscle relaxation training, practice in defecating a water-filled balloon, and instruction in effective straining is effective in approximately 70% of patients who have failed to respond to laxative treatment. For both incontinence and dyssynergic defecation, the benefits of biofeedback last at least 12 months.

Chiarioni G, Whitehead WE. Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7080, USA. Nat Clin Pract Gastroenterol Hepatol. 2008 Jul;5(7):371-82.

BACKGROUND: The invocation Namu Amida Butsu (Nembutsu), voices the hope of rebirth into Amida's Pure Land. In the Nembutsu, Buddhists imagine that they are absorbed into Amida's Pure Land. Shiritori, a Japanese word chain game, is a common task used to activate language related regions in Japanese. The purpose of this study was to identify the regions activated during praying of the Namo Amida Butsu (Nembutsu), and the reciting of Buddhist scriptures (Sutra). MATERIAL and METHOD: Functional MRI (fMRI) was used to identify the regions activated by the Nenbutsu, the Sutra and the Shiritori in eight highlytrained Japanese monks. RESULTS: The task of repeating the Nenbutsu activates the medial frontal gyrus, which is mainly related to mental concentration and visuospatial attention, similar to the areas activated by meditation. The task of reciting the Sutra activates the left lateral middle frontal gyrus, the right angular gyrus, and the right supramarginal gyrus, which are related to visuospatial attention also involved in the area activated by meditation. CONCLUSION: These results suggest that different types of meditation in Japanese Buddhism showed different brain regional activation. The Nenbutsu activated the prefrontal cortex, and the Sutra activated the left dorsolateral prefrontal cortex and right parietal cortex.

Shimomura T, Fujiki M, Akiyoshi J, Yoshida T, Tabata M, Kabasawa H, Kobayashi H. Dept. of Neurosurgery, Oita University Faculty of Medicine, Oita, 879-5593, Japan. Turk Neurosurg. 2008 Apr;18(2):134-41.

BACKGROUND: Despite the fact that the assumption of a relationship between self-mutilation and dissociative disorders (DD) has a long history, there is little empirical evidence to support this premise. The present study examined this relationship and investigated whether this commonality is associated with innate hypnotic capacity. METHODS: Fifty patients diagnosed with DD and 50 control subjects with major depression were assessed by using a self-mutilation questionnaire, Dissociative Experiences Scale, Traumatic Experiences Checklist, and the Eye-Roll Sign for their self-mutilating behaviors, dissociative symptoms, early trauma, and innate hypnotic capacity, respectively. RESULTS: We have found that 82% of the present sample of patients with DD injured themselves. They had higher scores on trauma, dissociation and eye-roll measurements than controls. In addition, DD patients with self-mutilation were more likely to have high scores of trauma, dissociation and eye-roll than those without self-mutilation. Innate hypnotic capacity was a strong predictor of self-mutilating behavior in DD patients. CONCLUSIONS: This study strongly supports the assumption that patients with DD are at high risk for self-mutilating behavior and points to the necessity of routine screening for self-mutilating behavior as well as the hypnotic capacity which may constitute a high risk for self-injury in this patient group.

Isr J Psychiatry Relat Sci. 2008;45(1):39-48. Ebrinc S, Semiz UB, Basoglu C, Cetin M, Agargun MY, Algul A, Ates A. GATA Haydarpasa Training Hospital, Department of Psychiatry, Istanbul, Turkey.

Michael Ellner is the President of one of the world's largest not-for-profit Alternative Health Information Networks (HEAL -- Health Education AIDS Liaison-NYC).

He was an active member of The National Institutes of Health (NIH)Complimentary Therapies Working Group (1989-1992).

His honors include "Educator of the Year" from the National Guild of Hypnotists (1995) and the National Federation of NeuroLinguistic Psychologists (1997). Induction into the National Guild of Hypnotists (2006) Order of the Braid Council.

He is a Diplomat of the International Medical & Dental Hypnotherapy Association.

For more information visit: www.Elner.info

Health professionals' beliefs and attitudes toward hypnosis may make them reluctant to use it or even to foster misapplications and iatrogenic uses of hypnosis. The Valencia Scale on Attitudes and Beliefs toward Hypnosis-Therapist version (VSABH-T) is a specific instrument to evaluate therapists' attitudes and beliefs. The aims of this study are to evaluate the 8-factor structure of the VSABH-T proposed from a confirmatory perspective. The sample comprised 1,661 licensed psychologists who are members of the Spanish Psychological Association for the initial test and 787 for the retest. Results confirmed the 8-factor structure obtained in a previous exploratory study, namely: Fear, Memory, Help, Control, Collaboration, Interest, Magic, and Marginal. The scale also showed adequate psychometric properties, including good internal consistency and test-retest reliability.

Int J Clin Exp Hypn. 2008 Jul;56(3):281-94. Capafons A, Espejo B, Mendoza ME. University of Valencia, Spain. antonio.capafons@uv.es

This article adopts a holistic view of Alzheimer's disease. Biomedical, psychological and social aspects of the condition are discussed, and aetiology, epidemiology, diagnosis and treatment explored. A range of approaches to working with people with Alzheimer's disease, based on a psychological model of dementia, is described including reminiscence and cognitive stimulation therapy.

McCabe L. University of Stirling, Stirling. l.f.m.mccabe@stir.ac.uk Nurs Stand. 2008 Jun 25-Jul 1;22(42):50-6; quiz 58.

A randomized controlled trial compared a group of bulimic patients receiving 6 weeks of individual guided imagery therapy with a control group receiving standard care. Fifty participants who met the criteria for bulimia nervosa completed the study. Measures of eating disorder symptoms, psychological functioning and the response to the guided imagery experience were used. The guided imagery treatment substantially reduced bingeing and purging episodes; the imagery group had a 74% mean reduction of bingeing and a 73% reduction of vomiting. The imagery treatment also demonstrated improvement in attitudes about eating, dieting and body weight in comparison to the control group. In addition, the guided imagery group demonstrated improvement on psychological measures of aloneness and the ability for self-comforting. The study concludes that guided imagery is an effective treatment for bulimia nervosa, at least in the short-term.

Neurofeedback of functional magnetic resonance imaging (fMRI) can be used to acquire selective control over activation in circumscribed brain areas, potentially inducing behavioral changes, depending on the functional role of the targeted cortical sites. In the present study, we used fMRI-neurofeedback to train subjects to enhance regional activation in the right inferior frontal gyrus (IFG) to influence speech processing and to modulate language-related performance. Seven subjects underwent real-time fMRI-neurofeedback training and succeeded in achieving voluntary regulation of their right Brodmann's area (BA) 45. To examine short-term behavioral impact, two linguistic tasks were carried out immediately before and after the training. A significant improvement of accuracy was observed for the identification of emotional prosodic intonations but not for syntactic processing. This evidence supports a role for the right IFG in the processing of emotional information and evaluation of affective salience. The present study confirms the efficacy of fMRI-biofeedback for noninvasive self-regulation of circumscribed brain activity. Hum Brain Mapp, 2008. (c) 2008 Wiley-Liss, Inc.

Rota G, Sitaram R, Veit R, Erb M, Weiskopf N, Dogil G, Birbaumer N. Institute for Natural Language Processing, University of Stuttgart, Stuttgart, Germany. Hum Brain Mapp. 2008 Jul 25.

BACKGROUND: The literature supporting the use of music therapy in palliative care is growing. However, the number of quantitative research studies investigating the use of music therapy in palliative care, and specifically anxiety, is limited. OBJECTIVE: The aim of this research project was to examine the effectiveness of a single music therapy session in reducing anxiety for terminally ill patients. DESIGN: A randomized-controlled design was implemented and the following hypotheses tested. There will be a significant difference between the experimental and control groups on anxiety levels as demonstrated by the anxiety measurement of the Edmonton Symptom Assessment System (ESAS), and heart rate. The experimental group received a single music therapy intervention and the control group received a volunteer visit. SETTING/SUBJECTS: Twenty-five participants with end-stage terminal disease receiving inpatient hospice services were recruited. RESULTS: The first hypothesis was supported. Results demonstrated a significant reduction in anxiety for the experimental group on the anxiety measurement of the ESAS (p = 0.005). A post hoc analysis found significant reductions in other measurements on the ESAS in the experimental group, specifically pain (p = 0.019), tiredness (p = 0.024) and drowsiness (p = 0.018). The second hypothesis was not supported. CONCLUSIONS: The study supports the use of music therapy to manage anxiety in terminally ill patients. Further studies are required to examine the effect of music therapy over a longer time period, as well as addressing other symptom issues.

Horne-Thompson A, Grocke D. Calvary Health Care Bethlehem, Melbourne, Victoria, Australia. thompson_anne@optusnet.com.au J Palliat Med. 2008 May;11(4):582-90.

It is a tenet of cognitive behavioral treatment of persistent pain problems that ex-patients should adhere to treatment methods over the longer term, in order to maintain and to extend treatment gains. However, no research has quantified the causal influence of adherence on short-term outcome in this field. The aims of this study are to assess determinants of adherence to treatment recommendations in several domains, and to examine the extent to which cognitive and behavioral adherence predicts better outcome of cognitive behavioral treatment for persistent pain. Longitudinal data from a sample of 2345 persistent pain patients who attended a multicomponent treatment programme were subjected to structural equation modeling. Adherence emerged as a mediating factor linking post-treatment and follow-up treatment outcome, but contributed only 3% unique variance to follow-up outcomes. Combined end-of-treatment outcomes and adherence factors accounted for 72% of the variance in outcome at one-month follow-up. Notwithstanding shortcomings in the measurement of adherence, these findings question the emphasis normally given to adherence in the maintenance of behavioral and cognitive change, and clinical implications are discussed.

Curran C, Williams AC, Potts HW. Research Department of Clinical, Education and Health Psychology, University College London, Gower Street, London WC1E 6BT, United Kingdom. Eur J Pain. 2008 Jul 22.

Attention to internal body sensations is practiced in most meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundalini) to an age- and body mass index-matched group of nonmeditators. Contrary to our prediction, we found no evidence that meditators were superior to nonmeditators in the heartbeat detection task, across several sessions and respiratory modulation conditions. Compared to nonmeditators, however, meditators consistently rated their interoceptive performance as superior and the difficulty of the task as easier. These results provide evidence against the notion that practicing attention to internal body sensations, a core feature of meditation, enhances the ability to sense the heartbeat at rest.

Khalsa SS, Rudrauf D, Damasio AR, Davidson RJ, Lutz A, Tranel D. Neuroscience Graduate Program, Department of Neurology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. sahib-khalsa@uiowa.edu Psychophysiology. 2008 Jul;45(4):671-7.

Carol Look's specialty is inspiring clients to attract abundance into their lives by using EFT to clear limiting beliefs, release resistance and build their "prosperity consciousness." Before becoming trained in numerous Energy Psychology methods such as Thought Field Therapy (TFT), Emotional Freedom Techniques (EFT) and the Tapas Acupressure Technique (TAT), Carol was trained as a Clinical Social Worker and earned her Doctoral Degree in Clinical Hypnotherapy. She was among the first group of practitioners in the world to be certified by EFT founder Gary Craig as an EFT Master.

Carol worked as an addictions specialist for eight years at Freedom Institute, an out-patient substance abuse facility in New York City. Since 1991, she has been a team member of Touchstone, an organization that teaches people how to improve interpersonal communication skills. Dr. Look currently maintains a private practice in New York City. In addition to teaching approved Level 1 and Level 2 EFT classes, Carol leads EFT workshops around the country on the topics of Attracting Abundance, Anxiety Relief, Clearing Addictions, and Weight Loss. She has been invited to teach EFT classes for organizations such as the National Guild of Hypnotists (NGH), the Association of Comprehensive Energy Psychology (ACEP), the National Institute for the Clinical Application of Behavioral Medicine (NICABM), the Toronto Energy Psychology Conference (Toronto-EPC) and the Center for Spirituality and Psychotherapy (CSP).

For more information visit: www.CarolLook.com

Previous studies have shown that suggesting childhood events can influence current self-reported attitudes towards future behavior. This study shows that suggesting a false past event (i.e. becoming sick on a specific food during childhood) can modify present behavior (i.e. reduce eating of the food). Participants screened to be normal eaters received or did not receive a suggestion that they likely became sick on spoiled peach yogurt as a child. One week later they took part in an allegedly separate marketing taste-test study, during which they rated preferences for a variety of crackers and yogurts. After completing ratings, participants were invited to freely eat the remaining food while completing questionnaires. Results revealed that the participants receiving the suggestion expressed lower preference specifically for peach yogurt, and ate less yogurt of all the types, while not differing in eating of crackers. These results demonstrate that suggesting false past events influences subsequent behavior.

Acta Psychol (Amst). 2008 Jun;128(2):304-9. Epub 2008 Apr 15. Scoboria A, Mazzoni G, Jarry JL. University of Windsor, Department of Psychology, Windsor, Ontario, Canada. scoboria@uwindsor.ca

The hematopoietic stem cell transplant (HSCT) experience is emotionally and physically stressful for cancer patients who undergo this procedure. Mindfulness-based interventions have been studied in patients with various diagnoses, including cancer, although minimal work has applied this intervention to hospitalized patients. Use of mindfulness meditation has potential to provide HSCT patients with coping skills to deal with unpleasant symptoms and an uncertain future. This exploratory study examined feasibility, physiological arousal, and psychological and physical symptoms in HSCT patients participating in a mindfulness meditation intervention that begins before and continues throughout hospitalization and involves one-on-one guided sessions and daily practice using a 17-minute meditation CD. Of the 20 participants, 78.9% completed the intervention. Statistically significant decreases in heart and respiratory rates and improvements in symptoms immediately before and after each session were found. These findings demonstrate feasibility and preliminary support of a mindfulness meditation intervention with symptomatic, hospitalized cancer patients.

Bauer-Wu S, Sullivan AM, Rosenbaum E, Ott MJ, Powell M, McLoughlin M, Healey MW. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA. sbauerw@emory.edu Integr Cancer Ther. 2008 Jun;7(2):62-9.

Bill O'Connell teaches hypnosis to students all over the world through his powerful audio and video home study courses. Many students have written thanking Bill for making the learning process easy and fun. In addition to his private practice in St. Charles, IL, Bill is the founder and president of Hypnosis Secrets, Inc.

Approximately half of patients with sleep-disordered breathing (SDB) also experience insomnia. The relationship between these two common sleep disorders is complex and unclear but patients with both SDB and insomnia have poorer sleep quality and are more likely to have psychiatric disorders than those with SDB alone. SDB is more common in men than women; however, the incidence of comorbid insomnia is greater in women with SDB than in men. The management of comorbid SDB and insomnia involves the screening of patients with insomnia or psychiatric disorders for SDB; although interviews may be effective in diagnosing SDB in patients with insomnia, polysomnography can diagnose veiled SDB. To address comorbid SDB and insomnia therapies should be aimed at both disorders. Patients should first be encouraged to improve their sleep hygiene and make lifestyle changes to improve sleep. Treatments for SDB include continuous positive airway pressure and oral appliances, while upper airway surgery may improve sleep outcomes in some patients. The use of pharmacological drugs such as hypnotics for the treatment of insomnia in patients with SDB remains controversial.

Sleep Med. 2007 Dec;8 Suppl 4:S21-5. Lavie P. Lloyd Rigler Sleep Apnea Research Laboratory, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. plavie@tx.technion.ac.il

In the practice of music therapy, the use of the sounds of a live naturally singing voice appears to be the most effective; in some cases, results are obtained whereas there are no results using musical sounds, and generally results are obtained in a much shorter time. Sounds and singing in just intonation are particularly efficient. This practice introduces to a deep understanding of sound therapy. Sketched here are the vocal soundbody relationship and the vocal sound consciousness relationship, which are relevant in this therapy. Finally clinical examples are given (coma states, loss of speech, old persons, states close to death, mind handicapped persons, depression, etc.). Bibliography I. Reznikoff: On Primitive Elements of Musical Meaning, www.musicandmeaning.net, Journal of Music and Meaning 3 (Invited papers), 2005.

Reznikoff I. Université de Paris X, Département de Philosophie, 92001 Nanterre, France, dominiqueleconte@yahoo.fr. J Acoust Soc Am. 2008 May;123(5):3798.

Migraine headaches are associated with symptoms of depression and anxiety (Waldie and Poulton Journal of Neurology, Neurosurgery, and Psychiatry 72: 86-92, 2002) and feelings of low self-efficacy (French et al. Headache, 40: 647-656, 2000). Previous research suggests that spiritual meditation may ameliorate some of the negative traits associated with migraine headaches (Wachholtz and Pargament Journal of behavioral Medicine, 30: 311-318, 2005). This study examined two primary questions: (1) Is spiritual meditation more effective in enhancing pain tolerance and reducing migraine headache related symptoms than secular meditation and relaxation? and, (2) Does spiritual meditation create better mental, physical, and spiritual health outcomes than secular meditation and relaxation techniques? Eighty-three meditation naïve, frequent migraineurs were taught Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Secular Meditation, or Muscle Relaxation which participants practiced for 20 min a day for one month. Pre-post tests measured pain tolerance (with a cold pressor task), headache frequency, and mental and spiritual health variables. Compared to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and negative affect, as well as greater increases in pain tolerance, headache-related self-efficacy, daily spiritual experiences, and existential well being.

Wachholtz AB, Pargament KI. Department of Psychiatry, University of Mass Medical Center, 55 Lake Ave, Worcester, MA, 01655, USA, WachholA@ummhc.org. J Behav Med. 2008 Aug;31(4):351-66.

Chronic pain is a complex phenomenon that causes a significant disruption in the lives of those affected. Chronic pain is difficult to treat and challenges healthcare professionals' abilities to implement effective treatments. Therefore, chronic pain sufferers often seek complementary alternative medicine therapies such as meditation. Literature reviews have examined studies using mindfulness-based stress reduction program as an intervention for a variety of health problems. However, no reviews exist looking at a specific patient population's utilization of meditation-based programs. Therefore, the purpose of this integrative review is to examine studies that have investigated meditation as an intervention for chronic pain, identify gaps in the literature, and make recommendations for further research.

Teixeira ME. Hightstown Medical Associates, East Windsor, NJ 08520, USA. Bet3079@comcast.net Holist Nurs Pract. 2008 Jul-Aug;22(4):225-34.

The scientific discovery of novel training paradigms has yielded better understanding of basic mechanisms underlying cortical plasticity, learning and development. This study is a first step in evaluating Tai Chi (TC), the Chinese slow-motion meditative exercise, as a training paradigm that, while not engaging in direct tactile stimulus training, elicits enhanced tactile acuity in long-term practitioners. The rationale for this study comes from the fact that, unlike previously studied direct-touch tactile training paradigms, TC practitioners focus specific mental attention on the body's extremities including the fingertips and hands as they perform their slow routine. To determine whether TC is associated with enhanced tactile acuity, experienced adult TC practitioners were recruited and compared to age-gender matched controls. A blinded assessor used a validated method (Van Boven et al. in Neurology 54(12): 2230-2236, 2000) to compare TC practitioners' and controls' ability to discriminate between two different orientations (parallel and horizontal) across different grating widths at the fingertip. Study results showed that TC practitioners' tactile spatial acuity was superior to that of the matched controls (P < 0.04). There was a trend showing TC may have an enhanced effect on older practitioners (P < 0.066), suggesting that TC may slow age related decline in this measure. To the best of our knowledge, this is the first study to evaluate a long-term attentional practice's effects on a perceptual measure. Longitudinal studies are needed to examine whether TC initiates or is merely correlated with perceptual changes and whether it elicits long-term plasticity in primary sensory cortical maps. Further studies should also assess whether related somatosensory attentional practices (such as Yoga, mindfulness meditation and Qigong) achieve similar effects.

Kerr CE, Shaw JR, Wasserman RH, Chen VW, Kanojia A, Bayer T, Kelley JM. Harvard Osher Research Center, Harvard Medical School, Boston, MA 02215, USA. catherine_kerr@hms.harvard.edu Exp Brain Res. 2008 Jun;188(2):317-22.

The 1950's rivalry between Milton H. Erickson, MD, and David Elman created an intellectual schism in the world of hypnotherapy. The friction between the psychiatrist and the former stage hypnotist has left an enduring legacy of distrust and name calling between various factions. This problem belies the benefit that could exist should the adherents of their legacies could just for a moment start exploring the similarities rather than remaining dogmatically mired in the differences.

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It was established that use of autogenous training makes possible to increase efficiency of the therapy, leading to considerable more evident improvement of somatic and psychotic state, decrease of pain syndrome. Predictors of efficiency of autogenous training were marked out. Indications for use the method in medical rehabilitation of patients with irritable colon syndrome with constipation dominance were elaborated.

Vopr Kurortol Fizioter Lech Fiz Kult. 2008 Jan-Feb;(1):24-7. Pakhomova IV, A?vazian TA, Za?tsev VP, Gusakova EV, Molina LP.

by Edward J. Longo CCH RBT

The principle of penetrating the subconscious mind is as simple as offering a positive suggestion, a new thought, or a different truth. This is where the memory functions at its very best. The subconscious mind is programmed like an endless tape, implanted within the complex synapses and cells of the brain. Actually, you become what your subconscious mind thinks. Then, our thoughts and beliefs transform us into our character and give us our physiological makeup.

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by Debra Mittler, CHt

There is an ever growing epidemic of eating disorders amongst both women and men. Some start as young as six years of age. People who develop eating disorders usually do it to cope with life circumstances. It is an unconscious reaction to develop a sense of control, escape feelings, avoid responsibility or stop the process of life. They "think" these behaviors make them feel better. They usually are not aware of, and are disconnected from the physical and emotional harm they are doing on their mind, body and spirit. These people tend to have low self-esteem and can view themselves with a lot of negativity. Some feel that nothing is ever good enough, (mostly themselves). Generally their thoughts, feelings and behaviors stem from the limiting beliefs they have about themselves and the world.

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Bryan M. Knight holds a degree in psychology from Sir George Williams University, a Master's in social work from McGill University and a doctorate in counseling from Columbia Pacific University for his dissertation, Professional Love: the Hypnotic Power of Psychotherapy. Dr. Knight is the author of numerous articles and several books, including the People Paradox; Enjoying Single Parenthood; Love, Sex & Hypnosis: Secrets of Psychotherapy; Health and Happiness with Hypnosis. Dr. Knight created The International Registry of Professional Hypnotherapists and The Global Directory of Hypnosis Training.

The psychological issues facing medical and surgical patients suffering from traumatic injuries are numerous and varied. These injuries may occur in the settings of armed conflict, terrorist attack, natural disaster, or accident. The goal of preventing or decreasing significant and disabling psychiatric comorbidity can be the objective and assignment of a Psychiatry Consultation Liaison Service (PCLS) within the hospital setting. A comprehensive trauma consultation service could be designed to assist the entire medical complex in its response to various events. The needs of the patient, the patient's primary support group, and the medical staff must be considered in the development of a treatment strategy for the setting of a traumatic event. This article describes the integration of a Preventive Medical Psychiatry Service (PMP) at Walter Reed Army Medical Center (WRAMC) into a traditional PCLS. The PMP model is built upon the biopsychosocial model and psychodynamic developmental concepts.

J Am Acad Psychoanal Dyn Psychiatry. 2007 Winter;35(4):555-73. Wain HJ, Gabriel GM. Psychiatry Consultation Liaison Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. Harold.Wain@na.amedd.army.mil

To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP), we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an 8-week mindfulness meditation program. Participants were 27 adults >/=65 years of age with CLBP of at least moderate severity and of at least 3 months duration. We found several themes reflecting the beneficial effects of mindfulness meditation on pain, attention, sleep, and achieving well-being. Various methods of pain reduction were used, including distraction, increased body awareness leading to behavior change, better pain coping, and direct pain reduction through meditation. Participants described improved attention skills. A number of participants reported improved sleep latency as well as quality of sleep. Participants described achieving well-being during and after a meditation session that had immediate effects on mood elevation but also long-term global effects on improved quality of life. Several themes were identified related to pain reduction, improved attention, improved sleep, and achieving well-being resulting from mindfulness meditation that suggest it has promising potential as a nonpharmacologic treatment of chronic pain for older adults. PERSPECTIVE: Community-dwelling older adults with chronic low back pain experience numerous benefits from mindfulness meditation including less pain, improved attention, better sleep, enhanced well-being, and improved quality of life. Additional research is needed to determine how mindfulness meditation works and how it might help with other chronic illnesses.

Morone NE, Lynch CS, Greco CM, Tindle HA, Weiner DK. Department of Medicine, Division of General Internal Medicine, Pittsburgh, Pennsylvania. J Pain. 2008 Jun 10.

Previous eyewitness memory research has shown that biased lineup instructions reduce identification accuracy, primarily by increasing false-positive identifications in target-absent lineups. Because some attempts at identification do not rely on a witness's memory of the perpetrator but instead involve matching photos to images on surveillance video, the authors investigated the effects of biased instructions on identification accuracy in a matching task. In Experiment 1, biased instructions did not affect the overall accuracy of participants who used video images as an identification aid, but nearly all correct decisions occurred with target-present photo spreads. Both biased and unbiased instructions resulted in high false-positive rates. In Experiment 2, which focused on video-photo matching accuracy with target-absent photo spreads, unbiased instructions led to more correct responses (i.e., fewer false positives). These findings suggest that investigators should not relax precautions against biased instructions when people attempt to match photos to an unfamiliar person recorded on video.

J Gen Psychol. 2008 Jan;135(1):23-36. Thompson WB, Johnson J. Department of Psychology, Niagara University, Niagara Falls, NY 14109, USA. wbt@niagara.edu

Zalman Segal is a highly respected and sought-after counselor, trainer and author. He is known for his unparalleled success in inducing clients and students to increase motivation or alter behavior patterns through hypnosis by applying strong analytical, intuitive and interpersonal skills.

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The various forms of treatment for tinnitus that have been tested in properly controlled trials can be classified as pharmacological, acoustic-physical, and psychological. In clinical trials, no pharmacological agent has been shown to have lasting effect on the presence or severity of tinnitus, although there are promising signs in an animal model. Acoustic devices do not seem to influence tinnitus, although appropriately fitted hearing aids may slightly reduce its prominence. Of physical treatments, cortical implantation may hold some promise of being effective for tinnitus suppression in selected cases. A psychological treatment that has emerged as consistently beneficial is cognitive-behavior therapy in terms of affecting overall wellbeing and reducing level of tinnitus annoyance.

Noble W. Trends Amplif. 2008 Jul 17.

The use of complementary and alternative medicine (CAM) is increasing. CAM includes mind-body interventions, biologically based therapies, energy therapies, and body-based methods. Primary brain tumors arise within the brain and have a poor prognosis when malignant. Even patients with benign tumors suffer neurologic and systemic symptoms as a result of the tumor or its treatment. CAM is used by 30% of brain tumor patients, who often do not report its use to their physician. Herbal medicines may affect the metabolism of prescribed medications or produce adverse effects that may be attributed to other causes. In patients with systemic cancer, mind-body modalities such as meditation and relaxation therapy have been shown to be helpful in reducing anxiety and pain; acupuncture and hypnotherapy may also reduce both pain and nausea. Recent preclinical studies have reported that ginseng, Scutellaria baicalensis, and Angelica sinensis may promote apoptosis of tumor cells or exercise antiangiogenic effects. Further studies are needed to evaluate the impact of CAM on symptom control or tumor growth in this vulnerable patient population.

Armstrong TS, Gilbert MR. Department of Integrative Nursing Care, University of Texas Health Science Center School of Nursing, 6901 Bertner Avenue, Houston, TX 77030, USA. Terri.S.Armstrong@uth.tmc.edu Curr Neurol Neurosci Rep. 2008 May;8(3):264-8.

This article presents an overview of speech and language difficulties in children and briefly comments on intervention practices. Difficulties affecting the development of speech and language in children are considered to be the most common of paediatric disabilities and may have long-lasting effects on social skills, behaviour, education and employment. Referral to speech and language therapy services is crucial and primary health care workers have an important role in identifying those at risk. Some signposts for referral are given, though mechanisms and criteria will differ from Trust to Trust. Communication is acknowledged to be a central element in an individual's health and well-being and is critical to emotional, cognitive and social functioning. The application of the ICF framework is considered.

Vitkovitch J. Speech and Language School of Allied Health Professionals, University of East Anglia, Norwich. J Fam Health Care. 2008;18(3):93-5.

The purpose of this study was to examine the outcomes of individual Buddhist counseling interventions for patients suffering from symptoms of anxiety. A single-group pretest and posttest design was used to measure outcomes. Twenty-one patients participated in the study as voluntary subjects, all of whom completed two sessions of Buddhist counseling interventions. The individual Buddhist counseling program was developed by the investigators based on the Buddhist doctrine. The outcomes were evaluated with the use of the State-Trait Anxiety Inventory. Data were analyzed using the Friedman test, which provides an indicator for evidence-based outcomes related to anxiety reduction scores. The results revealed that the scores on the state anxiety test in relation to the trait anxiety test had been reduced at the 1-month follow-up. The findings from content analysis showed that when the patients practiced mindfulness, they were able to accept unpleasant situations calmly. Sixteen patients were prescribed lower doses of antianxiety medications. Furthermore, medication was discontinued for two patients, and three other patients continued their prescribed medication regimen completely. The study indicates that counseling as a basis from Buddhist principles has the potential to benefit patients with emotional anxiety-based problems.

Rungreangkulkij S, Wongtakee W. Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand. somrun@kku.ac.th Arch Psychiatr Nurs. 2008 Jun;22(3):127-34.

Negative reactions to placebo medications -- sometimes called "nocebo effects" -- are well documented. Similar responses can be induced in suggestible patients when providers use language that tends to increase patients' stress and negative expectations. Several common "language traps" are examined and alternative ways to communicate with patients are suggested.

Am J Nurs. 2008 Mar;108(3):52-7. Schenk PW. Clinical Psychology, Private Practice, Tucker, GA, USA. drpaulschenk@earthlink.net

CONTEXT: The use of complementary therapies in conjunction with conventional care has great potential to address patient pain, complication rates, and recovery time. Few studies of such therapies have been conducted in hospital settings where some of the most stressful procedures are performed on a regular basis. OBJECTIVE: We hypothesized that patients receiving healing touch (HT) would see improved outcomes. DESIGN: Patients were randomized into 1 of 3 treatment groups: no intervention, partial intervention (visitors), and an HT group. SETTING: This study was conducted in an acute-care hospital in a large metropolitan area. PATIENTS OR OTHER PARTICIPANTS: Patients undergoing first-time elective coronary artery bypass surgery were invited to participate. There were 237 study subjects. INTERVENTION: HT is an energy-based therapeutic approach to healing that arose out of nursing in the early 1980s. HT aids relaxation and supports the body's natural healing process. MAIN OUTCOME MEASURES: This study consisted of 6 outcome measures: postoperative length of stay, incidence of postoperative atrial fibrillation, use of anti-emetic medication, amount of narcotic pain medication, functional status, and anxiety. RESULTS: Analysis was conducted for all patients and separately by inpatient/outpatient status. Though no significant decrease in the use of pain medication, anti-emetic medication, or incidence of atrial fibrillation was observed, significant differences were noted in anxiety scores and length ofstay. All HT patients showed a greater decrease in anxiety scores when compared to the visitor and control groups. In addition, there was a significant difference in outpatient HT length of stay when compared to the visitor and control groups.

MacIntyre B, Hamilton J, Fricke T, Ma W, Mehle S, Michel M. Cardiovascular Telemetry, HealthEast Saint Joseph's Hospital, St Paul, Minnesota, USA. Altern Ther Health Med. 2008 Jul-Aug;14(4):24-32.

We conducted two studies to examine how interviewers' nonverbal behaviors affect children's perceptions and suggestibility. In the first study, 42 8- to 10-year-olds watched video clips showing an interviewer displaying combinations of supportive and nonsupportive nonverbal behaviors and were asked to rate the interviewer on six attributes (e.g., friendliness, strictness). Smiling received high ratings on the positive attributes (i.e., friendly, helpful, and sincere), and fidgeting received high ratings on the negative attributes (i.e., strict, bored, and stressed). For the second study, 86 8- to 10-year-olds participated in a learning activity about the vocal chords. One week later, they were interviewed individually about the activity by an interviewer adopting either the supportive (i.e., smiling) or nonsupportive (i.e., fidgeting) behavior. Children questioned by the nonsupportive interviewer were less accurate and more likely to falsely report having been touched than were those questioned by the supportive interviewer. Children questioned by the supportive interviewer were also more likely to say that they did not know an answer than were children questioned by the nonsupportive interviewer. Participants in both conditions gave more correct answers to questions about central, as opposed to peripheral, details of the activity. Implications of these findings for the appropriate interviewing of child witnesses are discussed.

J Exp Child Psychol. 2008 May;100(1):17-39. Epub 2008 Mar 7. Almerigogna J, Ost J, Akehurst L, Fluck M. Department of Psychology, University of Portsmouth, King Henry Building, Portsmouth, Hampshire, UK. jehanne.almerigogna@port.ac.uk

Contemplative education includes practices that aim to help a person cultivate conscious awareness, especially internal self-awareness and awareness of one's connection to the world. Such practices include meditation, movement, and the contemplation of nature. Exploration is under way to determine if these practices might assist young people in their development, as they do in adulthood.

Jennings PA. Initiative on Contemplation and Education at the Garrison Institute and San Francisco State University. New Dir Youth Dev. 2008 Summer;(118):101-5.

The effects of implementation intentions and posthypnotic suggestion were investigated in 2 studies. In Experiment 1, participants with high levels of hypnotic suggestibility were instructed to take placebo pills as part of an investigation of how to best enhance compliance with medical instruction. In Experiment 2, participants with high, medium, and low levels of hypnotic suggestibility were asked to run in place, take their pulse rate before, and send an e-mail report to the experimenter each day. Experiment 1 revealed enhanced adherence as a function of both implementation intentions and posthypnotic suggestion. Experiment 2 failed to find any significant main effects but found a significant interaction between suggestibility and the effects of posthypnotic suggestion. Posthypnotic suggestion enhanced adherence among high suggestible participants but lowered it among low suggestibles.

Int J Clin Exp Hypn. 2008 Apr;56(2):143-55. Carvalho C, Mazzoni G, Kirsch I, Meo M, Santandrea M. Higher Institute of Applied Psychology, Lisbon, Portugal. Claudia.carvalho@ispa.pt

Tobacco use is disproportionately represented among both alcohol-use disorders (AUDs) and anxiety disorders (ANX) compared to the general population [Kalman, D. A., Morissette, S. B., & George, T. P. (2005). Co-morbidity of nicotine and tobacco use in psychiatric and substance use disorders. The American Journal on Addictions, 14, 1-18]. Despite this common overlap, little is known about how smokers with co-occurring AUD-ANX differ from their nonsmoking counterparts. Seventy-two patients participated in a larger clinical trial evaluating the efficacy of venlafaxine and cognitive-behavioral therapy for AUD-ANX. Differences between daily smokers (n=23), chippers (n=12) and nonsmokers (n=37) with AUD-ANX were examined with respect to intensity and frequency of alcohol use, anxiety symptoms, depressed mood, and stress. Point prevalence of current daily smoking was 31.9%, which is considerably lower than traditionally reported in AUD studies. Consistent with predictions, daily smokers reported higher levels of alcohol dependence, average drinks per drinking occasion, and peak blood concentration levels in a day than nonsmokers during the 90 days prior to assessment. Chippers were nonsignificantly different from either smokers or nonsmokers. Smokers and nonsmokers did not differ with respect to percent heavy drinking days or emotional symptoms.

Morissette SB, Gulliver SB, Kamholz BW, Duade J, Farchione T, Devine E, Brown TA, Barlow DH, Ciraulo D. VA Boston Healthcare System, USA; Boston University School of Medicine, USA; Boston University Department of Psychology, USA. Addict Behav. 2008 Jun 12.

Quality of life (QOL) of cancer patients is often diminished due to the side effects of treatment and symptoms of the disease itself. Medical Qigong (coordination of gentle exercise and relaxation through meditation and breathing exercise based on Chinese medicine theory of energy channels) may be an effective therapy for improving QOL, symptoms and side effects, and longevity of cancer patients. In this pilot study, the feasibility, acceptability, and impact of Medical Qigong (MQ) were evaluated on outcomes in cancer patients. Thirty patients diagnosed with heterogeneous cancers, were randomly assigned to two groups: a control group that received usual medical care and an intervention group who participated in a MQ program for 8 weeks in addition to receiving usual medical care. Randomization was stratified by completion of cancer treatment (n = 14) or under chemotherapy (n = 16). Patients completed measures before and after the program. Quality of life and symptoms were measured by the EORTC QLQ-C 30 and progress of disease by the inflammation biomarker (CRP: c-reactive protein) via a blood test was assessed. The MQ intervention group reported clinically significant improved global QOL scores pre- and post-intervention. The MQ intervention also reduced the symptoms of side effects of cancer treatment and inflammation biomarker (CRP) compare to the control group. Due to the small sample size, however, the results were not statistically significant between treatment and the control groups. Data from the pilot study suggest that MQ with usual medical treatment can enhance the QOL of cancer patients and reduce inflammation. This study needs a further investigation with a larger sample size.

Oh B, Butow P, Mullan B, Clarke S. School of Public Health, Faculty of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia. bsoh@med.usyd.edu.au Am J Chin Med. 2008;36(3):459-72.