Full Title: Systematic review of post-treatment psychosocial and behaviour change interventions for men with cancer.

The psychosocial impacts of a cancer diagnosis include reduced quality of life, poorer inter-personal relationships, hopelessness and mental illness. Worse outcomes, including mortality rates have been found for single men with cancer compared with women and partnered men. The aim of this systematic review was to examine the effectiveness of post-treatment psychosocial and behaviour change interventions for adult men with cancer, in order to inform the development of an intervention. A focus on single men was intended. Methods: Ten databases were searched via Ovid and Web of Science. Papers were systematically extracted by title, abstract and full paper according to the inclusion/exclusion criteria. Full papers were assessed by two authors. Inclusion criteria: participants at any stage of a cancer diagnosis, >/=50% male and aged 18+; psychosocial and/or behavioural post-treatment interventions, using any format; a one-three level of evidence. Couple/carer/family interventions were excluded. Results: From 9948 studies initially identified, 11 were finally included in the review. They implemented cognitive behaviour therapy, hypnosis or psychoeducational interventions. All studies had some positive results, however, lack of reporting of intervention content and methodological issues limit the findings. No studies intervened with single men, and none provided comparative outcomes for marital status.Conclusions: Effectiveness of interventions was difficult to assess as, while all had benefits, their generalisability was limited due to methodological and reporting limitations. Improved reporting procedures are required to allow for replication. Copyright (c) 2009 John Wiley & Sons, Ltd.

Psychooncology. 2009 Jul 9. Dale HL, Adair PM, Humphris GM. Department of Clinical Psychology, NHS Fife, Cupar, UK.

by Jane Nash, BEd, MEd, CHt, NLP Master

I met Anne at a community Weight Management program I was delivering. She learned and practiced Neuro Linguistic Programming techniques following a mixture of Paul McKenna, John Plester and my own techniques rolled into a four week program. During this time it became apparent that she really needed relief from the intense physical pain she experienced on a daily basis. Following a short discussion, we agreed to work together to relieve the symptoms in her body caused by emotional isAnnes which she believed were holding onto the body and adding to her pain levels.

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BACKGROUND: Mindfulness-based stress reduction (MBSR) is a clinically standardized meditation that has shown consistent efficacy for many mental and physical disorders. Less attention has been given to the possible benefits that it may have in healthy subjects. The aim of the present review and meta-analysis is to better investigate current evidence about the efficacy of MBSR in healthy subjects, with a particular focus on its benefits for stress reduction. MATERIALS AND METHODS: A literature search was conducted using MEDLINE (PubMed), the ISI Web of Knowledge, the Cochrane database, and the references of retrieved articles. The search included articles written in English published prior to September 2008, and identified ten, mainly low-quality, studies. Cohen's d effect size between meditators and controls on stress reduction and spirituality enhancement values were calculated. RESULTS: MBSR showed a nonspecific effect on stress reduction in comparison to an inactive control, both in reducing stress and in enhancing spirituality values, and a possible specific effect compared to an intervention designed to be structurally equivalent to the meditation program. A direct comparison study between MBSR and standard relaxation training found that both treatments were equally able to reduce stress. Furthermore, MBSR was able to reduce ruminative thinking and trait anxiety, as well as to increase empathy and self-compassion. CONCLUSIONS: MBSR is able to reduce stress levels in healthy people. However, important limitations of the included studies as well as the paucity of evidence about possible specific effects of MBSR in comparison to other nonspecific treatments underline the necessity of further research.

J Altern Complement Med. 2009 May;15(5):593-600. Chiesa A, Serretti A. Institute of Psychiatry, University of Bologna, Bologna, Italy. albertopnl@yahoo.it

Full Title: The meaning of the music: the role of music in palliative care music therapy as perceived by bereaved caregivers of advanced cancer patients.

In an earlier qualitative research study exploring the meaning of preloss music therapy to bereaved caregivers who participated in sessions through a home-based hospice program, various narrative accounts revealed the significance of music in music therapy sessions. In this study, the role of music in palliative care music therapy is examined and representatively summarized, followed by a review of strategies provided by this author to home hospice patients and their caregivers. The reported perceptions of the meaning of music to 7 bereaved caregivers are presented, including a review of themes and associated narrations that illustrated its significance. The caregivers described these aspects of music in sessions to have memorable and lasting effects as follows: "music is a conduit,'' "music gets inside us,'' "live music makes a difference,'' and "music is love.'' Findings support the benefits of preloss music therapy for bereaved caregivers.

Am J Hosp Palliat Care. 2009 Feb-Mar;26(1):33-9. Magill L. University of Windsor, 1671 Victoria Avenue, Windsor, Ontario, Canada. lucannem@uwindsor.ca

(1) Patients frequently complain of occasional bowel movement disorders, associated with abdominal pain or discomfort, but they are rarely due to an underlying organ involvement. Even when patients have recurrent symptoms, serious disorders are no more frequent in these patients than in the general population, unless other manifestations, anaemia, or an inflammatory syndrome is also present; (2) There is currently no way of radically modifying the natural course of recurrent irritable bowel syndrome; (3) The effects of antispasmodics on abdominal pain have been tested in about 20 randomised controlled trials. Pinaverium and peppermint essential oil have the best-documented efficacy and only moderate adverse effects. Antispasmodics with marked atropinic effects do not have a favourable risk-benefit balance; (4) Tricylic antidepressants seem to have only modest analgesic effects in this setting. In contrast, their adverse effects are frequent and they have somewhat negative risk-benefit balances. Nor has the efficacy of selective serotonin reuptake inhibitor antidepressants (SSRIs) been demonstrated; (5) Alosetron and tegaserod carry a risk of potentially life-threatening adverse effects and therefore have negative risk-benefit balances; (6) Seeds of plants such as psyllium and ispaghul, as well as raw apples and pears, have a limited impact on constipation and pain. Osmotic laxatives are effective on constipation. Symptomatic treatments for constipation can sometimes aggravate abdominal discomfort; (7) Loperamide has been poorly assessed in patients with recurrent irritable bowel syndrome with diarrhoea. It modestly slows bowel movement but does not relieve pain or abdominal discomfort; (8) Dietary measures have not been tested in comparative trials. Some patients are convinced that certain foods provoke a recurrence of irritable bowel syndrome, but restrictive diets carry a risk of nutritional deficiencies; (9) Various techniques intended to control emotional and psychological disturbances have been proposed, including relaxation, biofeedback, hypnosis, and psychotherapy. The results of clinical trials are not convincing; (10) Oral products containing live bacteria, designed to change the equilibrium of intestinal flora, have been tested in 13 placebo-controlled trials, with inconsistent results. A few cases of septicaemia have been reported; (11) The six available trials of acupuncture (versus sham acupuncture) showed no more than a placebo effect; (12) In practice, patients who have recurrent irritable bowel syndrome but with no other signs of a condition warranting specific treatment should be reassured as to the harmless nature of their disorder if a careful physical examination and basic laboratory tests are negative. The only available treatments have purely symptomatic effects and only limited efficacy. It is best to avoid using all treatments and additional diagnostic investigations that carry a risk of disproportionate adverse effects.

Prescrire Int. 2009 Apr;18(100):75-9.

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are unique attentional disorders which primarily involve slowed frontal brain wave activity and hypo-perfusion of cerebral blood flow in the frontal regions, particularly during tasks such as reading. A variety of disorders, such as anxiety, depression and Oppositional Defiant Disorder (ODD), are often co-morbid with ADD, thus creating a plethora of complications in treatment procedures. Audio-Visual Entrainment (AVE) lends itself well for the treatment of ADD/ADHD. AVE exerts a major wide spread influence over the cortex in terms of dominant frequency. AVE has also been shown to produce dramatic increases in cerebral blood flow. Several studies involving the use of AVE in the treatment of ADD/ADHD and its related disorders have been completed. AVE as a treatment modality for ADD/ADHD has produced wide-spread improvements including secondary improvements in IQ, behaviour, attention, impulsiveness, hyperactivity, anxiety, depression, ODD and reading level. In particular, AVE has proven itself to be an effective and affordable treatment of special-needs children within a school setting.

Full Text.

Full Title: Cognitive-behavioural therapy for young children with anxiety disorders: Comparison of a Child + Parent condition versus a Parent Only condition.

The present study compared the efficacy of a group-based cognitive-behavioural treatment (GCBT) delivered exclusively to parents of young anxious children (between 4 and 8 years of age) with the same intervention delivered to both children and parents, relative to a Wait-list Control condition. Parents of children in the Parent Only condition (N = 25) received 10 weekly sessions of GCBT whereas children and parents in the Parent + Child condition (N = 24) each received 10 weekly sessions of GCBT. Intent-to-treat analyses indicated that both active treatment conditions were superior to the Wait-list condition (N = 11), with 55.3% of children in the Parent Only condition and 54.8% of children in the Parent + Child condition no longer meeting criteria for their principal diagnosis at post-treatment. These treatment gains were maintained in both treatment conditions at six-month and 12-month follow-up assessments. There were no significant differences between the two active conditions on other outcome measures including parental psychopathology and parenting style. However, an unexpected finding was that parenting satisfaction and to some extent parenting competence reduced significantly from pre- to post-treatment regardless of the active treatment condition. The present results suggest that GCBT delivered exclusively to parents of young anxious children may be a viable treatment alternative for improving accessibility to efficacious treatments for children with anxiety disorders and for reducing costs associated with mental health care delivery.

Behav Res Ther. 2009 May 7. Waters AM, Ford LA, Wharton TA, Cobham VE. School of Psychology, Griffith University, Queensland, Gold Coast Campus, QLD 4222, Australia.

A review by Judith E. Pearson, Ph.D

Crown House Publishing Co. LLC, Wales

Copyright, 2009

Followers of Bill O'Hanlon will delight in the recent release of his six new CDs, all influenced by the work of Milton H. Erickson. If you don't know much about Milton Erickson, this set of CDs will serve as a good introduction to Ericksonian hypnosis.

The recordings demonstrate O'Hanlon's versatility with hypnosis, rapport, and story-telling. In each 40- to 60-minute presentation, his voice is friendly and comforting to listen to, with excellent inflection and pacing. Bill tells his stories in such a relaxed and casual manner that they seem spontaneous and fresh, as though you were hearing them over a mug of beer or a cup of coffee. Here is a brief review on each CD.

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By Sharon M. O'Connor, RN

How is life treating you? Many women in our culture feel pressured by a combination of home and work demands. At work, many have increased responsibilities because of cutbacks along with concerns about their own jobs. At home, we have responsibilities of taking care of our children, errands, and household tasks, as women tend to take on the bulk of the home responsibilities in addition to being business professionals and entrepreneurs. All of this responsibility creates a lot of stress. The American Psychological Association online study reports 77% of those polled said they experienced physical symptoms of stress during the prior month; 73% experienced psychological stress during that same time frame. If you're experiencing stress, you're not alone.

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Full Title: The brain under self-control: modulation of inhibitory and monitoring cortical networks during hypnotic paralysis.

Brain mechanisms of hypnosis are poorly known. Cognitive accounts proposed that executive attentional systems may cause selective inhibition or disconnection of some mental operations. To assess motor and inhibitory brain circuits during hypnotic paralysis, we designed a go-no-go task while volunteers underwent functional magnetic resonance imaging (fMRI) in three conditions: normal state, hypnotic left-hand paralysis, and feigned paralysis. Preparatory activation arose in right motor cortex despite left hypnotic paralysis, indicating preserved motor intentions, but with concomitant increases in precuneus regions that normally mediate imagery and self-awareness. Precuneus also showed enhanced functional connectivity with right motor cortex. Right frontal areas subserving inhibition were activated by no-go trials in normal state and by feigned paralysis, but irrespective of motor blockade or execution during hypnosis. These results suggest that hypnosis may enhance self-monitoring processes to allow internal representations generated by the suggestion to guide behavior but does not act through direct motor inhibition.

Neuron. 2009 Jun 25;62(6):862-75. Cojan Y, Waber L, Schwartz S, Rossier L, Forster A, Vuilleumier P. Department of Neuroscience, University Medical School, University of Geneva, Geneva, Switzerland. yann.cojan@unige.ch

by David Kohlhagen LPC, NBCCH

In Force of Habit any emotional, psychological, mental, physical, biological or cognitive behavior is a habit if it is automatic, if it "does itself" without intentional conscious effort. Breathing, heartbeat and blood and lymph circulation, physical wound healing, etc. (the autonomic nervous system and other biological functions) are Type I habits. When they are functioning normally they are not the focus of psychological treatment. Type II habits are the usual therapy presenting symptoms. They include depression, anxiety, phobias, stress and PTSD symptoms, the habit disorders, and sexual problems. We were not born with any Type II habits: we learn them. When Type I habits have become modified and are not functioning normally (as in high blood pressure, the stress disorders, digestive and sleep problems, asthma, allergies, immune disorders and any number of physical and medical problems) they become Type II habits and the focus of psychotherapeutic treatment.

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BACKGROUND: Individuals with coronary heart disease (CHD) often suffer from severe distress putting them at greater risk for complications. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients, however its efficacy for CHD patients needs to be evaluated. OBJECTIVES: To examine the effects of music interventions with standard care versus standard care alone on psychological and physiological responses in persons with CHD. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PSYCINFO, LILACS, Science Citation Index, www.musictherapyworld.net, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register (all to May 2008). We handsearched music therapy journals and reference lists, and contacted relevant experts to identify unpublished manuscripts. There was no language restriction. SELECTION CRITERIA: We included all randomized controlled trials that compared music interventions and standard care with standard care alone for persons with CHD. DATA COLLECTION AND ANALYSIS: Data were extracted, and methodological quality was assessed, independently by the two reviewers. Additional information was sought from the trial researchers when necessary. Results are presented using weighted mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Posttest scores were used. In cases of significant baseline difference, we used change scores. MAIN RESULTS: Twenty-three trials (1461 participants) were included. Music listening was the main intervention used, and 21 of the studies did not include a trained music therapist.Results indicated that music listening has a moderate effect on anxiety in patients with CHD, however results were inconsistent across studies. This review did not find strong evidence for reduction of psychological distress. Findings indicated that listening to music reduces heart rate, respiratory rate and blood pressure. Studies that included two or more music sessions led to a small and consistent pain-reducing effect.No strong evidence was found for peripheral skin temperature. None of the studies considered hormone levels and only one study considered quality of life as an outcome variable. AUTHORS' CONCLUSIONS: Music listening may have a beneficial effect on blood pressure, heart rate, respiratory rate, anxiety, and pain in persons with CHD. However, the quality of the evidence is not strong and the clinical significance unclear.Most studies examined the effects of listening to pre-recorded music. More research is needed on the effects of music offered by a trained music therapist.

Cochrane Database Syst Rev. 2009 Apr 15;(2):CD006577. Bradt J, Dileo C. Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Presser Hall, 2001 North 13 Street, Philadelphia, USA. jbradt@temple.edu

Cognitive deficits are routinely evident in schizophrenia, and are of sufficient magnitude to influence functional outcomes in work, social functioning and illness management. Cognitive remediation is an evidenced-based non-pharmacological treatment for the neurocognitive deficits seen in schizophrenia. Narrowly defined, cognitive remediation is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning, but from the vantage of the psychiatric rehabilitation field, cognitive remediation is a therapy which engages the patient in learning activities that enhance the neurocognitive skills relevant to their chosen recovery goals. Cognitive remediation programs vary in the extent to which they reflect these narrow or broader perspectives but six meta-analytic studies report moderate range effect sizes on cognitive test performance, and daily functioning. Reciprocal interactions between baseline ability level, the type of instructional techniques used, and motivation provide some explanatory power for the heterogeneity in patient response to cognitive remediation.

Neuropsychol Rev. 2009 May 15. Medalia A, Choi J. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA, amedalia@aol.com.

Born and raised in Brooklyn, New York, Marta now lives in South Florida. She has had a private practice for thirty years focusing on women's issues, mind/body healing and relationships. She holds an MS in Counseling Psychology and a BS in Education. In addition, she is a trained hypnotherapist, certified metaphysician, intimacy trainer, emotional-body healer, certified Kaizen Creative Coach and Florida State Mediator. Her personal passion to share, heal and teach, combined with her academic expertise have brought her clients from around the country.

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by Debra Burdick, LCSW

Until the last 10-15 years, scientist believed that our brains were essentially hardwired and we were not able to change them much over our lifetime. More recent research has proven without a doubt that we do have the ability to change our minds; that in fact we can actually change the neurons and neuronal networks in our brains.

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Full Title: Post-traumatic stress disorders in medical practice: diagnostic and therapeutic guidelines in primary care

Posttraumatic stress disorder (PTSD) is a prevalent and disabling condition. The patients suffering from PTSD often consult primary care clinician for non-specific symptoms. The aim of this work is to find out useful clinical guidelines for diagnosis and therapy in primary care, starting from a literature review (1981-2009) and a preliminary observational study. 20 patients with PTSD had a specific trauma-focused psychotherapy, called "Trauma and Reintegration Psychotherapy (TRP)". This is a psychodynamic eclectic treatment combining Ericksonian Hypnosis and EMDR techniques. The results show a more important decrease of PTSD symptoms in patient's beneficiating of the TRP, than the average of the usual clinical studies. This could be linked to an early diagnosis made by the primary care general practitioners.

Bull Soc Sci Med Grand Duche Luxemb. 2009;(1):67-78. Miller N, Lazignac C, Jecker F, Zürcher M, Damsa C. Espace Psychothérapeutique Hogan, 86 Grand Rue, Montreux.

by Jon Rhodes

Professors and lay people alike have all pondered the question of how hypnosis works. This has been going on for close to 200 years. How does hypnosis work? Does hypnosis even work for that matter? The various theories and myths continue, with skeptics and fanatics alike. Despite all this rhetoric, no one has even so far managed to come up with an accepted definition of exactly what hypnosis is.

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Full Title: Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR).

Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.

Complement Ther Clin Pract. 2009 May;15(2):61-6. Irving JA, Dobkin PL, Park J. Department of Educational and Counselling Psychology, McGill University, Quebec, Canada. Julie.irving@mail.mcgill.ca

INTRODUCTION: A previous study (carried out in 2003-2004) had included 34 patients with traumatic brain injury in order to study the feasibility and usefulness of music therapy in patients with this type of injury. OBJECTIVE: To evaluate the effect of music therapy on mood, anxiety and depression in institutionalised patients with traumatic brain injury. STUDY METHODOLOGY: A prospective, observational study. MATERIALS AND METHODS: Thirteen patients with traumatic brain injury were included in the present study and took part in individual, weekly, 1-hour music therapy sessions over a period of 20 weeks. Each session was divided into two 30-minute periods - one devoted to listening to music (receptive music therapy) and the other to playing an instrument (active music therapy). The assessment criteria (measured at weeks 1, 5, 10, 15 and 20) were mood (on the face scale) and anxiety-depression (on the Hospital Anxiety and Depression [HAD] Scale). Mood was assessed immediately before and after the first music therapy session and every fifth session. RESULTS: Music therapy enabled a significant improvement in mood, from the first session onwards. This short-term effect was confirmed by the immediate changes in the scores after music therapy sessions (from 4.6+/-3.2 to 2.6+/-2; p<0.01). Music therapy also led to a significant reduction in anxiety-depression (p<0.05) from week 10 onwards and up until the end of the study (week 20). CONCLUSION: These results confirm the usefulness of music therapy in the treatment of anxiety-depression and mood in patients with traumatic brain injury. Music therapy could usefully form an integral part of the management programme for these patients.

Ann Phys Rehabil Med. 2009 Feb;52(1):30-40. Guétin S, Soua B, Voiriot G, Picot MC, Hérisson C. Service de neurologie, centre Mémoire de ressources et de recherches (CMRR), Inserm U888, CHRU Montpellier, 34295 Montpellier, France. stephane.guetin@yahoo.fr

There is a paucity of empirical study about the effects of evidence-based psychotherapy for posttraumatic stress disorder (PTSD) on concurrent health concerns including sleep impairment. This study compares the differential effects of cognitive processing therapy (CPT) and prolonged exposure (PE) on health-related concerns and sleep impairment within a PTSD sample of female, adult rape survivors (N = 108). Results showed that participants in both treatments reported lower health-related concerns over treatment and follow-up, but there were relatively more improvements in the CPT condition. Examination of sleep quality indicated significant improvement in both CPT and PE across treatment and follow-up and no significant differences between treatments. These results are discussed with regard to the different mechanisms thought to underlie the treatments and future innovations in PTSD treatment.

J Trauma Stress. 2009 May 22. Galovski TE, Monson C, Bruce SE, Resick PA. Department of Psychology, Center for Trauma Recovery, University of Missouri-St. Louis, St. Louis, MO.

by Tim Brunson, PhD

Meditation is an often misunderstood practice with several variations that are taught by many different religions. It often is described in terms of calm-abiding (i.e. a quieting of the mind) or analytical (i.e. focused on a particular concept such as compassion). The unifying concept is a meditator's ability to harness their mental processes.

The direct mental benefits of a successful meditation session include a quieting of the anterior cingulate cortex (ACC) – which plays a key role in transitioning between thoughts – and the activation of the parasympathetic division of the autonomic nervous system. However, while this may have a relaxation benefit – with all the implications for improving the digestive process and boosting the immune system – researchers are increasingly becoming aware of the potential for meditation to help with higher brain functions. Indeed, beyond the benefits derived from meditation-induced relaxation, it is the stimulative affect of analytical meditation that may have the biggest benefit.

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Full Title: Are subjective memory problems related to suggestibility, compliance, false memories, and objective memory performance?

The relationship between subjective memory beliefs and suggestibility, compliance, false memories, and objective memory performance was studied in a community sample of young and middle-aged people (N = 142). We hypothesized that people with subjective memory problems would exhibit higher suggestibility and compliance levels and would be more susceptible to false recollections than those who are optimistic about their memory. In addition, we expected a discrepancy between subjective memory judgments and objective memory performance. We found that subjective memory judgments correlated significantly with compliance, with more negative memory judgments accompanying higher levels of compliance. Contrary to our expectation, subjective memory problems did not correlate with suggestibility or false recollections. Furthermore, participants were accurate in estimating their objective memory performance.

Am J Psychol. 2009 Summer;122(2):249-57. Van Bergen S, Jelicic M, Merckelbach H. Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands. s.venbergen@psychology.unimaas.nl

by Ron Schefdore, DDS

and

Jack Maggiore, DDS

Many health care professionals are turning to blood screening test kits to quickly and accurately screen current and potential patients to help improve their health and possibly save their lives. These tests can be used at home by the patient or can be administered by a health care professional using only 1-4 drops of blood. Within the dental community, these tests have proven to improve treatment acceptance and increase quality referrals of patients by health care professionals (1). This is an example of a major paradigm shift occurring in a health care profession not accustomed to serving a leading role in systemic disease detection, whereby the outcome is the improved overall health of patients. While many dental offices have seen their incomes decrease over the past two years, offices that have implemented in-office blood screenings and follow the Healthy Heart Dentistry® program have realized sustained growth in revenues, patient base, and referrals. We describe below two such strategies for achieving this level of success.

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OBJECTIVE: To rigorously evaluate the time course of cognitive change in a cohort of individuals with HIV-associated neurocognitive disorders (HAND) initiating combination antiretroviral therapy (CART), and to investigate which demographic, laboratory, and treatment factors are associated with neuropsychological (NP) outcome (or "any NP improvement"). METHODS: Study participants included 37 HIV+ individuals with mild to moderate NP impairment who initiated CART and underwent NP testing at 12, 24, 36, and 48 weeks thereafter. NP change was assessed using a regression-based change score that was normed on a separate NP-stable group thereby controlling for regression toward the mean and practice effect. Mixed-effect regression models adjusting for loss to follow-up were used to evaluate the time course of cognitive change and its association with baseline and time-varying predictors. RESULTS: In persons with HAND initiating CART, cognitive improvement happens soon after initiation (13% at week 12), but more often 24, 36, and up to 48 weeks after initiation (up to 41%), with fewer than 5% demonstrating significant worsening. In multivariate analyses, unique predictors of NP improvement included more severe baseline NP impairment and higher CART CNS penetration index. Greater viral load decrease was associated with NP improvement only in univariate analyses. CONCLUSION: Clinically meaningful neuropsychological improvement seemed to peak around 24-36 weeks after combination antiretroviral therapy initiation and was prolonged over the 1-year study period. This study also provides new evidence that benefit may be maximized by choosing antiretroviral medications that reach therapeutic concentrations in the CNS.

Neurology. 2009 May 27. Cysique LA, Vaida F, Letendre S, Gibson S, Cherner M, Woods SP, McCutchan JA, Heaton RK, Ellis RJ. >From the Department of Psychiatry (L.A.C., M.C., S.P.W., R.K.H.), Division of Biostatistics and Bioinformatics, Department of Family and Preventive Medicine (F.V.), Department of Medicine (S.L., S.G., J.A.M.), and Department of Neurosciences (R.J.E.), University of California at San Diego; and Brain Sciences (L.A.C.), University of New South Wales, Sydney, Australia.

Pauline is a Registered Nurse with over 24 years experience in the obstetrics field. Pauline's areas of expertise include enhancing fertility, healthy pregnancy, childbirth and HypnoBirthing, grief resolution due to pregnancy and infant loss, help with post partum depression, pre and post surgical relaxation and healing, fighting cancer, eliminating stress, anxiety and fear, enhancing relaxation, pain management, weight management, smoking cessation, and studying. Pauline gave a presentation to the Association of Women's Health, Obstetric and Neonatal Nursing on September 29, 2006. The focus of the presentation was how hypnosis can help during pregnancy, childbirth and beyond. Nurses learned how and why hypnosis works. They also learned how Evidence Based Practice and Hypnosis complement each other beautifully to ensure a good outcome for both the mom and the baby.

For more information visit www.HeartFelt-Hypnosis.com.

by Derrick Lonsdale, M.B.B.S.

An 84-year old man had sudden onset of chronic insomnia, localized palmar tenderness and "trigger finger" of the left hand ring finger. Laboratory studies indicated thiamin deficiency, increased inflammatory markers and fasting blood triglycerides. He discontinued sugar completely without changes in dietary supplements or life style. Gradual improvement in insomnia, trigger finger, weight loss and laboratory studies occurred over 6 months. Then a single minimal ingestion of simple carbohydrate resulted next day in increased blood triglycerides and thiamin pyrophosphate effect (TPPE) on transketolase activity (TKA).

Complete article click here.

Full Title: Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal-cord injury.

Thirty-seven adults with spinal-cord injury and chronic pain were randomly assigned to receive 10 sessions of self-hypnosis (HYP) or EMG biofeedback relaxation (BIO) training for pain management. Participants in both treatment conditions reported substantial, but similar, decreases in pain intensity from before to after the treatment sessions. However, participants in the HYP condition, but not the BIO condition, reported statistically significant decreases in daily average pain pre- to posttreatment. These pre- to posttreatment decreases in pain reported by the HYP participants were maintained at 3-month follow-up. Participants in the HYP condition, but not the BIO condition, also reported significant pre- to posttreatment increases in perceived control over pain, but this change was not maintained at the 3-month follow-up.

Int J Clin Exp Hypn. 2009 Jul;57(3):239-68. Jensen MP, Barber J, Romano JM, Hanley MA, Raichle KA, Molton IR, Engel JM, Osborne TL, Stoelb BL, Cardenas DD, Patterson DR. Department of Rehabilitation Medicine, University of Washington, Seattle, Washington 98195-6490, USA.

by Frederic Luskin, PhD, Ken Silvestri, EdD, and Jed Rosen, MSW, LCSW

Forgiveness is the word we use when we want to say we have let go of a particular wound or grievance that we were stuck on. When used properly it is the ultimate balm to heal fractured relationships. Unfortunately it is not practiced enough and too often misunderstood to be effectively utilized by suffering couples. In addition therapists who work with wounded clients are mostly untrained in how to help their clients forgive their past and present partners. Remember that John Gottman found that 70% of all marital issues that couples start with in their relationships remain. The bad news is trying to change our partners rarely works. The good news is that when appropriately understood forgiving them does work. Forgiveness was found by Gottman and other researchers to be a key factor in successful long term relationships.

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Serious mental disorders have considerable individual and societal impact, and traditional treatments may show limited effects. Music therapy may be beneficial in psychosis and depression, including treatment-resistant cases. The aim of this review was to examine the benefits of music therapy for people with serious mental disorders. All existing prospective studies were combined using mixed-effects meta-analysis models, allowing to examine the influence of study design (RCT vs. CCT vs. pre-post study), type of disorder (psychotic vs. non-psychotic), and number of sessions. Results showed that music therapy, when added to standard care, has strong and significant effects on global state, general symptoms, negative symptoms, depression, anxiety, functioning, and musical engagement. Significant dose-effect relationships were identified for general, negative, and depressive symptoms, as well as functioning, with explained variance ranging from 73% to 78%. Small effect sizes for these outcomes are achieved after 3 to 10, large effects after 16 to 51 sessions. The findings suggest that music therapy is an effective treatment which helps people with psychotic and non-psychotic severe mental disorders to improve global state, symptoms, and functioning. Slight improvements can be seen with a few therapy sessions, but longer courses or more frequent sessions are needed to achieve more substantial benefits.

Clin Psychol Rev. 2009 Apr;29(3):193-207. Gold C, Solli HP, Krüger V, Lie SA. Unifob Health, Bergen, Norway. christian.gold@grieg.uib.no

Full Title: Cognitive-behavioural therapy for adolescents with bulimic symptomatology: The acceptability and effectiveness of internet-based delivery.

BACKGROUND: The evidence base for the treatment of adolescents with bulimia nervosa (BN) is limited. AIMS: To assess the feasibility, acceptability, and clinical outcomes of a web-based cognitive-behavioural (CBT) intervention for adolescents with bulimic symptomatology. METHOD: 101 participants were recruited from eating disorders clinics or from beat, a UK-wide eating disorders charity. The programme consisted of online CBT sessions ('Overcoming Bulimia Online'), peer support via message boards, and email support from a clinician. Participants' bulimic symptomatology and service utilisation were assessed by interview at baseline and at three and six months. Participants' views of the treatment package were also determined. RESULTS: There were significant improvements in eating disorder symptoms and service contacts from baseline to three months, which were maintained at six months. Participants' views of the intervention were positive. CONCLUSIONS: The intervention has the potential for use as a first step in the treatment of adolescents with bulimic symptomatology.

Behav Res Ther. 2009 May 27. Pretorius N, Arcelus J, Beecham J, Dawson H, Doherty F, Eisler I, Gallagher C, Gowers S, Isaacs G, Johnson-Sabine E, Jones A, Newell C, Morris J, Richards L, Ringwood S, Rowlands L, Simic M, Treasure J, Waller G, Williams C, Yi I, Yoshioka M, Schmidt U. Section of Eating Disorders, Institute of Psychiatry, King's College, Box 059, De Crespigny Park, London SE5 8AZ, United Kingdom.

by Debra Burdick, LCSW

Protecting your brain is an extremely important component of optimum brain fitness. Damage can occur in a variety of ways including obvious ones like accidents and illness. But be wary of those cleaning products and even cosmetics that we expose ourselves and our children to on a routine basis. Just think how your bathroom smells after a shower or a cleaning. Many of those fragrances and chemicals act as neurotoxins to our brain. One author calls this 'chemical brain injury'.

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OBJECTIVE: An estimated 24% of patients referred to epilepsy clinics actually have nonepileptic seizures. Various procedures have been used to precipitate nonepileptic events. The goal of this study was to use hypnosis in seizure provocation and differentiation between epileptic and nonepileptic seizure events. METHODS: Fifty study participants were enrolled from the Via Christi Comprehensive Epilepsy Center's video/electroencephalography unit. Patients underwent the Hypnotic Induction Profile (HIP) to assess susceptibility to hypnosis. After completion of the HIP, participants underwent hypnosis by a physician trained to do so. They received a hypnotic suggestion to have a seizure. All seizure-like events were classified as either an epileptic, nonepileptic, or undetermined event based on whether or not the patient had abnormal EEG activity during the event. RESULTS: Of the 50 participants enrolled, 3 withdrew consent, resulting in 47 participants. Seven (15%) participants failed to have an event of any type and were classified as undetermined. Sixteen (34%) participants were classified as having epileptic seizure events, and 24 (51%) participants had nonepileptic events. Most participants were Caucasian (87%), female (57%), and unemployed (55%). HIP scores ranged from 0 to 10. Participants classified with nonepileptic scores had higher mean HIP scores (8.08, SD 2.483) than those diagnosed with epileptic seizures [5.94, SD 3.492, t(25)=2.126, P=0.044]. The sensitivity of eliciting a nonepileptic event during hypnosis was only 0.46, but the specificity was 0.88. CONCLUSION: Hypnosis may be considered as a method of seizure provocation. Events provoked by hypnotic suggestion were more likely than not to be nonepileptic events. However, the current study has moderate specificity and poor sensitivity. Seizures could not be induced in patients who did not also have spontaneous seizures. Additional methodologies for seizure provocation need to be explored.

Epilepsy Behav. 2009 May 20. Khan AY, Baade L, Ablah E, McNerney V, Golewale MH, Liow K. Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.

by Mark Gorkin, LICSW

With these basic functions and words of wisdom in mind, let me illustrate the purposes and dramatic consequences of the healing, harmonizing, and harnessing power of motivational humor. The following four morale-ity tales demonstrate how this mirthful and memorable intervention technique relaxes, reenergizes and rejuvenates team performance. And, hopefully, you'll also discover how humor theory and practice come together and play.

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Full Title: Treating children traumatized by war and Tsunami: a comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka

BACKGROUND: The North-Eastern part of Sri Lanka had already been affected by civil war when the 2004 Tsunami wave hit the region, leading to high rates of posttraumatic stress disorder (PTSD) in children. In the acute aftermath of the Tsunami we tested the efficacy of two pragmatic short-term interventions when applied by trained local counselors. METHODS: A randomized treatment comparison was implemented in a refugee camp in a severely affected community. 31 children who presented with a preliminary diagnosis of PTSD were randomly assigned either to six sessions Narrative Exposure Therapy for children (KIDNET) or six sessions of meditation-relaxation (MED-RELAX). Outcome measures included severity of PTSD symptoms, level of functioning and physical health. RESULTS: In both treatment conditions, PTSD symptoms and impairment in functioning were significantly reduced at one month post-test and remained stable over time. At 6 months follow-up, recovery rates were 81% for the children in the KIDNET group and 71% for those in the MED-RELAX group. There was no significant difference between the two therapy groups in any outcome measure. CONCLUSION: As recovery rates in the treatment groups exceeded the expected rates of natural recovery, the study provides preliminary evidence for the effectiveness of NET as well as meditation-relaxation techniques when carried out by trained local counselors for the treatment of PTSD in children in the direct aftermath of mass disasters. TRIAL REGISTRATION: ClinicalTrials.gov Identifier:NCT00820391.

BMC Psychiatry. 2009 May 13;9:22. Catani C, Kohiladevy M, Ruf M, Schauer E, Elbert T, Neuner F. Department of Psychology, University of Bielefeld, 33501 Bielefeld, Germany. claudia.catani@uni-bielefeld.de

Full Title: Impact of music therapy on anxiety and depression for patients with Alzheimer's disease and on the burden felt by the main caregiver (feasibility study).

INTRODUCTION: The impact of music therapy on dementia care for patients with Alzheimer's disease (AD) is well-recognized. Music alters the different components of the disease through sensory, cognitive, emotional, behavioral and social impacts. The academic aspect of music therapy in this area was based on the fact that music can alter the various components of the overall evolution of this disease. We found around 10 case studies presenting various results from receptive music therapy sessions on patients with Alzheimer's disease.

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Full Title: Long-term effects on cancer survivors' quality of life of physical training versus physical training combined with cognitive-behavioral therapy: results from a randomized trial.

BACKGROUND: We compared the effect of a 12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitive-behavioral therapy (once weekly) with the effect of 12-week group-based physical training (twice weekly) on cancer survivors' quality of life over a 1-year period. MATERIALS AND METHODS: One hundred forty-seven survivors [48.8 +/- 10.9 years (mean +/- SD), all cancer types, medical treatment >/=3 months ago] were randomly assigned to either physical training (PT, n = 71) or to physical training plus cognitive-behavioral therapy (PT + CBT, n = 76). Quality of life and physical activity levels were measured before and immediately after the intervention and at 3- and 9-month post-intervention using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 questionnaire and the Physical Activity Scale for the Elderly, respectively. RESULTS: Multilevel linear mixed-effects models revealed no differential pattern in change of quality of life and physical activity between PT and PT + CBT. In both PT and PT + CBT, quality of life and physical activity were significantly and clinically relevantly improved immediately following the intervention and also at 3- and 9-month post-intervention compared to pre-intervention (p < 0.001). CONCLUSION: Self-management physical training had substantial and durable positive effects on cancer survivors' quality of life. Participants maintained physical activity levels once the program was completed. Combining physical training with our cognitive-behavioral intervention did not add to these beneficial effects of physical training neither in the short-term nor in the long-term. Physical training should be implemented within the framework of standard care for cancer survivors.

Support Care Cancer. 2009 Jun;17(6):653-63. May AM, Korstjens I, van Weert E, van den Borne B, Hoekstra-Weebers JE, van der Schans CP, Mesters I, Passchier J, Grobbee DE, Ros WJ. Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands, a.m.may@umcutrecht.nl.

by Tim Brunson, PhD

When perceptions or anticipation/imagination creates new input, the brain's initial action is to match the newly acquired phenomena with existing patterns stored in the explicit or implicit memory systems. When the brain fails to find a match, similar stored patterns are synthesized with externally or internally derived perceptions in order to produce new patterns. This can be looked upon either as a thinking process or as creativity.

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Hypnotically assisted treatments have been used to reduce stress, improve gastrointestinal motility, strengthen immune function, and potentially reduce inflammation. Such treatments may also help reduce disease flares and improve quality of life in inflammatory bowel diseases (IBD). The authors report the results of a case series of 8 white female patients with inactive IBD. All participants initiated and completed treatment, supporting the general acceptability of hypnotically assisted treatment among IBD patients. There was a significant improvement in IBD-quality of life scores for the group posttreatment, t(7) = -3.38, p = .01, with a mean improvement in quality of life of 29 points with significant changes in all 4 subscales. No negative effects of treatment were found.

Int J Clin Exp Hypn. 2007 Oct;55(4):457-66. Keefer L, Keshavarzian A. Rush University Medical Center, Chicago, Illinois, USA. laurie.keefer@northwestern.edu

STUDY DESIGN: Systematic review of reported adverse events. OBJECTIVE: To evaluate the tolerability and safety of chiropractic procedures. SUMMARY OF BACKGROUND DATA: Despite the increasing popularity of chiropractic, there are few properly designed prospective controlled trials, and there is a disproportionate lack of evaluation of its safety profile. The literature reports multiple neurologic complications of spinal manipulation, some of which are clinically relevant and even life threatening. METHODS: We performed an electronic search in 2 databases: Pubmed and the Cochrane Library for the years 1966 to 2007. All articles that reported adverse reactions associated with chiropractic were included irrespective of type of design. The outcome measures were the type of adverse events associated or attributed to chiropractic interventions and their frequency. RESULTS: A total of 376 potential relevant articles were identified, 330 of which were discarded after abstract or complete article analysis. The search identified 46 articles that included data concerning adverse events: 1 randomized controlled trial, 2 case-control studies, 7 prospective studies, 12 surveys, 3 retrospective studies, and 115 case reports. Most of the adverse events reported were benign and transitory, however, there are reports of complications that were life threatening, such as arterial dissection, myelopathy, vertebral disc extrusion, and epidural hematoma. The frequency of adverse events varied between 33% and 60.9%, and the frequency of serious adverse events varied between 5 strokes/100,000 manipulations to 1.46 serious adverse events/10,000,000 manipulations and 2.68 deaths/10,000,000 manipulations. CONCLUSION: There is no robust data concerning the incidence or prevalence of adverse reactions after chiropractic. Further investigations are urgently needed to assess definite conclusions regarding this issue.

Spine. 2009 May 15;34(11):E405-13. Gouveia LO, Castanho P, Ferreira JJ. Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal. lilianafog@gmail.com

by David Siever, Edmonton, ALberta, Canada

A great deal of temporo-mandibular joint dysfunction and myofascial pain dysfunction is activated in relation to anxiety and fear responses to challenging tasks, self-criticism and daily stresses. AVE, like passive meditation, appears to effectively alleviate these symptoms.

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