September 10, 2010 – twenty third mailing
An evidence-based blog on stress, health & wellbeing (August posts)
Greetings
The twelve August posts to this evidence-based blog on stress, health & wellbeing are detailed in the calendar view. They include four more from July’s British Association for Behavioural and Cognitive Psychotherapies (BABCP) Conference in Manchester, three on recent improvements in CBT treatment for complex PTSD & survivors of child abuse, two (compassion practice & therapeutic writing) about the new “Life skills for stress, health & wellbeing” training I’ve been running, a couple on interesting recent research, and one about a three day workshop this November on “Friendship”. I’ve also added a dozen recent general interest research abstracts to the end of this email. For some readers these will be written in scientific gobbledygook, but others may find fascinating nuggets of new health information.
The four further posts about July’s BABCP Conference are all triggered by Jamie Pennebaker’s plenary lecture on expressive writing – although pretty much all comments & research findings are likely to apply to talking as well. The first post is entitled “Jamie Pennebaker, expressive writing & emotional suppression”, the second “Expressive writing & timing issues”, the third “Disagreeing with Jamie Pennebaker – writing can help past, present & future concerns”& the fourth “Disagreeing with Jamie Pennebaker – writing can be used with positive experiences too”.
Three posts are triggered by the recent American Journal of Psychiatry research paper – and linked editorial – on developments in treating complex posttraumatic stress disorder (PTSD). The research paper showed that preceding exposure treatment with a short training in affect/interpersonal regulation resulted in fewer dropouts, less treatment-associated distress, and improved rates of PTSD remission. See “Improving treatments for complex PTSD and for survivors of child abuse (first post)”, “Improving treatments … (second post)”and “Improving treatments … (third post)”.
There are a couple of further posts on session ten of the “Life skills for stress, health & wellbeing”course that I’ve been running. One is on the nitty-gritty of teaching (and learning) compassion-focused meditation practices – “Life skills for stress, health & wellbeing, tenth session (part 1 – goodwill practice)”. The other is about teaching (and learning) therapeutic writing – “Life skills … tenth session (part 2 – therapeutic writing)”.
There are also two posts on interesting recent research. One is “Recent research: six studies on money, happiness, romance, leadership, self-compassion & avoidance”and the other is my usual roundup “Review of recent research”listing journal abstracts in three overlapping categories – thirty papers on Cognitive Behavioural Therapy, twenty eight on Depression, and thirty two on General Wellbeingcoveringa multitude of stress, health & wellbeing related subjects from cigarette smoking & panic disorder, aspirin for psychotic symptoms, & the lack of obvious nutritional benefits associated with organic foods, to wealth & happiness, rudeness at work, & complementary therapies for depression.
Finally there’s a bit of advertising. An old friend and I are running a three day residential workshop on “Friendship”at the end of November. There are huge mortality, stress & wellbeing implications of good (or not-so-good) social networks. The workshop will present data & background theories but primarily will focus on exploring friendship (and other close relationships) more personally & experientially. Get in touch if you’re interested in coming.
As I’ve mentioned before, this blog is intended as a free resource for people who are interested in stress, health & wellbeing. Its key feature is that I read a lot of emerging research and bring over 30 years’ experience as a medical doctor and psychotherapist to the “sifting-out-what’s-valuable” task. Going to the tag cloud will give you a searchable view of subjects I’ve touched on in the blog. There’s also a linked searchable list of over 250 good health-related websites that I’ve checked out, an 8-session MP3-recording Autogenic relaxation/meditation course, and several hundred freely downloadable stress, health & wellbeing relevant handouts & questionnaires.
If this information isn’t of interest to you (or if I’ve contacted you at two different addresses) – simply reply to this email with “unsubscribe” in the subject line and I’ll take that email address off the mailing list. Similarly, if you know anybody who would like to be on the mailing list, let me know and I’m very happy to make sure they’re included.
With all good wishes
James
78 Polwarth Terrace
Edinburgh, EH11 1NJ
Tel: 0131 337 8474
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Esposito, K., F. Giugliano, et al. (2010). "Dietary Factors, Mediterranean Diet and Erectile Dysfunction." Journal of Sexual Medicine 7(7): 2338-2345.
ABSTRACT Introduction. Although epidemiological evidence seems to support a role for lifestyle factors in the pathogenesis of erectile dysfunction (ED), limited data are available suggesting that dietary changes may improve ED. Aim. To provide an update on clinical evidence regarding the role of dietary factors in ED. Methods. A systematic literature search was performed using MEDLINE and other database (EMBASE, SCOPUS) with MeSH terms and keywords for “erectile dysfunction”, “diet”, “dietary patterns”, “Mediterranean diet”, and “lifestyle”. Main Outcome Measures. To examine the data relating to erectile dysfunction with dietary factors, its relationship and the impact of dietary treatment. Results. Only few studies assessed the role or the effect of diet on ED. A dietary pattern which is high in fruit, vegetables, nuts, whole grains, and fish but low in red and processed meat and refined grains is more represented in subjects without ED. Mediterranean diet has been proposed as a healthy dietary pattern based on evidence that greater adherence to this diet is associated with lower all-cause and disease-specific survival. In type 2 diabetic men, those with the highest adherence to the Mediterranean diet had the lowest prevalence of ED and were more likely to be sexually active. In clinical trials, Mediterranean diet was more effective than a control diet in ameliorating ED or restoring absent ED in people with obesity or metabolic syndrome. Conclusion. The adoption of a Mediterranean diet may be associated with an improvement of erectile dysfunction.
Gopinath, B., V. M. Flood, et al. (2010). "Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss." Am J Clin Nutr 92(2): 416-421.
Background: Identification of modifiable risk factors that could prevent or slow the development of age-related hearing loss (presbycusis) would be valuable. Dietary polyunsaturated fatty acid (PUFA) intake may be related to age-related hearing loss. Objective: We aimed to determine the association between dietary intakes of omega-3 (n-3) PUFAs and fish and the risk of presbycusis. Design: The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss (1997-1999 to 2002-2004). We collected dietary data by using a semiquantitative food-frequency questionnaire and calculated PUFA and fish intakes. In 2956 participants (aged [≥]50 y), we measured presbycusis, which we defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz >25 decibels of hearing loss. Results: There was an inverse association between total n-3 PUFA intake and prevalent hearing loss [odds ratio (OR) per SD increase in energy-adjusted n-3 PUFAs: 0.89; 95% CI: 0.81, 0.99]. There was an inverse association between long-chain n-3 PUFAs and incident hearing loss (OR per SD increase in long-chain n-3 PUFAs: 0.76; 95% CI: 0.60, 0.97). Participants who had > or = 2 servings of fish/wk compared with participants who had <1 serving of fish/wk had a significantly reduced risk (42%) of developing presbycusis at follow-up (multivariate-adjusted OR: 0.58; 95% CI: 0.35, 0.95). There was an association between consumption of > or = 1 to <2 servings/wk of fish and a reduced risk of a progression of hearing loss (OR: 0.53; 95% CI: 0.32, 0.88). Conclusions: There was an inverse association between higher intakes of long-chain n-3 PUFAs and regular weekly consumption of fish and hearing loss. Dietary intervention with n-3 PUFAs could prevent or delay the development of age-related hearing loss.
Hamer, M., E. Stamatakis, et al. (2010). "Objectively Assessed Secondhand Smoke Exposure and Mental Health in Adults: Cross-sectional and Prospective Evidence From the Scottish Health Survey." Arch Gen Psychiatry 67(8): 850-855.
Context Secondhand smoke (SHS) exposure has been related to various somatic health outcomes, although very little is known about the association between SHS exposure and mental health. Objective To assess the associations between mental health and SHS exposure, which was objectively measured using the salivary cotinine level as a circulating biochemical marker. Design, Setting, and Participants In a cross-sectional and longitudinal study, a representative sample of 5560 nonsmoking adults (mean [SD] age, 49.8 [15.4] years; 45.5% men) and 2595 smokers (mean [SD] age, 44.8 [14.8] years; 50.2% men) without history of mental illness was drawn from the 1998 and 2003 Scottish Health Survey. A priori, study participants with cotinine values of 15.00 {micro}g/L or higher (to convert to nanomoles per liter, multiply by 5.675) were assumed to be smokers and recategorized as such in all analyses. Main Outcome Measures A score greater than 3 on the 12-item General Health Questionnaire was used as an indicator of psychological distress. Incident psychiatric hospital admissions over 6 years of follow-up were also recorded. Results Psychological distress was apparent in 14.5% of the sample. In logistic regression analyses of the cross-sectional data, after adjustments for a range of covariates, high SHS exposure among nonsmokers (cotinine level >0.70 and <15.00 {micro}g/L) was associated with higher odds of psychological distress (odds ratio = 1.49; 95% confidence interval, 1.13-1.97) in comparison with participants with cotinine levels below the limit of detection ([≤]0.05 {micro}g/L). In prospective analyses, risk of a psychiatric hospital admission was related to high SHS exposure (multivariate adjusted hazard ratio = 2.84; 95% confidence interval, 1.07-7.59) and active smoking (multivariate adjusted hazard ratio = 3.74; 95% confidence interval, 1.55-8.98). Conclusions Exposure to SHS is associated with psychological distress and risk of future psychiatric illness in healthy adults. These concordant findings using 2 different research designs emphasize the importance of reducing SHS exposure at a population level not only for physical health but also for mental health.
Hou, W. H., P. T. Chiang, et al. (2010). "Treatment effects of massage therapy in depressed people: a meta-analysis." J Clin Psychiatry 71(7): 894-901.
OBJECTIVE: To systematically investigate the treatment effects of massage therapy in depressed people by incorporating data from recent studies. DATA SOURCES: A meta-analysis of randomized controlled trials (RCTs) of massage therapy in depressed people was conducted using published studies from PubMed, EMBASE, PsycINFO, and CINAHL electronic database from inception until July 2008. The terms used for the search were derived from medical subheading term (MeSH) massage combined with MeSH depression. Hand searching was also checked for bibliographies of relevant articles. Retrieval articles were constrained to RCTs/clinical trials and human subjects. No language restrictions were imposed. STUDY SELECTION: We included 17 studies containing 786 persons from 246 retrieved references. Trials with other intervention, combined therapy, and massage on infants or pregnant women were excluded. DATA EXTRACTION: Two reviewers independently performed initial screen and assessed quality indicators by Jadad scale. Data were extracted on publication year, participant characteristics, and outcomes by another single reviewer. DATA SYNTHESIS: All trials showed positive effect of massage therapy on depressed people. Seventeen RCTs were of moderate quality, with a mean quality score of 6.4 (SD = 0.85). The pooled standardized mean difference in fixed- and random-effects models were 0.76 (95% CI, 0.61-0.91) and 0.73 (95% CI, 0.52-0.93), respectively. Both indicated significant effectiveness in the treatment group compared with the control group. The variance between these studies revealed possible heterogeneity (tau(2) = 0.06, Cochran chi(2)(16) = 25.77, P = .06). CONCLUSIONS: Massage therapy is significantly associated with alleviated depressive symptoms. However, standardized protocols of massage therapy, various depression rating scales, and target populations in further studies are suggested.
Huppert, F. A. and D. M. Johnson (2010). "A controlled trial of mindfulness training in schools: The importance of practice for an impact on well-being." The Journal of Positive Psychology 5(4): 264 - 274.
We report the results of a short programme of mindfulness training administered to adolescent boys in a classroom setting. Intervention and control groups (N = 155) were compared on measures of mindfulness, resilience and psychological well-being. Although the overall differences between the two groups failed to reach significance, we found that within the mindfulness group, there was a significant positive association between the amount of individual practice outside the classroom and improvement in psychological well-being and mindfulness. We also found that the improvement in well-being was related to personality variables (agreeableness and emotional stability). Most students reported enjoying and benefiting from the mindfulness training, and 74% said they would like to continue with it in the future. The results of this preliminary study are encouraging. Further work is needed to refine the training programme and undertake a definitive randomised controlled trial, using both subjective and objective outcome measures, with long-term follow-up.
Keast, D. R., T. A. Nicklas, et al. (2010). "Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999-2004." Am J Clin Nutr 92(2): 428-435.
Background: Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. Objective: This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12-18 y of age (n = 5811). Design: We conducted secondary analyses of 24-h diet recalls and anthropometric data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. We classified adolescents by frequency of snack consumption (0, 1, 2, 3, and > or = 4 snacks/d) and by the percentage of energy intake from snacks (0%, <10%, 10-19%, 20-29%, 30-39%, and > or = 40%). We classified adolescents who had a body mass index (BMI) > or = 85th percentile of BMI-for-age as overweight or obese. We defined abdominal obesity as a waist circumference > or = 90th percentile. We determined covariate-adjusted prevalences of overweight or obesity and abdominal obesity and odds ratios with SUDAAN software (release 9.0.1; Research Triangle Institute, Research Triangle Park, NC). Results: Mean values of all obesity indicators studied were inversely associated with snacking frequency and percentage of energy from snacks. The prevalence of overweight or obesity and of abdominal obesity decreased with increased snacking frequency and with increased percentage of energy from snacks. Odds ratios (95% CIs) for overweight or obesity and for abdominal obesity ranged from 0.63 (0.48, 0.85) to 0.40 (0.29, 0.57) and from 0.61 (0.43, 0.86) to 0.36 (0.21, 0.63) for 2 to > or = 4 snacks/d, respectively. Reduced risks of overweight or obesity and abdominal obesity were associated with snacking. Conclusion: Snackers, compared with nonsnackers, were less likely to be overweight or obese and less likely to have abdominal obesity.
Kuyken, W., T. Dalgleish, et al. (in press). "How Does Mindfulness-based Cognitive Therapy Work?" in press. doi:10.1016/j.brat.2010.08.003
Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression (Kuyken et al., 2008; Ma & Teasdale, 2004; Teasdale et al., 2000). To date, no compelling research addresses MBCT’s mechanisms of change. This study determines whether MBCT’s treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with 3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction. MBCT’s effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group. MBCT’s treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.
Schueller, S. M. and M. E. P. Seligman (2010). "Pursuit of pleasure, engagement, and meaning: Relationships to subjective and objective measures of well-being." Journal of Positive Psychology 5(4): 253 - 263.
Pleasure, engagement, and meaning are all unique predictors of individuals’ well-being. We explored the relationship between the pursuit of each of these pathways and well-being. Participants (N = 13,565) visited a website and completed a measure about their orientation toward pleasure, engagement, and meaning as a pathway to happiness as well as measures of subjective and objective well-being (OWB). All three pathways correlated with higher levels of subjective well-being (SWB). Pursuing engagement and meaning, however, were more strongly related to SWB than pursuing pleasure. Objective indicators of well-being, including measures of occupational and educational attainment, displayed a similar pattern, with engagement and meaning positively related, whereas pleasure was negatively related. Although these results are merely correlational, it suggests that engaging and meaningful activities may have stronger influences on well-being than pursuing pleasure.
Skarupski, K. A., C. Tangney, et al. (2010). "Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time." Am J Clin Nutr 92(2): 330-335.