Stress, and humans physiological and psychological

Size: px
Start display at page:

Download "Stress, and humans physiological and psychological"

Transcription

1 Adolescent Male Health Stress and Stress Management Among Youth and Young Men American Journal of Men s Health Volume 2 Number 4 December Sage Publications / hosted at Dzung X. Vo, MD, and M. Jane Park, MPH Stress, and humans physiological and psychological responses to stressors, has a strong influence on health status (Cohen, Janicki- Deverts, & Miller, 2007; McEwen, 1998). A substantial body of research links stress to mental and physical health outcomes as well as behaviors that jeopardize health. The stress and stressors literature is vast and spans decades. Definitions and measurements of stress vary in this literature. Some research assesses physiological reaction to events or conditions considered stressful. Many studies examine psychosocial measures of stress, which can be broadly categorized as objective or subjective. Objective or environmental stressors may be acute (e.g., events such as natural disaster or the death of a relative) or chronic (e.g., poverty). Subjective measures assess individuals perceived stress (e.g., frequency of feeling stressed or self-reported ability to cope with life hassles). Some research investigates stress as a mediator (e.g., between socioeconomic status [SES] and health status); some research examines coping mechanisms as a mediator between stress and health outcomes. Adolescence presents a critical period to foster stress management skills. The second decade of life involves tremendous cognitive development that increases adolescents ability to think abstractly, reason, and plan (Halpern-Felsher, Millstein, & Irwin, 2002; Keating 1990). Inherent in this development is an emerging capacity to recognize stress and actively manage it. Stress research with adolescents has focused on outcomes that can be measured in youth, such as mental health problems and health-damaging behaviors. Stress research in adult populations has From The Division of Adolescent Medicine, University of California, San Francisco, California. Address correspondence to: M. Jane Park, Box 0503, LH245, San Francisco, CA ; jane.park@ucsf.edu. examined a broader range of health issues. Thus, promoting effective stress management in adolescence has implications for health across the lifespan. Studies have also examined stressors that adolescents face, using both subjective and objective measures. Although researchers debate which method is better suited for adolescents (Grant et al., 2003), this literature has identified many sources of stress experienced by adolescents. Some researchers report on daily hassles common in adolescence, such as conflicts with family and peers and academic pressure (and consequent lack of free, child-driven play); other research examines less common chronic and acute stressors, such as chronic illness, parental divorce, poverty, natural disaster, exposure to violence in communities, and sexual abuse (Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001; Finkelstein, Kubzansky, Capitman, & Goodman, 2007; Ginsburg, 2007a; Rasmussen, Aber, & Bhana, 2004; Turyk et al., 2007). This column will review research on how stress influences health outcomes and how effective coping mechanisms and stress management can reduce the negative impact of stress. Implications for practice and interventions in clinical and community settings are discussed. Whereas most research in these areas focuses on adults, the column highlights findings related to adolescents. Also highlighted is the relatively small literature that examines gender differences in stress and coping. Although this column focuses primarily on stress and stress management among individuals, it is critical to note that environments significantly influence stress exposure. A large literature on resilience has examined factors that lead young people to thrive despite exposure to adverse circumstances and stressors that threaten healthy development. This field of research has evolved from a focus on individual traits of resilient youth to identifying 353

2 354 American Journal of Men s Health / Vol. 2, No. 4, December 2008 aspects of adaptive systems that protect youth from negative consequences. Protective aspects include a close relationship with parents, opportunities for mastery and learning, and relationships with positive adults (Masten, 2007). Although it is important to strengthen individuals capacity to cope with stress and adversity, it is also critical to develop social policies that reduce stressors in the environment. Although such policies, for example, policies to reduce poverty, maltreatment, and violence, are beyond the scope of this column, it is nonetheless critical to note their importance. The Role of Stress in Health Hans Selye s (1936) classic theory of stress described the physiological response to perceived threats, often simplified as the fight-or-flight response (McEwen, 2005). A widely cited extension of this theory holds that stressful events of daily life cause repeated cycles of physiological and psychological changes, which result in allostatic load, or wear and tear on the body and brain. This model holds that the body s responses to acute stress are potentially adaptive in the short term, but can lead to deleterious health effects on many systems of the body in the long term (McEwen, 1998; McEwen & Seeman, 1999). A substantial body of research has examined the effects of stress on mental health as well as cardiovascular disease, and immune, endocrine, and metabolic function. In addition, a growing literature has implicated psychosocial stress and psychological distress in the development of a variety of nonspecific and medically unexplained somatic symptoms, or functional disorders (Hatcher & Arroll, 2008). Stressors and Mental Health A large body of research implicates stress in various mental health disorders among youth and adults. Several large studies among adults have linked chronic work-related stress and mental disorders in adults. High job strain, increased psychological demands, and job insecurity are strongly associated with depression, particularly among men (Blackmore et al., 2007; Cohen et al., 2007; Virtanen et al., 2007; Wang, 2005; Wang, Lesage, Schmitz, & Drapeau, 2008). Current evidence supports the importance of acute and chronic life stressors in the development of psychopathology among adolescents, a relationship largely mediated by family-based variables (Grant et al., 2003; Grant, Compas, Thurm, McMahon, & Gipson, 2004; Grant et al., 2006). It is well-known that life stress and exposure to stressful life events is a risk factor for suicide in youth (Gould, Greenberg, Velting, & Shaffer, 2003). Other research has linked perceived stress and/or stressful life events in adolescents and young adults to tobacco smoking (Siqueira, Diab, Bodian, & Rolnitzky, 2000), drug and alcohol use (Broman, 2005), and marijuana use (Siqueira, Diab, Bodian, & Rolnitzky, 2001). These findings suggest a potential role of self-medication for stress and psychological symptoms among adolescents. Research suggests normal brain development may be particularly vulnerable to stress during adolescence and puberty (Romeo & McEwen, 2006), making adolescents vulnerable to developing depression (Andersen & Teicher, 2008) and bipolar spectrum disorder (Alloy, Abramson, Walshaw, Keyser, & Gerstein, 2006). Young, postpubertal males appear to be less vulnerable to developing these two disorders compared with their female counterparts, in part because of hormonal differences (Andersen & Teicher 2008) and a less negative and ruminative cognitive style (Alloy et al., 2006). Studies examining the effects of gender in stress and psychopathology in adolescents have reported that, compared with girls, boys are more likely to respond to stressors with externalizing symptoms (such as aggression); and that particular stressors including poverty, divorce, and abuse appear to be associated with higher risk for negative outcomes among boys (Grant et al., 2006). Cardiovascular Disease and Related Conditions Research also implicates chronic stress in the development of hypertension, atherosclerosis, and cardiovascular disease (CVD; Esch, Stefano, Fricchione, & Benson, 2002; Krantz & McCeney, 2002; Rozanski, Blumenthal, & Kaplan, 1999). This literature largely focuses on adults. Literature links several personality traits, including anger as a response to stress, to the development of CVD (Rozanski et al., 1999). A large prospective study of young men reported an association between self-reported anger reactions to stress and premature CVD and myocardial infarction (Chang, Ford, Meoni, Wang, & Klag, 2002). Other research has confirmed the role of anger in CVD (Kubzansky, Davidson, & Rozanski, 2005; Shah, White, White, & Littler, 2004).

3 Stress and Stress Management / Vo, Park 355 There is relatively less literature on the cardiovascular effects of stress during adolescence and young adulthood, in part because it is difficult to study endpoint CVD outcomes in youth. The relatively small studies to date mostly support the role of anger and chronic stressors in the development of hypertension in adolescents and suggest that young males are particularly vulnerable to this effect (Clark & Armstead, 2000; Johnson, Spielberger, Wordern, & Jacob, 1987; Weinrich et al., 2000). Researchers investigating possible mechanisms between chronic stress and CVD point to corticosteroid and catecholamine dysregulation and chronic vascular inflammation (Black, 2006; Rozanski et al., 1999; Shah et al., 2004), which is consistent with the allostatic load model of chronic stress. Stress and the Immune System Literature in psychoneuroimmunology, endocrinology, and related fields have provided insights to help understand how stress can alter the complex relationships between the brain, endocrine, and immune systems to contribute to the development of disease (Blalock & Smith, 2007; Kemeny & Schedlowski, 2007). Stress affects the functioning of the autonomic nervous system and the hypothalamic pituitary adrenal (HPA) axis, which in turn affects immune functioning via various immunomodulators including catecholamines (e.g., epinephrine, norepinephrine) and glucocorticoids (e.g., cortisol; see Figure 1; Padgett & Glaser, 2003; Ziemssen & Kern, 2007). Although research has demonstrated that acute stress enhances the immune system, there is persuasive evidence that chronic stress suppresses immunity (Dhabhar, 2002; Godbout & Glaser, 2006; Kemeny & Schedlowski, 2007). Persuasive evidence indicates that stress increases susceptibility to viral respiratory infections, a relationship mediated by cytokine and cortisol regulation; increased social support and higher SES may be protective (Cohen, 2005). Stress plays a role in the recurrence of viral infections such herpes simplex virus Types 1 and 2, Epstein Barr virus, and herpes zoster virus (Cohen et al., 2007; Godbout & Glaser, 2006; Ziemssen & Kern, 2007). A small literature examining links between stress and cancer has provided inconclusive evidence for stress contributing to the initiation and progression of cancer (Cohen et al., 2007; Godbout & Glaser, 2006; Reiche, Nunes, & Morimoto, 2004). Similarly, the evidence to date regarding the role of stress in autoimmune diseases is inconclusive (Kemeny & Schedulowski, 2007). Emerging research suggests that personality and coping style may influence immunologic Figure 1 The brain, the immune system, and stress. As part of the stress response, the hyopthalamus releases corticotropinreleasing hormone (CRH), which stimulates the pituitary gland to release adrenicorticotropin hormone (ACTH). ACTH acts on the adrenal glands to release the stress hormone cortisol, which acts on the immune system in complex ways. Source: Wein (2000), from the National Institutes of Health. responses to stressors (Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002a). Stress and Metabolic Disorders Another body of literature suggests that chronic stress plays a role in the development of metabolic disorders including obesity, insulin resistance, and Type 2 diabetes mellitus (DM; Mietus-Snyder & Lustig, 2008; Tsatsoulis & Fountoulakis, 2006), which are increasingly serious public health problems among children and adolescents (Institute of Medicine, 2004). It is well-known that glucocorticoids and catecholamines, sometimes referred to as stress hormones or counter-regulatory hormones, oppose the action of insulin (Black, 2006; Brindley & Rolland, 1989). Emerging research supports the hypothesis that chronic stress leads to dysregulation of the HPA axis, causing chronic elevations of these hormones, contributing to the development of insulin resistance, Type 2 diabetes, visceral fat, and obesity (Black, 2006; Brindley & Rolland, 1989; Dallman et al., 2003). Research in animal models and human studies provides preliminary evidence supporting the hypothesis that chronic and acute stress causes increases in stress eating, and especially of calorie-dense comfort

4 356 American Journal of Men s Health / Vol. 2, No. 4, December 2008 foods, thereby contributing to obesity and insulin resistance (Dallman et al., 2003; Mietus-Snyder & Lustig, 2008; Pecoraro, Reyes, Gomez, Bhargava, & Dallman, 2004; Roemmich, Gurgol, & Epstein, 2003; Roemmich, Smith, Epstein, & Lambiase, 2007; Roemmich, Wright, & Epstein, 2002; Tsatsoulis & Fountoulakis, 2006). Gender Differences in Stress Responses Several studies have reported that, in response to a variety of stressors, women subjectively experience more stress and report more symptoms of stress than men and that perceived stress in women (but not men) is associated with health symptoms (Kudielka & Kirschbaum, 2005; Weekes, MacLean, & Berger, 2005). Research on gender differences in interpersonal relationships has reported that adolescent girls in general are more vulnerable to experiencing relationship stress and associated psychological distress; and that adolescent girls tend to find loss of closeness in relationship more stressful, whereas adolescent males tend to find loss of status in peer group more stressful (Rudolph, 2002). Some researchers have criticized the fight-or-flight model for inadequately describing stress responses in females and cite evidence that suggests that females are more likely to respond to stress by seeking social connection, caregiving, and nurturing behaviors, a response sometimes termed the tend-and-befriend response (Taylor et al., 2000). Recent research investigating HPA axis responses to stressors offers preliminary support for this view. Findings generally suggest that males experience higher cortisol responses to stress than women. Gender differences in stress response may be in part modulated by hormonal differences (Ennis, Kelly, & Lambert, 2001; Kajantie & Phillips, 2006; Kudielka & Kirschbaum, 2005; Taylor et al., 2000). Gender differences in HPA axis responses to stress are hypothesized to play a role in the observed gender disparities of stress-related diseases such as CVD and autoimmune diseases (Becker et al., 2007; Kudielka & Kirschbaum, 2005). Stress Management Strategies and Interventions Stress and Coping in Adolescents Although this section focuses on nonpharmacologic stress interventions, it should be noted that adolescents, like people of all ages, manage stress in a variety of ways. Definitions and measurement of coping in the literature vary, but coping generally refers to cognitive and behavioral efforts to manage stress (Bonica & Daniel, 2003; Compas et al., 2001). Various coping strategies and models have been described in youths. These include engagement or approach coping (which acknowledges stressful thoughts and emotions) versus disengagement or avoidance coping (which is oriented away from thoughts and emotions); and problem-focused coping (which emphasizes acting on the source of stress in the environment) versus emotion-focused coping (which emphasizes expressing one s emotional response to stress and seeking support; Bonica & Daniel, 2003; Compas et al., 2001). Although the relationships between stress, coping strategies, and resilience appear to be complex, the literature overall strongly suggests that coping is important in the psychological and physical health of youth, including adolescent health risk behaviors (Bonica & Daniel, 2003; Compas et al., 2001). There is some evidence that more active coping styles such as engagement and problem-focused coping are generally associated with better psychological functioning among adolescents (Clarke, 2006; Compas et al., 2001; Steiner, Erickson, Hernandez, & Pavelski, 2002). Accumulating evidence documents the beneficial effects of regular exercise in preventing or reducing the deleterious psychological, metabolic, and physiologic effects caused by chronic stress (Tsatsoulis & Fountoulakis, 2006). Healthy sleep patterns also affect mood regulation, coping, and mental health of adolescents; and psychosocial stress is known to disrupt normal sleep patterns, which can set up a vicious cycle of sleep and mood dysregulation (Dahl & Lewin, 2002; Graham, 2000). Mindfulness-Based Stress Reduction Mindfulness-based stress reduction (MBSR) is a strategy developed and initially implemented by Jon Kabat-Zinn at the University of Massachusetts Medical School in 1979 (Kabat-Zinn, 2003). Influenced by Eastern contemplative meditation practices, Kabat-Zinn (2003) has proposed an operational definition of mindfulness as... the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment (p. 145). This approach has been hypothesized to

5 Stress and Stress Management / Vo, Park 357 increase effective coping and behavioral change across a range of stressors by responding to stressful situations intentionally and effectively, rather than reacting with escalating panic or fear, thereby modulating the fight-or-flight and other psychological and physiological responses to stress (Miller, Fletcher, & Kabat-Zinn, 1995, p. 197). The standard MBSR curriculum is a skill-based and psychoeducational training program, consisting of 8 to 10 weekly group sessions that involve formal lectures, daily homework exercises, formal sitting meditation, body scan, walking meditation, and yoga (Baer, 2003; Proulx, 2003). A growing body of research has reported promising results of interventions using mindfulness-based interventions in patients with psychiatric illnesses. This includes studies of mindfulness-based cognitive therapy (MBCT), a variation of MBSR that incorporates theory and techniques of cognitive therapy. Several relatively small, uncontrolled studies of adults with generalized anxiety disorders have reported reduced anxiety and depressive symptoms after MBSR (Miller et al., 1995) or MBCT (Evans, et al., 2008). Several more recent randomized controlled trials in chronically depressed adults have reported that MBCT reduces residual depressive symptoms and dramatically reduces relapse rates of depression (Kingston, Dooley, Bates, Lawlor, & Malone, 2007; Ma & Teasdale, 2004; Teasdale et al., 2000; Williams, Russell, & Russell, 2008). Dialectical behavioral therapy, a form of individual psychotherapy that employs mindfulness training and cognitive-behavioral techniques, has been demonstrated in multiple well-controlled trials to be effective for the treatment borderline personality disorder; and preliminary evidence is emerging that supports the application of dialectical behavioral therapy in other psychiatric disorders including treatment-resistant depression and binge-eating disorder (Lynch, Trost, Salsman, & Linehan, 2007). Very preliminary evidence in adult populations also suggests that mindfulness-based interventions may be effective in the treatment of suicidality (Williams, Duggan, Crane, & Fennell, 2006), binge-eating disorder (Kristeller & Hallett, 1999), insomnia (Winbush, Gross, & Kreitzer, 2007; Yook et al., 2008), and bipolar disorder (Williams et al., 2008). Mindfulness training has been proposed for treating substance abuse as a skill for coping with negative thoughts, relapse triggers, and cravings (Bowen, Witkiewitz, Dillworth, & Marlatt, 2007; Marlatt & Chawla, 2007). Studies examining the impact of mindfulness meditation on substance abuse among high-risk adult populations have yielded promising, but mixed, results (Alterman, Koppenhaver, Mulholland, Ladden, & Baime, 2004; Bowen et al., 2006, 2007). There is also a growing literature examining mindfulness-based interventions in adults with medical illnesses. Several reviews of the literature have reported preliminary evidence that MBSR improves medical symptoms in a variety of conditions including chronic pain, psoriasis, and fibromyalgia (Baer, 2003; Bishop, 2002; Grossman, Niemann, Schmidt, & Walach, 2004; Proulx, 2003). Preliminary evidence also suggests that MBSR helps patients cope with the stress and physical symptoms related to a variety of psychological and medical conditions, suggesting a role for mindfulness strategies in coping with morbidity associated with chronic illness (Majumdar, Grossman, Dietz-Waschkowski, Kersig, & Walach, 2002; Reibel, Greeson, Brainard, & Rosenzweig, 2001). Two small, randomized, controlled trials of MBSR in nonclinical populations demonstrated decreased perceived stress and improved psychological functioning in the intervention groups (Astin, 1997; Williams, Kolar, Reger, & Pearson, 2001). Another body of literature has examined the role of mindfulness-based interventions in patients with cancer as a strategy to manage stress, promote relaxation, and alleviate physical discomfort and emotional distress. A randomized wait-list controlled study of adults with heterogeneous types and stages of cancer reported significantly lower symptoms of mood disturbance, anger, depression, confusion, stress, and physical symptoms in the intervention group (Carlson, Ursuliak, Goodey, Angen, & Speca, 2001; Speca, Carlson, Goodey, & Angen, 2000), findings consistent with other, mostly uncontrolled, studies of MBSR in cancer patients (Ott, Norris, & Bauer-Wu, 2006). Several studies reported improvements in psychological outcomes such as quality of life, symptoms of stress, sleep quality, and exercise in patients with breast and prostate cancer who underwent MBSR training (Carlson, Speca, Faris, & Patel, 2007; Carlson, Speca, Patel, & Goodey, 2003). These studies reported intriguing alterations in adrenal hormones, cortisol levels and secretion patterns, and decreased systolic blood pressure as well as a shift in immune cytokine patterns from a proinflammatory towards a more anti-inflammatory profile (Carlson et al., 2003, 2007; Carlson, Speca,

6 358 American Journal of Men s Health / Vol. 2, No. 4, December 2008 Patel, & Goodey, 2004). These findings raise the possibility that stress management interventions in cancer patients may affect not only reported coping and mood symptoms but also physiological parameters believed to play a role in health and disease. There is relatively less literature on MBSR among underserved populations and among youth. Several studies, mostly among Latino inner-city adults with heterogeneous medical issues, have reported evidence that MBSR improved medical and psychological symptoms, reduced chronic care medical visits, and was feasible and acceptable in this population (Roth & Creaser, 1997; Roth & Robbins, 2004; Roth & Stanley, 2002). A relatively small randomized wait-list control study of MBSR among premedical and medical students reported improved psychological distress and depression and increased empathy in the intervention group (Shapiro, Schwartz, & Bonner, 1998). Another randomized wait-list controlled trial of predominantly White female college undergraduates compared MBSR with another meditation-based stress management program. This study reported that both intervention groups had similar reductions of perceived stress and rumination, and that these improvements were mediated by higher scores on a mindfulness scale (Oman, Shapiro, Thoresen, Plante, & Flinders, 2008; Shapiro, Oman, Thoresen, Plante, & Flinders, 2008). Research on mindfulness-based interventions in children and adolescents is sparse (Ott, 2002). A pilot study of an intervention combining techniques from MBSR and Tai Chi at an inner-city middle school reported that such an intervention was feasible and acceptable in this age group and population. This report also underscored the importance of adapting mindfulness-based interventions for the developmental level of the participants (Wall, 2005). A randomized controlled study among healthy normotensive middle school students examined the effects of a simplified MBSR intervention on blood pressure and reported small but significant reductions in resting and ambulatory blood pressure and heart rate in the intervention group (Barnes, Davis, Murzynowski, & Treiber, 2004). Limitations of research on MBSR include methodological limitations, little research on cultural and racial/ethnic components of mindfulness, relatively few studies with youth subjects, and little discussion on gender-related aspects of mindfulness-based interventions. Despite these limitations, the literature to date offers promising evidence that mindfulness training can offer psychological and perhaps physiological benefits to patients with a range of psychiatric and medical illnesses. Further research should employ more rigorous methodology, investigate mindfulness interventions in youth populations, and examine possible gender differences in the intervention (Baer, 2003; Bishop, 2002; Grossman et al., 2004; Kabat-Zinn 2003; Proulx 2003). Mind Body Medicine and the Relaxation Response Other interventions employed to manage stress and the effects of stress on health include other forms of meditation (such as transcendental meditation), yoga, tai-chi, chi-gong, biofeedback, autogenic training (self-hypnosis), and progressive muscle relaxation. In the scientific literature, this heterogeneous group of interventions is sometimes broadly referred to as mind body techniques or grouped together under the umbrella of mind body medicine (Benson-Henry Institute for Mind Body Medicine; Esch, Fricchione, & Stefano, 2003; Vitetta, Anton, Cortizo, & Sali, 2005). The mind body medicine paradigm also emphasizes the importance of proper nutrition and exercise and reframing negative thinking patterns (Benson-Henry Institute for Mind Body Medicine; Jacobs, 2001a). This paradigm proposes that mind body interventions may be particularly useful to reduce stress from general psychosocial stressors and/or medical illness as well as an adjunctive strategy to treat stress-related illnesses (Jacobs, 2001b). These interventions are hypothesized to affect physiological responses to stress by inducing the relaxation response, an integrated pattern of physiological changes that opposes the fight-or-flight stress response, reduces sympathetic nervous system and autonomic nervous system activity, increases parasympathetic nervous system activity, and improves immune functioning (Benson, 1982; Deckro et al., 2002; Jacobs, 2001b). Although the scientific literatures on mind body medicine/relaxation response and mindfulness-based interventions are generally separate, the two models share certain major assumptions and often employ similar techniques, including yoga and sitting meditation (Baer, 2003; Wall, 2005). The literature on mind body medicine and the relaxation response is still developing and has methodological limitations. Several reviews of the literature have reported that mind body interventions and relaxation response techniques appear to be beneficial in headaches, certain autoimmune

7 Stress and Stress Management / Vo, Park 359 diseases, chronic pain, insomnia, anxiety and depression, and hypertension and CVD (Esch et al., 2003; Jacobs, 2001a). Research on the potential benefits of mind body interventions on immune functioning have reported overall promising, but mixed results (Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002b). Relaxation training is widely used among patients with cancer. A randomized controlled trial of a group intervention that included stress management and relaxation training among adults with melanoma reported reduced distress, improved coping, alterations in variables associated with improved immune functioning, and improved medical and mortality outcomes in the intervention group (Fawzy, Canada, & Fawzy, 2003). Other controlled studies of similar interventions among patients with cancer have confirmed the benefits of these interventions on psychological functioning, but have reported mixed results with regards to survival and mortality benefits (Boesen et al., 2007). Several studies have examined the use of mind body interventions and relaxation response among youth populations. A randomized wait-list controlled study of a formal 6-week multicomponent mind body training intervention among college students reported significantly decreased psychological distress, anxiety, and perceived stress in the intervention group (Deckro et al., 2002). Another randomized controlled trial of a stress management program among college students employed cognitive behavioral techniques, social support, and psychoeducation and reported improved resilience and coping and lower perceived stress in the intervention group (Steinhardt & Dolbier, 2008). A randomized controlled trial of progressive muscle relaxation training among male adolescents in Germany who reported subjective stress and had high scores on an anger expression scale reported significantly decreased anger scores as well as decreased salivary cortisol concentrations in the intervention group (Nickel et al., 2005). A randomized controlled trial examined the effects of stress reduction on blood pressure among inner-city African American adolescents (approximately 70% of whom were overweight); it compared transcendental meditation to a health education control group in a high school setting and reported that subjects in the transcendental meditation group had significantly reduced systolic blood pressure at 4 months, with a decrease in daytime systolic blood pressure of about 3.9 mm Hg (Barnes, Treiber, & Johnson, 2004). Several studies have examined stress management interventions in youth with DM. A randomized controlled trial of a stress management curriculum among adolescents and young adults with Type 1 DM employing psychoeducation, progressive muscle relaxation, and counseling around diet and exercise, reported significantly improved coping as well as improved glycemic control in the intervention group (Attari, Sartippour, Amini, & Haghighi, 2006). Another randomized controlled trial of cognitive coping skills training intervention among adolescents with Type 1 DM also reported improved psychological functioning and glycemic control in the intervention group (Grey et al., 1998; Grey, Davidson, Boland, & Tamborlane, 2001). This literature suggests that stress management should be an integral part of chronic disease management. Health Realization Another paradigm for stress management is referred to as health realization. This model starts with the assumption that people have innate wellbeing and internal resiliency to psychosocial stressors and aims to promote or restore this innate psychological health by reversing negative or unhealthy thought processes (Kelley, 2003, 2004). Health realization based psychotherapy has shown promise in adults with a range of psychiatric diagnoses (Kelley, 2004). Educational and empowerment programs based on the health realization/innate health model have been implemented with high-risk youth in a variety of settings including violenceridden housing projects, youth development programs, schools, and juvenile justice centers. These projects have reported improvements in school and family functioning and in subjective psychological functioning (Kelley, 2003, 2004). Implications for Clinical Services and Programs Clinicians and service providers can play an important role in identifying and helping youth and young men cope with stress. Preventive health counseling should involve routine screening for stress-related problems and psychoeducation regarding the role of stress in health and disease (see Table 1). Youth with risk factors such as chronic health conditions, medically unexplained somatic symptoms, low SES, unstable family environments, or exposure to violence, may have special needs related to stress and stress management which should be explored.

8 360 American Journal of Men s Health / Vol. 2, No. 4, December 2008 Table 1 Stress Management Resources for Clinicians and Patients Screening and counseling methods for primary care clinicians HEEADSSS (Goldenring & Rosen, 2004) is a popular psychosocial interviewing method for youth. HEEADSSS stands for home, education, eating, activities, drugs, sexuality, suicide/depression, and safety. SHADESS (Ginsburg, 2007b) is a modification of the HEEADSSS interview, which underscores resiliency by opening with questions about strengths, before questioning about risks. SHADESS stands for school, home, activities, drugs/substance use, emotions/depression, sexuality, and safety. BATHE (Lieberman & Stuart, 1999) is a brief supportive interviewing technique, adapted from psychotherapy for the primary care setting, used to explore and counsel patients around behavioral and stress-related concerns. BATHE stands for background, affect, troubling, handling, empathy. Mindfulness. Interest in MBSR has increased rapidly, with over 240 hospitals and clinics now offering mindfulness-based stress reduction (MBSR) classes nationwide. Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, offers a directory of MBSR classes nationwide as well as trainings for clinicians and educators, and scientific conferences. Clinicians can refer patients to MBSR classes ( Kabat-Zinn s (1990) widely read book contains an overview of mindfulness techniques as well as a description of the Stress Reduction Program at the University of Massachusetts. Suitable for clinicians and patients. Mind body medicine The Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital provides outpatient services as well as trainings for clinicians and policy makers. They also offer audio and video resources teaching relaxation techniques ( The National Institutes of Health maintains a Web site with an overview of mind-body medicine ( Schaffer and Yucha (2004) offer a practical, step-by-step description of how clinicians can apply relaxation response techniques in individual clinical settings. Stress management for teens. These tools have not been formally evaluated but were developed based on extensive clinical experience and what is known from the literature about stress and resilience in youth. The American Academy of Pediatrics Web site offers useful resources for clinicians and teens, including A Teen s Personalized Guide to Managing Stress (Ginsburg & Jablow, 2006; The National Institutes of Health Web site offers information and links to resources on stress management, including stress management in teens ( The Adolescent Health Working Group offers the Behavioral Health Toolkit, available for purchase or free download, which includes stress management handouts and exercises for teens ( Health realization The West Virginia Initiative for Innate Health at the Robert C. Byrd Health Sciences Center, West Virginia University, maintains a website with publications and resources related to the Health Realization/Innate Health model ( hsc.wvu.edu/wviih/) Clinicians can directly apply and teach stress management techniques, offer stress management exercises and handouts, and/or refer patients to stress management programs as appropriate (see Table 1). Counseling youth about stress and stress management can include encouraging youth to be aware of and decrease habitual negative thinking, encouraging youth to develop healthy and effective coping methods, and discussing risks and alternatives to unhealthy coping strategies such as substance use (American Academy of Child & Adolescent Psychiatry, 2005; American Academy of Family Physicians, 2006; Bonica & Daniel, 2003; Clarke, 2006). Counseling parents and families about stress in youth can include encouraging parents to monitor for physical and behavioral symptoms of stress in their teens and supporting a balanced academic, extracurricular, and play schedule (American Academy of Child & Adolescent Psychiatry, 2005; Ginsburg, 2007a). Routine preventive counseling and stress management counseling should also emphasize the importance of healthy nutrition, exercise, and sleep habits. At the community and policy level, stress reduction programs using strategies from mindfulness, relaxation, and health realization can be implemented in community settings including schools, youth development programs, and juvenile justice settings, to prevent and reduce youth risk behaviors outcomes associated with stress (Jacobs, 2001a; Kelley, 2003; Wall, 2005). Clinicians, health delivery organizations, and service providers working with youth should identify or develop local resources for stress management among the youth populations they serve. Clinical training

9 Stress and Stress Management / Vo, Park 361 programs should integrate a biopsychosocial model that describes how biological, psychological, and social factors interact and affect health and teach stress management and other behavioral and psychological interventions to promote health (Novack, et al., 2007). Conclusions It is well-recognized that the major sources of morbidity and mortality in youth are due to mental health and behavioral factors such as injury and violence, risky sexual behavior, substance use, and suicide (Irwin, Burg, & Uhler Cart, 2002), so the role of stress management in mental health and risk behaviors is particularly important in this age group. The literature demonstrates that chronic stress plays an important role in health and disease. Research in adults as well as some research in youth documents beneficial effects of various stress management strategies and interventions on a variety of psychological and health outcomes. Clinicians, youth service providers, and policy makers have an important role to play in identifying and helping youth manage the stress that is pervasive in the lives of many youth. Research on stress and stress management would benefit from more consistency in definition, conceptualization, and measurement of stress. More research is needed in the emerging area of stress management interventions among youth and young men in particular. Future research should investigate developmental, gender, socioeconomic, and cultural factors that affect stress and stress management in youth. Future research should also evaluate the effects of coping and stress management interventions on the most important behavioral and health outcomes in youth. Research on stress management interventions should employ rigorous scientific methodology when feasible, including appropriate control groups and longitudinal designs when possible. Last, but not least, researchers, clinicians, educators, and policy makers should attend not only to risks and negative health outcomes of stress and youth, but also maintain an emphasis on understanding and promoting positive youth development and resiliency, so that our youth can have achieve physical and emotional well-being. Acknowledgments The development of this article was supported in part by grants from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (U45MC and T71MC00003). References Alloy, L. B., Abramson, L. Y., Walshaw, P. D., Keyser, J., & Gerstein, R. K. (2006). A cognitive vulnerability-stress perspective on bipolar spectrum disorders in a normative adolescent brain, cognitive, and emotional development context. Development and Psychopathology, 18, Alterman, A. I., Koppenhaver, J. M., Mulholland, E., Ladden, L. J., & Baime, M. J. (2004). Pilot trial of effectiveness of mindfulness meditation for substance abuse patients. Journal of Substance Use, 9, American Academy of Child & Adolescent Psychiatry. (2005, May). Helping teenagers with stress. Retrieved July 24, 2008, from With+Stress&section=Facts+for+Families American Academy of Family Physicians. (2006, January). Teens and stress: Who has time for it? Retrieved July 24, 2008, from home/children/teens/prevention/278.printerview.html Andersen, S. L., & Teicher, M. H. (2008). Stress, sensitive periods and maturational events in adolescent depression. Trends in Neurosciences, 31, Astin, J. A. (1997). Stress reduction through mindfulness meditation. Effects on psychological symptomatology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics, 66, Attari, A., Sartippour, M., Amini, M., & Haghighi, S. (2006). Effect of stress management training on glycemic control in patients with type 1 diabetes. Diabetes Research and Clinical Practice, 73, Baer, R. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, Barnes, V. A., Treiber, F. A., & Johnson, M. H. (2004). Impact of transcendental meditation on ambulatory blood pressure in African-American adolescents. American Journal of Hypertension, 17, Barnes, V. A., Davis, H. C., Murzynowski, J. B., & Treiber, F. A. (2004). Impact of meditation on resting and ambulatory blood pressure and heart rate in youth. Psychosomatic Medicine, 66, Becker, J. B., Monteggia, L. M., Perrot-Sinal, T. S., Romeo, R. D., Taylor, J. R., Yehuda, R., et al. (2007). Stress and disease: Is being female a predisposing factor? Journal of Neuroscience, 27, Benson, H. (1982). The relaxation response: History, physiological basis and clinical usefulness. Acta Medica Scandinavica Supplementum, 660, Benson-Henry Institute for Mind-Body Medicine, Massachusetts General Hospital. History/Mission. Retrieved July 15, 2008, from

10 362 American Journal of Men s Health / Vol. 2, No. 4, December 2008 Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64, Black, P. H. (2006). The inflammatory consequences of psychologic stress: Relationship to insulin resistance, obesity, atherosclerosis and diabetes mellitus, Type II. Medical Hypotheses, 67, Blackmore, E. R., Stansfeld, S. A., Weller, I., Munce, S., Zagorski, B. M., & Stewart, D. E. (2007). Major depressive episodes and work stress: Results from a national population survey. American Journal of Public Health, 97, Blalock, J. E., & Smith, E. M. (2007). Conceptual development of the immune system as a sixth sense. Brain, Behavior, and Immunity, 21, Boesen, E. H., Boesen, S. H., Frederiksen, K., Ross, L., Dahlstrom, K., Schmidt, G., et al. (2007). Survival after a psychoeducational intervention for patients with cutaneous malignant melanoma: A replication study. Journal of Clinical Oncology, 25, Bonica, C., & Daniel, J. H. (2003). Helping adolescents cope with stress during stressful times. Current Opinion in Pediatrics, 15, Bowen, S., Witkiewitz, K., Dillworth, T. M., Chawla, N., Simpson, T. L., Ostafin, B. D., et al. (2006). Mindfulness meditation and substance use in an incarcerated population. Psychology of Addictive Behaviors, 20, Bowen, S., Witkiewitz, K., Dillworth, T. M., & Marlatt, G. A. (2007). The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addictive Behaviors, 32, Brindley, D. N., & Rolland, Y. (1989). Possible connections between stress, diabetes, obesity, hypertension and altered lipoprotein metabolism that may result in atherosclerosis. Clinical Science (London), 77, Broman, C. L. (2005). Stress, race, and substance use in college. College Student Journal, 39, Carlson, L. E., Speca, M., Faris, P., & Patel, K. D. (2007). One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain, Behavior, and Immunity, 21, Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65, Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology, 29, Carlson, L. E., Ursuliak, Z., Goodey, E., Angen, M., & Speca, M. (2001). The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support Care Cancer, 9, Chang, P. P., Ford, D. E., Meoni, L. A., Wang, N. Y., & Klag, M. J. (2002). Anger in young men and subsequent premature cardiovascular disease: The precursors study. Archives of Internal Medicine, 162, Clarke, A. T. (2006). Coping with interpersonal stress and psychosocial health among children and adolescents: A meta-analysis. Journal of Youth and Adolescence, 35, Clark, R., & Armstead, C. (2000). Preliminary study examining relationship between family environment and resting mean arterial pressure in African-American youth. Journal of Adolescent Health, 27, 3-5. Cohen, S. (2005). Keynote Presentation at the Eight International Congress of Behavioral Medicine: The Pittsburgh common cold studies: Psychosocial predictors of susceptibility to respiratory infectious illness. International Journal of Behavioral Medicine, 12, Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological stress and disease. Journal of the American Medical Association, 298, Compas, B. E., Connor-Smith, J. K., Saltzman, H., Thomsen, A. H., & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: Problems, progress, and potential in theory and research. Psychological Bulletin, 127, Dahl, R. E., & Lewin, D. S. (2002). Pathways to adolescent health sleep regulation and behavior. Journal of Adolescent Health, 31(Suppl. 6), Dallman, M. F., Pecoraro, N., Akana, S. F., La Fleur, S. E., Gomez, F., Houshyar, H., et al. (2003). Chronic stress and obesity: A new view of comfort food. Proceedings of the National Academy of Sciences of the United States of America, 100, Deckro, G. R., Ballinger, K. M., Hoyt, M., Wilcher, M., Dusek, J., Myers, P., et al. (2002). The evaluation of a mind/body intervention to reduce psychological distress and perceived stress in college students. Journal of American College Health, 50, Dhabhar, F. S. (2002). Stress-induced augmentation of immune function the role of stress hormones, leukocyte trafficking, and cytokines. Brain, Behavior, and Immunity, 16, Ennis, M., Kelly, K. S., & Lambert, P. L. (2001). Sex differences in cortisol excretion during anticipation of a psychological stressor: Possible support for the tendand-befriend hypothesis. Stress and Health, 17, Esch, T., Fricchione, G. L., & Stefano, G. B. (2003). The therapeutic use of the relaxation response in stress-related diseases. Medical Science Monitor, 9, RA23-RA34. Esch, T., Stefano, G. B., Fricchione, G. L., & Benson, H. (2002). Stress in cardiovascular diseases. Medical Science Monitor, 8, RA93-RA101.

11 Stress and Stress Management / Vo, Park 363 Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, Fawzy, F. I., Canada, A. L., & Fawzy, N. W. (2003). Malignant melanoma: Effects of a brief, structured psychiatric intervention on survival and recurrence at 10-year follow-up. Archives of General Psychiatry, 60, Finkelstein, D. M., Kubzansky, L. D., Capitman, J., & Goodman, E. (2007). Socioeconomic differences in adolescent stress: The role of psychological resources. Journal of Adolescent Health, 20, Ginsburg, K. R. (2007a). The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics, 119, Ginsburg, K. R. (2007b). Viewing our adolescent patients through a positive lens. Contemporary Pediatrics, 24, Ginsburg, K. R., & Jablow, M. M. (2006). A parent s guide to building resilience: Giving your child roots and wings. Elk Grove Village, IL: American Academy of Pediatrics. Godbout, J. P., & Glaser, R. (2006). Stress-induced immune dysregulation: Implications for wound healing, infectious disease and cancer. Journal of Neuroimmune Pharmacology, 1(4), Goldenring, J. M., & Rosen, D. S. (2004). Getting into adolescent heads: An essential update. Contemporary Pediatrics, 21, Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42, Graham, M. G. (Ed). (2000). Sleep needs, patterns, and difficulties of adolescents. Washington, DC: Forum on Adolescence, Board on Children, Youth, and Families, Commission on Behavioral and Social Sciences and Education, National Research Council, Institute of Medicine, National Academies Press. Grant, K. E., Compas, B. E., Stuhlmacher, A. F., Thurm, A. E., McMahon, S. D., & Halpert, J. A. (2003). Stressors and child and adolescent psychopathology: Moving from markers to mechanisms of risk. Psychological Bulletin, 129, Grant, K. E., Compas, B. E., Thurm, A. E., McMahon, S. D., Gipson, P. Y., Campbell, A. J., et al. (2006). Stressors and child and adolescent psychopathology: Evidence of moderating and mediating effects. Clinical Psychology Review, 26, Grant, K. E., Compas, B. E., Thurm, A. E., McMahon, S. D., & Gipson, P. Y. (2004). Stressors and child and adolescent psychopathology: Measurement issues and prospective effects. Journal of Clinical Child and Adolescent Psychology, 33, Grey, M., Boland, E. A., Davidson, M., Yu, C., Sullivan- Bolyai, S., & Tamborlane, W. V. (1998). Short-term effects of coping skills training as adjunct to intensive therapy in adolescents. Diabetes Care, 21, Grey, M., Davidson, M., Boland, E. A., & Tamborlane, W. V. (2001). Clinical and psychosocial factors associated with achievement of treatment goals in adolescents with diabetes mellitus. Journal of Adolescent Health, 28, Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57, Halpern-Felsher, B. L., Millstein, S. G., & Irwin, C. E., Jr. (2002). Work group II: Healthy adolescent psychosocial development. Journal of Adolescent Health, 31(Suppl. 6), Hatcher, S., & Arroll, B. (2008). Assessment and management of medically unexplained symptoms. British Medical Journal, 336, Institute of Medicine. (2004). Preventing childhood obesity: Health in the balance. Washington, DC: National Academy of Sciences. Retrieved July 31, 2008, from Irwin, C. E., Jr., Burg, S. J., & Uhler Cart, C. (2002). America s adolescents: Where have we been, where are we going? Journal of Adolescent Health, 31(Suppl. 2), Jacobs, G. D. (2001a). Clinical applications of the relaxation response and mind-body interventions. Journal of Alternative and Complementary Medicine, 7(Suppl. 1), S93-S101. Jacobs, G. D. (2001b). The physiology of mind-body interactions: The stress response and the relaxation response. Journal of Alternative and Complementary Medicine, 7(Suppl. 1), S83-S92. Johnson, E. H., Spielberger, C. D., Worden, T. J., & Jacob, G. A. (1987). Emotional and familial determinants of elevated blood pressure in black and white adolescent males. Journal of Psychosomatic Research, 31, Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10, Kajantie, E., & Phillips, D. I. (2006). The effects of sex and hormonal status on the physiological response to acute psychosocial stress. Psychoneuroendocrinology, 31, Keating, D. P. (1990). Adolescent thinking. Cambridge, MA: Harvard University Press. Kelley, T. M. (2003). Preventing youth violence through Health Realization. Youth Violence and Juvenile Justice, 1(4), Kelley, T. M. (2004). Health Realization: A principle-based psychology of positive youth development. Child and Youth Care Forum, 32, Kemeny, M. E., & Schedlowski, M. (2007). Understanding the interaction between psychosocial stress and immunerelated diseases: A stepwise progression. Brain, Behavior, and Immunity, 21, Kiecolt-Glaser, J. K., McGuire, L., Robles, T. F., & Glaser, R. (2002a). Psychoneuroimmunology and psychosomatic

Stress. Chapter Ten McGraw-Hill Higher Education. All rights reserved.

Stress. Chapter Ten McGraw-Hill Higher Education. All rights reserved. Stress Chapter Ten What Is Stress? } Stress is the collective physiological and emotional responses to any stimulus that disturbs an individual s homeostasis } A stressor is any physical or psychological

More information

Using Mindfulness to Live Well. Aleezé Moss Sattar, Ph.D., Associate Director, Mindfulness Institute Thomas Jefferson University

Using Mindfulness to Live Well. Aleezé Moss Sattar, Ph.D., Associate Director, Mindfulness Institute Thomas Jefferson University Using Mindfulness to Live Well Aleezé Moss Sattar, Ph.D., Associate Director, Mindfulness Institute Thomas Jefferson University Stress is the perception of a threat to our physical or psychological well-being

More information

Mindfulness. Mandakini Sadhir, MD Assistant Professor Division of Adolescent Medicine Department of Pediatrics UK HealthCare

Mindfulness. Mandakini Sadhir, MD Assistant Professor Division of Adolescent Medicine Department of Pediatrics UK HealthCare Mindfulness Calligraphy by Thich Nhat Hanh Mandakini Sadhir, MD Assistant Professor Division of Adolescent Medicine Department of Pediatrics UK HealthCare Adolescence Marked by pubertal growth, psychosocial

More information

Disclosures. I have no conflicts of interest to disclose

Disclosures. I have no conflicts of interest to disclose Embracing the Now! Promoting Resilience in Adolescents and Health Providers With Mindfulness Family Medicine Forum Vancouver, British Columbia November 7, 2013 Dzung X. Vo, MD Disclosures I have no conflicts

More information

Science Update: Inform Your Mindfulness Teaching and Practice with Current Research.

Science Update: Inform Your Mindfulness Teaching and Practice with Current Research. Science Update: Inform Your Mindfulness Teaching and Practice with Current Research www.behavioraltech.org Moderator Introduction Randy Wolbert, LMSW, CAADC, CCS www.behavioraltech.org How to Submit Questions

More information

EL29 Mindfulness Meditation

EL29 Mindfulness Meditation EL29 Mindfulness Meditation Lecture 3.2: Mindfulness-based cognitive therapy & stress reduction Quick check: How much can you recall so far? Which of the following is NOT a concern Buddhists have about

More information

WHATEVER IT TAKES! UNDERSTANDING ADVERSE CHILD EXPERIENCES. Nadine Burke Harris, MD, MPH CEO, Center for Youth Wellness March 1, 2013

WHATEVER IT TAKES! UNDERSTANDING ADVERSE CHILD EXPERIENCES. Nadine Burke Harris, MD, MPH CEO, Center for Youth Wellness March 1, 2013 WHATEVER IT TAKES! UNDERSTANDING ADVERSE CHILD EXPERIENCES Nadine Burke Harris, MD, MPH CEO, Center for Youth Wellness March 1, 2013 Effect of ACEs on Health, Learning & Behavior Background Brief overview

More information

Children and the Mind/Body Connection: Mindfulness-Based Practice with Children Who Have Cancer

Children and the Mind/Body Connection: Mindfulness-Based Practice with Children Who Have Cancer Children and the Mind/Body Connection: Mindfulness-Based Practice with Children Who Have Cancer Claire Schoen In recent years, clinicians have increased their use of mindfulness-based practice and have

More information

Mindfulness as a Mediator of Psychological Wellbeing in a Stress Reduction Intervention for Cancer Patients - a randomized study

Mindfulness as a Mediator of Psychological Wellbeing in a Stress Reduction Intervention for Cancer Patients - a randomized study Mindfulness as a Mediator of Psychological Wellbeing in a Stress Reduction Intervention for Cancer Patients - a randomized study Richard Bränström Department of oncology-pathology Karolinska Institute

More information

EL1A Mindfulness Meditation

EL1A Mindfulness Meditation EL1A Mindfulness Meditation Lecture 3.2: Mindfulness-based cognitive therapy & stress reduction Quick check: How much can you recall so far? Which of the following is NOT a concern Buddhists have about

More information

INDEX. B Behavioral activation, 121 competence, 38 flexibility, 29, 110 health, 2, 7, 8, 16, , 127, 144 management, 128

INDEX. B Behavioral activation, 121 competence, 38 flexibility, 29, 110 health, 2, 7, 8, 16, , 127, 144 management, 128 INDEX A Academic performance, 58, 91, 94, 99 Academic scores, 58 Academic skills, 79 Acceptance, 4, 57, 61, 64, 65, 78, 81, 88, 91, 107, 110 112, 114, 120 123, 128, 134, 139, 148, 151, 157 commitment therapy

More information

MIND-BODY PRACTICES TO MODULATE AUTONOMIC TONE FOR CHRONIC DISEASE MSA COALITION PATIENT & FAMILY CONFERENCE

MIND-BODY PRACTICES TO MODULATE AUTONOMIC TONE FOR CHRONIC DISEASE MSA COALITION PATIENT & FAMILY CONFERENCE MIND-BODY PRACTICES TO MODULATE AUTONOMIC TONE FOR CHRONIC DISEASE MSA COALITION PATIENT & FAMILY CONFERENCE Landrew Sevel, PhD Osher Center for Integrative Medicine at Vanderbilt Department of Psychiatry

More information

PSYCHOLOGY. Chapter 14 STRESS, LIFESTYLE, AND HEALTH PowerPoint Image Slideshow

PSYCHOLOGY. Chapter 14 STRESS, LIFESTYLE, AND HEALTH PowerPoint Image Slideshow PSYCHOLOGY Chapter 14 STRESS, LIFESTYLE, AND HEALTH PowerPoint Image Slideshow Stress, Lifestyle, and Health Stress: responding to events (stressors) that are appraised as being overwhelming or threatening

More information

UNC School of Social Work s Clinical Lecture Series

UNC School of Social Work s Clinical Lecture Series UNC School of Social Work s Clinical Lecture Series University of North Carolina at Chapel Hill School of Social Work October 26, 2015 Noga Zerubavel, Ph.D. Psychiatry & Behavioral Sciences Duke University

More information

Mental Health and Stress Management

Mental Health and Stress Management Mental Health and Stress Management In recent years, psychologists have become more interested in positive psychology Focus on positive emotions, characteristics, strengths, and conditions that create

More information

Best Practice Guideline

Best Practice Guideline Psychotherapy for Depression Indications for Psychotherapy: Best Practice Guideline *Patient s presenting symptoms. *Presenting History. *Willingness to participate in the therapeutic process. *Readiness

More information

A Review of the Literature on Mindfulness-Based Treatments for Patients with Cancer

A Review of the Literature on Mindfulness-Based Treatments for Patients with Cancer Pacific University CommonKnowledge School of Graduate Psychology College of Health Professions 7-24-2009 A Review of the Literature on Mindfulness-Based Treatments for Patients with Cancer Cooper C. Dean

More information

Stress, Health, and Coping

Stress, Health, and Coping Stress, Health, and Coping. Health Psychology The field concerned with the promotion of health and the prevention and treatment of illness as it relates to psychological factors Stress The general term

More information

CHAPTER 13 STRESS, COPING AND HEALTH

CHAPTER 13 STRESS, COPING AND HEALTH CHAPTER 13 STRESS, COPING AND HEALTH THE RELATIONSHIP BETWEEN STRESS AND DISEASE Contagious diseases vs. chronic diseases Biopsychosocial model Why? The Biomedical Model is unable to fully account for

More information

Mindfulness in Cancer Care. Christina Shennan Psychotherapist UKCP Dip MBAs CancerHelp

Mindfulness in Cancer Care. Christina Shennan Psychotherapist UKCP Dip MBAs CancerHelp Mindfulness in Cancer Care Christina Shennan Psychotherapist UKCP Dip MBAs CancerHelp Cancer and suffering Cancer is frequently accompanied by psychological suffering, often long lasting (1) 10 20% of

More information

BREATHE MINDFULNESS MINDFULNESS-BASED RELAPSE PREVENTION: AN OVERVIEW THERISSA LIBBY MARRCH FALL CONFERENCE 2014

BREATHE MINDFULNESS MINDFULNESS-BASED RELAPSE PREVENTION: AN OVERVIEW THERISSA LIBBY MARRCH FALL CONFERENCE 2014 MINDFULNESS-BASED RELAPSE PREVENTION: AN OVERVIEW THERISSA LIBBY MARRCH FALL CONFERENCE 2014 BREATHE Breath Meditation (Bowen, Chawla and Marlatt [Guilford, 2011] Mindfulness-Based Relapse Prevention for

More information

Adverse Childhood Experiences and Toxic Stress Among Agricultural Worker Families: The Role of Primary Care & Promotores(as)

Adverse Childhood Experiences and Toxic Stress Among Agricultural Worker Families: The Role of Primary Care & Promotores(as) Adverse Childhood Experiences and Toxic Stress Among Agricultural Worker Families: The Role of Primary Care & Promotores(as) ELENA REYES, PHD, CENTER DIRECTOR JAVIER ROSADO, PHD DIRECTOR CLINICAL RESEARCH

More information

From Risk to Protection: Engaging Caregivers Affected by Interpersonal Trauma in Child and Family Focused Trauma Treatment

From Risk to Protection: Engaging Caregivers Affected by Interpersonal Trauma in Child and Family Focused Trauma Treatment From Risk to Protection: Engaging Caregivers Affected by Interpersonal Trauma in Child and Family Focused Trauma Treatment Sarah Gardner, LCSW-C 4 th BIENNIAL TRAUMA CONFERENCE Addressing Trauma across

More information

Stress is like an iceberg. We can see one-eighth of it above, but what about what s below?

Stress is like an iceberg. We can see one-eighth of it above, but what about what s below? Chapter 4: Managing Stress & Coping With Loss Stress is like an iceberg. We can see one-eighth of it above, but what about what s below? Something to consider... The Japanese eat very little fat &... The

More information

Grief induced Substance abuse, Sickness, Death, and Dying

Grief induced Substance abuse, Sickness, Death, and Dying Mark H. Keep, M.D Pathways to Success, August 17, 2016 Grief induced Substance abuse, Sickness, Death, and Dying Each person responds to grief differently The nature of the loss to the person. The grieving

More information

7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER EIGHT CHAPTER OUTLINE. Stress and Physical Health. Oltmanns and Emery

7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER EIGHT CHAPTER OUTLINE. Stress and Physical Health. Oltmanns and Emery ABNORMAL PSYCHOLOGY SEVENTH EDITION Oltmanns and Emery PowerPoint Presentations Prepared by: Ashlea R. Smith, Ph.D. This multimedia and its contents are protected under copyright law. The following are

More information

Mental Health Problems in Primary Care: Prevent them before they occur

Mental Health Problems in Primary Care: Prevent them before they occur Mental Health Problems in Primary Care: Prevent them before they occur Professor Samuel YS Wong Division of Family Medicine and Primary Healthcare School of Public Health and Primary Care, Chinese University

More information

Health Psychology. What is Stress? Stress: Theories & Models. Stress: Theories & Models

Health Psychology. What is Stress? Stress: Theories & Models. Stress: Theories & Models Health Psychology Psychology 46.339 (01) Summer 2007 Instructor: Dr. Fuschia Sirois Wednesday July 18: Lecture 5 Prep. Guide 4 What is Stress? Stress is a negative emotional experience accompanied by predictable

More information

Relaxation and Stress Management Through Meditation. Dennis Abreu AM LCSW

Relaxation and Stress Management Through Meditation. Dennis Abreu AM LCSW Relaxation and Stress Management Through Meditation Dennis Abreu AM LCSW OBJECTIVES Early Childhood Suspension and Expulsion What is Stress Effects of stress on Central Nervous System Effects of Stress

More information

Gender Sensitive Factors in Girls Delinquency

Gender Sensitive Factors in Girls Delinquency Gender Sensitive Factors in Girls Delinquency Diana Fishbein, Ph.D. Research Triangle Institute Transdisciplinary Behavioral Science Program Shari Miller-Johnson, Ph.D. Duke University Center for Child

More information

Chapter 14: Stress and Health

Chapter 14: Stress and Health Chapter 14: Stress and Health Studying the Effects of Stress on Health n Behavioral Medicine: field that combines knowledge of biomedical perspec6ve and behavioral perspec6ve to study and treat health

More information

MINDFULNESS & EDUCATION. Davis Behavioral Health

MINDFULNESS & EDUCATION. Davis Behavioral Health MINDFULNESS & EDUCATION Davis Behavioral Health WELCOME & INTRODUCTIONS ØName ØSchool & position ØWhat brings you here? ØAny previous knowledge of mindfulness, or participation in mindfulness practice?

More information

The evidence behind mindful eating

The evidence behind mindful eating The evidence behind mindful eating Shawn N. Hondorp, PhD, ABPP Board Certified Clinical Health Psychologist Division of Psychiatry and Behavioral Medicine Spectrum Health System, Grand Rapids, MI Adjunct

More information

Chapter 7 Physical Disorders and Health Psychology

Chapter 7 Physical Disorders and Health Psychology Page 1 Chapter 7 Physical Disorders and Health Psychology Psychological and Social Factors that Influence Health Psychological, Behavioral, and Social Factors Are major contributors to medical illness

More information

OVERVIEW OVERVIEW MINDFULNESS APPROACHES IN ADDICTION TREATMENT AND! LONG-TERM RECOVERY MANAGEMENT THERISSA LIBBY! METROPOLITAN STATE UNIVERSITY

OVERVIEW OVERVIEW MINDFULNESS APPROACHES IN ADDICTION TREATMENT AND! LONG-TERM RECOVERY MANAGEMENT THERISSA LIBBY! METROPOLITAN STATE UNIVERSITY MINDFULNESS APPROACHES IN ADDICTION TREATMENT AND! LONG-TERM RECOVERY MANAGEMENT THERISSA LIBBY! METROPOLITAN STATE UNIVERSITY RUTGERS SUMMER SCHOOL OF ADDICTION STUDIES 2015 1 2 OVERVIEW OVERVIEW Tuesday!

More information

Trauma and Stress: Neurobiology and the Impact on Development

Trauma and Stress: Neurobiology and the Impact on Development Trauma and Stress: Neurobiology and the Impact on Development https://www.cbsnews.com/news/oprah winfrey treatingchildhood trauma ELIZABETH REEVE MD HEALTHPARTNERS MEDICAL GROUP Why is This Topic Important?

More information

ACCPH Mindfulness Therapy

ACCPH Mindfulness Therapy ACCPH Mindfulness Therapy Mindfulness Mindfulness originated from Buddhist meditation that helps people focus on the present to gain greater awareness of their emotions and improve general well-being.

More information

WORKING WITH CHRONICALLY ILL CHILDREN & YOUTH. Angela L. Neese University of Indianapolis

WORKING WITH CHRONICALLY ILL CHILDREN & YOUTH. Angela L. Neese University of Indianapolis WORKING WITH CHRONICALLY ILL CHILDREN & YOUTH Angela L. Neese University of Indianapolis OBJECTIVES Chronic illness in children and adolescents Stress related to chronic illness in youth Psychological

More information

By The American Institute of Health Care Professionals, Inc.

By The American Institute of Health Care Professionals, Inc. By The American Institute of Health Care Professionals, Inc. Table Of Content 2 The Impact Of Stress 4 What is 5 Conditions Treated By MBSR 6 Principles of MBSR 7 The Basis Of Mindfulness 8 The Core Of

More information

Mindfulness Meditation: Use in TBI Rehabilitation. Liesel-Ann C. Meusel, Ph.D., C.Psych. Lesley A. Ruttan, Ph.D., C.Psych.

Mindfulness Meditation: Use in TBI Rehabilitation. Liesel-Ann C. Meusel, Ph.D., C.Psych. Lesley A. Ruttan, Ph.D., C.Psych. Mindfulness Meditation: Use in TBI Rehabilitation Liesel-Ann C. Meusel, Ph.D., C.Psych. Lesley A. Ruttan, Ph.D., C.Psych. February 2, 2018 Overview & Learning Objectives Mindfulness Meditation What is

More information

Stress and Disease. Chapter 8. Elsevier items and derived items 2008 by Mosby, Inc., an affiliate of Elsevier Inc.

Stress and Disease. Chapter 8. Elsevier items and derived items 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Stress and Disease Chapter 8 Stress A person experiences stress when a demand exceeds a person s coping abilities, resulting in reactions such as disturbances of cognition, emotion, and behavior that can

More information

MEDICAL POLICY EFFECTIVE DATE: 04/28/11 REVISED DATE: 04/26/12, 04/25/13, 04/24/14, 06/25/15, 06/22/16, 06/22/17

MEDICAL POLICY EFFECTIVE DATE: 04/28/11 REVISED DATE: 04/26/12, 04/25/13, 04/24/14, 06/25/15, 06/22/16, 06/22/17 MEDICAL POLICY SUBJECT: STANDARD DIALECTICAL BEHAVIOR A nonprofit independent licensee of the BlueCross BlueShield Association PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered,

More information

Patient Navigation Intervention HIV and Mental Health

Patient Navigation Intervention HIV and Mental Health Enhanced Patient Navigation for HIV - Positive Women of Color Patient Navigation Intervention HIV and Mental Health Causes Biological Causes Biochemical Disturbances Genetics Infections- can cause brain

More information

Presented by Tim Burns.

Presented by Tim Burns. Mindfulness and the Brain Presented by Tim Burns www.timburnseducare.com Star Walk Star Walk The Mindful Brain Mindfulness Paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.

More information

Unique Experience of the World

Unique Experience of the World Unique Experience of the World Preparing for Anticipated World Dangerous BIOLOGY OF STRESS CHARACTERISTICS Brawn over Brains Focused: Fight, Flight or Freeze OUTCOME Individual & species survive the worst

More information

CARLOWMindfulness. Slow Down. Let Go. Be Well. MBSR PARTICIPANT APPLICATION INFORMATION and REGISTRATION. Dear Applicant.

CARLOWMindfulness. Slow Down. Let Go. Be Well. MBSR PARTICIPANT APPLICATION INFORMATION and REGISTRATION. Dear Applicant. CARLOWMindfulness Slow Down. Let Go. Be Well MBSR PARTICIPANT APPLICATION INFORMATION and REGISTRATION Dear Applicant. Please review this Application and Registration Document and complete the registration

More information

Mindfulness: A New Frontier in Healthy Aging

Mindfulness: A New Frontier in Healthy Aging Mindfulness: A New Frontier in Healthy Aging Robin R. Whitebird PhD, MSW, LISW Associate Professor, School of Social Work St Catherine University University of St Thomas Objectives Define and discuss mindfulness

More information

Mindfulness: A New Frontier in Healthy Aging

Mindfulness: A New Frontier in Healthy Aging Mindfulness: A New Frontier in Healthy Aging Robin R. Whitebird PhD, MSW, LISW Associate Professor, School of Social Work St Catherine University University of St Thomas 1 Objectives Define and discuss

More information

Mindfulness-Based Treatments for Alcohol and Substance Use Disorders

Mindfulness-Based Treatments for Alcohol and Substance Use Disorders Mindfulness-Based Treatments for Alcohol and Substance Use Disorders Katie Witkiewitz, PhD University of New Mexico katiew@unm.edu Research supported by Washington State University-Vancouver, University

More information

DOWNLOAD PDF PREVENTING DRUG USE AMONG YOUTH THROUGH COMMUNITY OUTREACH

DOWNLOAD PDF PREVENTING DRUG USE AMONG YOUTH THROUGH COMMUNITY OUTREACH Chapter 1 : Preventing Drug Misuse and Addiction: The Best Strategy National Institute on Drug Abuse (N Congress directed the military to establish pilot community outreach programs to reduce the demand

More information

Outline. How does burnout manifest? 24/05/2016. Mindfulness to Address Chronic Stress and Burnout: An Educational Imperative. Take Home Messages

Outline. How does burnout manifest? 24/05/2016. Mindfulness to Address Chronic Stress and Burnout: An Educational Imperative. Take Home Messages Mindfulness to Address Chronic Stress and Burnout: An Educational Imperative Aviad Haramati, PhD Professor of Physiology and Medicine Director, Center for Innovation and Leadership in Education (CENTILE)

More information

Stress: The Good, Bad, and the Ugly Part One. Catherine Nelson, Ph.D. University of Utah

Stress: The Good, Bad, and the Ugly Part One. Catherine Nelson, Ph.D. University of Utah Stress: The Good, Bad, and the Ugly Part One Catherine Nelson, Ph.D. University of Utah Cathy.nelson@utah.edu Course Overview: Stress Session One Definitions Physiology Toxic Stress Risk factors for experiencing

More information

The Co-Occurring Disorders Treatment Program

The Co-Occurring Disorders Treatment Program G R O U P D E S C R I P T I O N S The Co-Occurring Disorders Treatment Program is designed to provide a continuum of services to the substance abusing and dually diagnosed populations. These services include

More information

Nancy Heath, Ph.D. Department of Educational and Counselling Psychology. Image source:

Nancy Heath, Ph.D. Department of Educational and Counselling Psychology. Image source: Nancy Heath, Ph.D. Department of Educational and Counselling Psychology Image source: www.klara.be/.../cdlargethumb Why am I here? Stress in the workplace Stress and Emotion Reactivity & Regulation Mindfulness

More information

Managing Stress Through Mindfulness. Brett Wade, PhD

Managing Stress Through Mindfulness. Brett Wade, PhD Managing Stress Through Mindfulness Brett Wade, PhD Plan 45 min Observe: one of four levels Background Statistics of mental health related to students Why are mental health statistics for students on the

More information

Anxiety in Children & Adolescents 4/1/2019. Mental Health America of Eastern Missouri. Addressing Anxiety and Depression In Children.

Anxiety in Children & Adolescents 4/1/2019. Mental Health America of Eastern Missouri. Addressing Anxiety and Depression In Children. Addressing Anxiety and Depression In Children 1 Mental Health America of Eastern Missouri Our Mission To promote mental health and to improve the care and treatment of persons with mental illness through

More information

Running head: MINDFULNESS AND PSYCHOLOGICAL WELLBEING. A Longitudinal Multilevel Analysis of the Intra-Individual Relationship Between Mindfulness

Running head: MINDFULNESS AND PSYCHOLOGICAL WELLBEING. A Longitudinal Multilevel Analysis of the Intra-Individual Relationship Between Mindfulness Mindfulness and Psychological Wellbeing 1 Running head: MINDFULNESS AND PSYCHOLOGICAL WELLBEING A Longitudinal Multilevel Analysis of the Intra-Individual Relationship Between Mindfulness and Psychological

More information

MINDFULNESS INCREASES ANALYTICAL THOUGHT AND DECREASES JUST WORLD BELIEFS

MINDFULNESS INCREASES ANALYTICAL THOUGHT AND DECREASES JUST WORLD BELIEFS Submitted: December 15, 2016 Revised: May 11, 2016 Accepted: January 18, 2017 MINDFULNESS INCREASES ANALYTICAL THOUGHT AND DECREASES JUST WORLD BELIEFS Carey J. Fitzgerald University of South Carolina

More information

Body Scan: Managing Pain, Illness, & Stress With Guided Mindfulness Meditation By Sona, Vidyamala READ ONLINE

Body Scan: Managing Pain, Illness, & Stress With Guided Mindfulness Meditation By Sona, Vidyamala READ ONLINE Body Scan: Managing Pain, Illness, & Stress With Guided Mindfulness Meditation By Sona, Vidyamala READ ONLINE If searching for the book by Sona, Vidyamala Body Scan: Managing Pain, Illness, & Stress with

More information

What nurses need to know about Trauma-Informed Care

What nurses need to know about Trauma-Informed Care What nurses need to know about Trauma-Informed Care Define trauma-informed care Identify how to assess for trauma Tap in to resources for these patients and their families Kaiser Permanente,1995-1997

More information

TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT:

TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT: TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT: How to Appreciate, Assess and Address Heather C. Forkey, M.D. Foster Children Evaluation Service (FaCES) UMass Children s Medical Center Worcester MA Disclosure

More information

15 Minute Hour A Hands-on Workshop

15 Minute Hour A Hands-on Workshop 15 Minute Hour A Hands-on Workshop Marian R. Stuart, Ph.D. Emeritus Professor of Family Medicine Rutgers-Robert Wood Johnson Medical School Focus of Presentation The connection between primary care and

More information

INFORMING, EDUCATING, EMPOWERING FAMILIES

INFORMING, EDUCATING, EMPOWERING FAMILIES INFORMING, EDUCATING, EMPOWERING FAMILIES 617-236-7210 www.fcsn.org fcsninfo@fcsn.org The Role of Occupational Therapy in Supporting Children who have Experienced Trauma Presented by: Marisa Capogreco,

More information

Stress, Health, & Coping. Radwan Banimustafa MD

Stress, Health, & Coping. Radwan Banimustafa MD Stress, Health, & Coping Radwan Banimustafa MD Introduction: What Is Stress? Stress a negative emotional state occurring in response to events that are perceived as taxing or exceeding a person s resources

More information

SUBSTANCE ABUSE A Quick Reference Handout by Lindsey Long

SUBSTANCE ABUSE A Quick Reference Handout by Lindsey Long Substance Abuse 1 SUBSTANCE ABUSE A Quick Reference Handout by Lindsey Long Diagnostic Criteria (APA, 2004) Within a 12 month period, a pattern of substance use leading to significant impairment or distress

More information

Mental Health America of Eastern Missouri

Mental Health America of Eastern Missouri Be Where You Are everyday mindfulness for mental wellness Mental Health America of Eastern Missouri Our Mission To promote mental health and to improve the care and treatment of persons with mental illness

More information

How do I handle difficult situations with my friends, family, community, and school work?

How do I handle difficult situations with my friends, family, community, and school work? How do I handle difficult situations with my friends, family, community, and school work? Let s Assess YOUR Stress *Go to www.mindtools.com/pages/article/newtcs_82.htm *Complete the Social Readjustment

More information

The Endocrine response to Stress. Dr. Sajeda Al-Chalabi Assistant Professor Head of Dept. Of Physiology

The Endocrine response to Stress. Dr. Sajeda Al-Chalabi Assistant Professor Head of Dept. Of Physiology The Endocrine response to Stress Dr. Sajeda Al-Chalabi Assistant Professor Head of Dept. Of Physiology The Physiology of Stress A series of neural and chemical reactions meant for physical survival

More information

Goal of Presentation 10/23/2017. Mindfulness. Mindfulness and Relapse Prevention

Goal of Presentation 10/23/2017. Mindfulness. Mindfulness and Relapse Prevention Mindfulness and Relapse Prevention Lynn Catlin, PhD, Presenter With help from Sheryl Lilke, Intern Extraordinaire Goal of Presentation Increase Understanding of How Mindfulness Can Aid Preventing Relapse

More information

Stressed out! The science and practice of stress management. Bonnie A. McGregor, Ph.D.

Stressed out! The science and practice of stress management. Bonnie A. McGregor, Ph.D. Stressed out! The science and practice of stress management Bonnie A. McGregor, Ph.D. % endorsing item (n = 134) Cancer survivors beliefs about cancer causes 60 50 40 30 20 10 0 Genetics Stress God's will

More information

Roots of Adult Disease Traced to Early Childhood Adversity

Roots of Adult Disease Traced to Early Childhood Adversity Contact: Millicent Lawton Center on the Developing Child millicent_lawton@harvard.edu (617) 496-0429 Roots of Adult Disease Traced to Early Childhood Adversity Early childhood programs could prevent chronic

More information

Pain Management: More than Just a Pill

Pain Management: More than Just a Pill Pain Management: More than Just a Pill ANNE LYNCH-JORDAN, PHD ASSISTANT PROFESSOR PEDIATRICS & ANESTHESIOLOGY UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE CINCINNATI CHILDREN S HOSPITAL MEDICAL CENTER

More information

Pain Management: More than Just a Pill

Pain Management: More than Just a Pill Pain Management: More than Just a Pill ANNE LYNCH- JORDAN, PHD ASSISTANT PROFESSOR PEDIATRICS & ANESTHESIOLOGY UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE CINCINNATI CHILDREN S HOSPITAL MEDICAL CENTER

More information

Dr. Delphine Collin-Vézina, Ph.D.

Dr. Delphine Collin-Vézina, Ph.D. Interview Presentation Tier 2 Canada Research Chair Position School of Social Work McGill University Dr. Delphine Collin-Vézina, Ph.D. Career Path Academic Studies and Research Realizations Applied research

More information

Welcome to the 2013 Iowa Adverse Childhood Experiences Summit. Data into Action: Crafting a Response to Iowa s ACE Score

Welcome to the 2013 Iowa Adverse Childhood Experiences Summit. Data into Action: Crafting a Response to Iowa s ACE Score Welcome to the 2013 Iowa Adverse Childhood Experiences Summit Data into Action: Crafting a Response to Iowa s ACE Score Dr. Nadine Burke Harris Founder and Chief Executive Officer, Center for Youth Wellness

More information

Sleep and mental wellbeing: exploring the links

Sleep and mental wellbeing: exploring the links Sleep and mental wellbeing: exploring the links Like most physiological functions, the length and quality of sleep is influenced by a host of biological, environmental and lifestyle factors. Across all

More information

Identifying and Treating Anxiety Disorders

Identifying and Treating Anxiety Disorders June 2015 NEWS Identifying and Treating Anxiety Disorders From being afraid of the dark to getting nervous before major exams, some anxiety is a normal part of childhood and adolescence. But when worries

More information

Test 1(ch 1 3) sp 06, due 2/9/06. Student: 1. Optimism, trust, and self confidence are components of

Test 1(ch 1 3) sp 06, due 2/9/06. Student: 1. Optimism, trust, and self confidence are components of Test 1(ch 1 3) sp 06, due 2/9/06 Student: 1. Optimism, trust, and self confidence are components of A. physical wellness. B. emotional wellness. C. spiritual wellness. D. interpersonal wellness. 2. People

More information

RESEARCH-TO-PRACTICE SUMMARY

RESEARCH-TO-PRACTICE SUMMARY Dialog, 18(1), 113-117 Copyright 2015, ISSN: 1930-9325 RESEARCH-TO-PRACTICE SUMMARY Addressing Trauma in a Diverse Head Start Sample: Relevance for Practitioners Marla Pfenninger Saint Gilles and John

More information

Establishing the Link: Assessment and Intervention of Children and Adults October 23, 2018

Establishing the Link: Assessment and Intervention of Children and Adults October 23, 2018 Mental Health Aspects in Persons with Intellectual/Developmental Disabilities: Assessment and Diagnostic Practices (Keynote Speaker) Robert J. Fletcher, DSW, ACSW, LCSW, NADD-CC NADD Founder & CEO Emeritus

More information

Module 2: Types of Groups Used in Substance Abuse Treatment. Based on material in Chapter 2 of TIP 41, Substance Abuse Treatment: Group Therapy

Module 2: Types of Groups Used in Substance Abuse Treatment. Based on material in Chapter 2 of TIP 41, Substance Abuse Treatment: Group Therapy Module 2: Types of Groups Used in Substance Abuse Treatment Based on material in Chapter 2 of TIP 41, Substance Abuse Treatment: Group Therapy U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse

More information

Effects of Mindful Breathing on Depression in Japanese University Students: Focusing on Negative Rumination and Self-Acceptance

Effects of Mindful Breathing on Depression in Japanese University Students: Focusing on Negative Rumination and Self-Acceptance WASEDA RILAS JOURNAL NO. 5 Effects of Mindful Breathing on Depression in Japanese University Students: Focusing on Negative Rumination and Self-Acceptance Manami MAEKAWA This study examined the effects

More information

INTEGRATIVE MEDICINE

INTEGRATIVE MEDICINE THE EFFICACY AND COST EFFECTIVENESS OF INTEGRATIVE MEDICINE A Review of the Medical and Corporate Literature A Bravewell Collaborative Report Health & Wellbeing By Erminia (Mimi) Guarneri, MD Founder and

More information

MINDFULNESS-BASED INTERVENTIONS & INFERTILITY CARE

MINDFULNESS-BASED INTERVENTIONS & INFERTILITY CARE Sexual Health in the Context of Infertility Treatment, Saturday, 1 July, 2017 University Hospital of Geneva 14H15-14h50 MINDFULNESS-BASED INTERVENTIONS & INFERTILITY CARE PD Dr Isabelle STREULI, Hélène

More information

Homework Tracking Notes

Homework Tracking Notes Homework Tracking Food & activity records online (myfitnesspal) Meditation practice days this week Food, activity & mood journal (paper) Specific food or eating behavior goal: Specific activity /fun goal:

More information

COGNITIVE BEHAVIOR THERAPY (CBT) & DIALECTICAL BEHAVIOR THERAPY (DBT)

COGNITIVE BEHAVIOR THERAPY (CBT) & DIALECTICAL BEHAVIOR THERAPY (DBT) COGNITIVE BEHAVIOR THERAPY (CBT) & DIALECTICAL BEHAVIOR THERAPY (DBT) Kim Bullock, MD Clinical Associate Professor, Director of Neurobehavioral Clinic Director of Virtual Reality Therapy Lab Department

More information

Health and Well-Being in Communities of Color

Health and Well-Being in Communities of Color Health and Well-Being in Communities of Color A Consideration of Transcendental Meditation: A Means of Empowerment Randolph Carter East Ed Presented at the 38 th Annual Minority Health Conference UNC Gillings

More information

October 8, 2013 Teens and Stress Presented by: Susan Sakamoto, MSW, MHP, EMMHS, CMH

October 8, 2013 Teens and Stress Presented by: Susan Sakamoto, MSW, MHP, EMMHS, CMH October 8, 2013 Teens and Stress Presented by: Susan Sakamoto, MSW, MHP, EMMHS, CMH susans@youtheastsideservices.org A lifeline for kids and families AGENDA Who Is YES? Let s Talk Stress o What is it?

More information

Addiction and the Mind

Addiction and the Mind Addiction and the Mind G. Alan Marlatt, Ph.D. University of Washington Addictive Behaviors Research Center abrc@u.washington.edu http://depts.washington.edu/abrc Brickman s Model of Helping & Coping

More information

Strategies to Gain Acceptance for Wellness/ Mind-Body Programs by Skeptical Residents and Clinical Faculty: Stress Physiology

Strategies to Gain Acceptance for Wellness/ Mind-Body Programs by Skeptical Residents and Clinical Faculty: Stress Physiology Strategies to Gain Acceptance for Wellness/ Mind-Body Programs by Skeptical Residents and Clinical Faculty: Stress Physiology Michael D. Lumpkin, PhD Professor of Integrative Physiology and Biochemistry

More information

Changing the odds for children exposed to trauma and stress

Changing the odds for children exposed to trauma and stress Changing the odds for children exposed to trauma and stress Jennifer Hays-Grudo, PhD Regents Professor Human Development and Family Science Adjunct Professor of Pediatrics OSU Center for Health Sciences

More information

Hammen Publications since 2000

Hammen Publications since 2000 Hammen, 1 Hammen Publications since 2000 Rao, U., Daley, S., & Hammen, C. (2000). Relationship between depression and substance use disorders in adolescent women during the transition to adulthood. Journal

More information

What makes us ill?

What makes us ill? www.unifr.ch/psycho/en/research/psycli What makes us ill? What makes us ill? Looking for vulnerability factors for mental illness Prof. Dr. Chantal Martin-Soelch In the framework of the burden of mental

More information

Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder Presenter: Date: Jacqueline Pei, R. Psych., PhD Carmen Rasmussen, PhD May 5, 2009 The FASD Learning

More information

CHILDHOOD TRAUMA AND ITS RELATIONSHIP TO PTSD.!! Andrea DuBose, LMSW

CHILDHOOD TRAUMA AND ITS RELATIONSHIP TO PTSD.!! Andrea DuBose, LMSW CHILDHOOD TRAUMA AND ITS RELATIONSHIP TO PTSD!! Andrea DuBose, LMSW "There are words that Never Show on the body that are deeper and more harmful than anything that bleeds" Laurel K. Hamilton, Mistral's

More information

Should I Meditate? Mindfulness and Meditation for the Pharmacy Professional

Should I Meditate? Mindfulness and Meditation for the Pharmacy Professional Should I Meditate? Mindfulness and Meditation for the Pharmacy Professional North Suburban Pharmacists of Chicagoland Association January 8, 2019 Charisse Johnson, PharmD, MS Chicago State University College

More information

Psychology Session 13 Stress and Health

Psychology Session 13 Stress and Health Psychology Session 13 Stress and Health Date: December 2 nd, 2016 Course instructor: Cherry Chan Mothercraft College Agenda 1. Personality and health 2. Stress 3. Coping with stress 4. Common stressors

More information

STRESS AND HEALTH CHAPTER 16

STRESS AND HEALTH CHAPTER 16 1 STRESS AND HEALTH CHAPTER 16 STRESS & HEALTH Where are we going today? Definitions of stress Causes: Bring on the stressors! How does stress affect us physically? Physiological Stress Response Stress

More information

Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 7: Anxiety Disorders. Anxiety Disorders

Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 7: Anxiety Disorders. Anxiety Disorders Anxiety Disorders Experiencing Anxiety Anxiety: characterized by strong negative emotion and tension in anticipation of future danger or threat Moderate amounts of anxiety is adaptive; helps us cope with

More information

Spokane Pain Conference October 27, 2017 Patty Bullick, MSW, LCSW Riverwood Counseling, LLC Coeur d Alene, Idaho

Spokane Pain Conference October 27, 2017 Patty Bullick, MSW, LCSW Riverwood Counseling, LLC Coeur d Alene, Idaho Spokane Pain Conference October 27, 2017 Patty Bullick, MSW, LCSW Riverwood Counseling, LLC Coeur d Alene, Idaho Good afternoon. My name is Patty Bullick, and I'm speaking on the Psychological Treatment

More information