Understanding the Impact of Meditative Homework on Metacognitive Processes in the Context of Mindfulness...
DepressionMindfulness based cognitive therapy (MBCT) is a group psycho-educational treatment designed to reduce the risk of recurrent depression by integrating mindfulness based meditation practices with cognitive therapy techniques. MBCT comprises eight weekly two-hour group sessions. Additionally, participants are required to commit to one hour per day of between sessions meditative homework assignments six days per week. Existing quantitative research suggest that MBCT is an effective intervention for preventing depressive relapse in patients with three or more episodes of depression (Teasdale et al.2000, Ma & Teasdale, 2004). The focus of qualitative research has been on evaluating the acceptability of MBCT for various clinical populations; participants' accounts have been positive indicating MBCT may be a potential therapeutic tool for treating older adults (Graham & Senthinathan, 2007), psychosis (Abba, Chadwick, & Stevenson, 2008), Parkinson's disease (Fitzpatrick, Simpson, & Smith, 2010) as well as acute depression (Mason & Hargreaves, 2001). The benefits of undertaking meditative mindfulness practice in the context of MBCT have been linked to changes in metacognitive processes. Two distinct multi-level information processing frameworks dealing with how thoughts are processed from a metacognitive perspective have been proposed: The Interacting Cognitive Subsystems (ICS; Teasdale, 1999a, 1999b) and the Self Regulatory Executive Function (S-REF; Wells, 2000) theory. The ICS framework forms a rationale for meditative aspects of the MBCT programme. The S-REF model differs from the ICS theory in its conceptualisation of the object or 'being' mode of metacognitive processing. Regular daily practice of mindfulness meditation has been regarded as among the most essential aspects of mindfulness programmes (Kabat-Zinn, 1990; Mason & Hargreaves, 2001). Existing studies, with their focus on effectiveness or acceptability of MBCT as an intervention, have thus far excluded an important aspect of the course involving the experience of meditative homework assignments. Therefore, the aim of this study was to explore subjective accounts of the meaning of carrying out meditative homework assignments in the context of a National Health Service (NHS) run MBCT course. The research questions focused on the impact of meditative homework on thought processes as well as an exploration of barriers and facilitating factors from a participant's perspective.Six individual in-depth interviews were conducted with participants all of whom had completed the full MBCT programme. Interpretive phenomenological Analysis (IPA) was used as the methodology for analysing interview transcripts. Data analysis began with a detailed examination of one case until a thorough analysis was completed after which subsequent cases were analysed. Finally a cross case analysis was carried out where individual themes were interrogated for similarities and differences (Smith, et al., 2009). Two master themes were presented: 'The relationship of meditative homework to metacognitive experience' and 'Motivating and discouraging factors for engagement in meditative practice'. Results reveal a transformation in metacognitive processes as a result of undertaking meditative homework. The subjective experience of metacognitive processes is examined in the context of existing psychological theories including the ICS (Teasdale, 1999a, 1999b) as well as the S-REF (Wells, 2000) theory involving metacognitions. A model for perceived facilitating factors and difficulties experienced in carrying out meditative homework is constructed based on the Integrated Theoretical Foundations Model for CBT homework assignment (Kazantzis, et al., 2005). The model explores participants' motivation in three stages of the homework process: firstly during assignment of the meditative homework task, secondly in completing the planned task and finally carrying out review of the task in question. Implications of the present study are discussed in relation to psychological literature, homework assignment and the practise of MBCT.
Bioactive Glass as Bone Graft Substitute in Operative Treatment of Bone - a 10 Years Follow-up Study...
Depressed Lateral Condyle FractureBenign Bone Tumour Cavity1 moreThe main aim is to evaluate the long-term safety and bone healing in the operated area and to compare bioactive glass granules with autogenous bone as a filler material.
Postpartum Thyroid Measures and Mood
Postpartum DepressionWomen with abnormal serum thyroid antibody levels or abnormal TSH and/or T4 values are more likely than their normal counterparts to have higher scores on a common postpartum depression screening test.
Primary Prevention of Major Depression in Later Life
DepressionThe Institute of Medicine has called for studies of "indicated" preventive interventions to reduce the incidence of mental illness in persons already symptomatic but not yet presenting with fully developed clinical syndromes. The investigators' Advanced Center for Interventions and Services Research in Late Life Mood Disorders has embraced the development and testing of preventive interventions as one of its key objectives. The investigators propose to test the following hypotheses related to primary prevention of major depressive episodes in old age, focusing on elderly patients who have symptoms of emotional distress but who are not yet presenting with the full syndrome of a major depressive episode. Hypothesis 1: Problem solving therapy (PST) will be superior to an attention-only control (dietary education) in lowering the two-year incidence of episodes of syndromal major depression in already symptomatic elderly primary care patients. Hypothesis 2: PST will also prevent higher levels of depressive symptoms and associated disabilities, over a two-year period of follow-up.
Girls in Transition Study: Helping Girls Enter the Teenage Years
DepressionAnxietyThis is a pilot study of the Girls in Transition (GT) program, an intervention designed to promote resilience and reduce gender-related risk factors for depression. The goal of the study is to gather preliminary data on the effects of the GT program.
Exploring a Potential Blood Test to Diagnose Major Depressive Disorder
Major Depressive DisorderThe purpose of this study is to develop a blood test for major depression and measure the effects of ziprasidone monotherapy on these markers. Specific Aim: Using a multiplex biomarker assay we will measure levels of 16 biomarkers in patients with MDD enrolled in this ancillary study (adjunct to study NCT00555997) and compare these results to those of healthy controls" (defined as research subjects who have not met criteria for any lifetime Axis-I disorder (DSM-IV)) from an existing dataset at PHB.
Measuring Stress in Women With Newly Diagnosed Stage I, Stage II, or Stage III Breast Cancer or...
Anxiety DisorderBreast Cancer2 moreRATIONALE: Gathering information about how patients respond to stress and measuring stress levels in women with newly diagnosed breast cancer may help doctors provide better methods of treatment and on-going care. PURPOSE: This research study is measuring stress in women with newly diagnosed stage I, stage II, or stage III breast cancer or ductal carcinoma in situ of the breast.
Assessing Treatment Emergent Suicidal Ideation in Patients With Major Depression
DepressionThis study will develop a new methodology to evaluate any treatment-emergent suicidal ideation that might occur when an antidepressant treatment has been started and/or during times when doses are increased in patients with major depressive disorder.
Translating Research Into Practice for Postpartum Depression
Postpartum DepressionThis is a study to assess the impact of introducing screening and planned follow up for postpartum depression. All women ages 18 to 45 who speak English or Spanish who come to the enrolled community family medicine offices will either be given usual care or screened using the Edinburgh Postnatal Depression Screening tool. If the EDPS score is high the women will be given the PHQ-9 to more clearly identify the specific likelihood of being depressed. Women who are determined to be depressed will be treated with medication or counseling based on the preference of the women and their physicians. Women will be followed through nurse initiated phone calls and visits to the physicians office. Outcomes include the level of depression symptoms, measure of comfort with parenting, and satisfaction with partner relationships comparing baseline levels with those at 6 and 12 months from the usual care and intervention sites. These data will be collected by questionnaire. In addition, with the women's permission, medical records will be reviewed.
Clinical and Biological Characteristics of Psychotic Depression
DepressionPsychotic Disorders2 moreThe primary objective of this study is to investigate the relationships among findings in structural and functional neuroimaging, cognitive testing and HPA (hypothalamic-pituitary-adrenal) axis dysregulation in psychotic depression.