Dwight Mazmanian

Pilot evaluation of a mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries

Primary objective: To examine the potential efficacy of a mindfulness-based stress reduction approach to improve quality of life in individuals who have suffered traumatic brain injuries. Research design: Pre-post design with drop-outs as controls. Methods and procedures: We recruited individuals with mild to moderate brain injuries, at least 1 year post-injury. We measured their quality of life, psychological status, and function. Results of 10 participants who completed the programme were compared to three drop-outs with complete data. Experimental intervention: The intervention was delivered in 12-weekly group sessions. The intervention relied on insight meditation, breathing exercises, guided visualization, and group discussion. We aimed to encourage a new way of thinking about disability and life to bring a sense of acceptance, allowing participants to move beyond limiting beliefs. Main outcomes and results: The treatment group mean quality of life (SF-36) improved by 15.40 (SD = 9.08) compared to − 1.67 (SD = 16.65; p = 0.036) for controls. Improvements on the cognitive-affective domain of the Beck Depression Inventory II (BDI-II) were reported (p = 0.029), while changes in the overall BDI-II (p = 0.059) and the Positive Symptom Distress Inventory of the SCL-90R (p = 0.054) approached statistical significance. Conclusions: The intervention was simple, and improved quality of life after other treatment avenues for these participants were exhausted.

The choose-short effect in pigeon memory for stimulus duration: Subjective shortening versus coding models

A symbolic delayed matching procedure may be used to study memory for stimulus duration in pigeons. Short and long presentations of a light sample stimulus are mapped onto the choke of visually differentiated comparison keys. When delay is varied in such a symbolic delayed matching procedure, pigeons show increasing preference for the short-sample key as the delay becomes longer (choose-short effect), even after a long sample stimulus has been presented. Two theoretical explanations of the choose-short effect are suggested. A subjective shortening model holds that the choose-short effect arises from progressive shortening of the memory of stimulus duration as the delay proceeds. An alternative coding model suggests that the choose-short effect arises from stimulus generalization after an initial response instruction to peck the long-sample key has been forgotten. These two models were tested by training pigeons to peck a third comparison key after no sample stimulus had been presented. Shifts in key preferences over delays ranging from 0 to 21 sec clearly supported the coding model.

An MRI study of subgenual prefrontal cortex in patients with familial and non-familial bipolar I disorder

BACKGROUND Over the past few years there has been an interest in the use of magnetic resonance imaging (MRI) to study specific brain regions in bipolar disorder. The present study compared the grey matter volume in the subgenual prefrontal cortex in patients with familial and non-familial bipolar disorder and normal control subjects. METHODS MRI brain scans were performed on 12 patients with bipolar I disorder including six patients with a positive family history of bipolar disorder as well as eight control subjects. RESULTS There was a significant reduction in the grey matter volume in the right subgenual prefrontal cortex, but not in the left subgenual prefrontal cortex. A family history x sex interaction with right prefrontal cortex volume was also observed as a trend. For females, a positive family history was associated with reduced right prefrontal cortex volumes; for males, a positive family history was associated with increased right prefrontal cortex volumes. LIMITATIONS Small sample size, reduced statistical power. CONCLUSION These data add to the emerging literature on structural changes in the subgenual prefrontal cortex in bipolar disorder, especially in patients with a positive family history.

Risk of Obsessive-Compulsive Disorder in Pregnant and Postpartum Women: A Meta-Analysis

OBJECTIVE Although pregnant and postpartum women are presumed to be at greater risk of obsessive-compulsive disorder (OCD) than the general population, the evidence has been inconclusive. This meta-analysis provides an estimate of OCD prevalence in pregnant and postpartum women and synthesizes the evidence that pregnant and postpartum women are at greater risk of OCD compared to the general population. DATA SOURCES An electronic search of Google Scholar, PsycINFO, PsychARTICLES, and PubMed was performed by using the search terms OCD, obsessive-compulsive disorder, pregnancy, postpartum, prevalence, and epidemiology. We supplemented our search with articles referenced in the obtained sources. The search was conducted until August 2012 without date restrictions. STUDY SELECTION We included English-language studies reporting OCD prevalence (diagnosed according to DSM-III-R, DSM-IV, or ICD-10 criteria) in pregnant (12 studies) or postpartum (up to 12 months; 7 studies) women using structured diagnostic interviews. We also included a sample of regionally matched control studies (10 studies) estimating 12-month prevalence in the general female population for comparison. The control studies were limited to those conducted during the same time frame as the pregnant and postpartum studies. DATA EXTRACTION We extracted author name, year of publication, diagnostic measure, sample size, diagnostic criteria, country, assessment time, subject population, and the point prevalence of OCD. RESULTS Mixed- and random-effects models revealed an increase in OCD prevalence across pregnancy and the postpartum period with the lowest prevalence in the general population (mean = 1.08%) followed by pregnant (mean = 2.07%) and postpartum women (mean = 2.43%). An exploratory analysis of regionally matched risk-ratios revealed both pregnant (mean = 1.45) and postpartum (mean = 2.38) women to be at greater risk of experiencing OCD compared to the general female population, with an aggregate risk ratio of 1.79. CONCLUSIONS Pregnant and postpartum women are more likely to experience OCD compared to the general population.

Spatial memory in rats under restricted viewing conditions

Abstract In a procedure devised by J. A. Walker and D. S. Olton (Learning and Motivation, 1979 , 10, 73–84), rats were placed on two arms of a four-arm radial maze and then were placed in the center of the maze to test how accurately they could choose the alleys on which they had not been placed. In three experiments, the conditions under which animals viewed the environment from the arms were varied. In Experiment 1, both the extent of spatial view and the exposure time were varied factorially in a within-subjects design; animals viewed the environment down a tunnel or had a 180° or 360° view, and subjects were allowed to view the environment for either 2 or 20 sec. In Experiment 2, a between-subjects design was used, in which different groups of subjects were tested repeatedly under either the tunnel, 180°, or 360° conditions. Both experiments showed that animals could avoid the arms previously visited at no better than a chance level of accuracy in the tunnel viewing condition but could perform with progressively better accuracy at the 180 and 360° viewing conditions. Animals also were more accurate in Experiment 1 after viewing for 20 sec than after viewing for 2 sec. Experiment 3 involved a procedure in which restricted viewing conditions were used both during arm placements and testing. Animals tested under tunnel viewing eventually achieved above-chance performance with this procedure, but did not exceed chance as rapidly as groups tested with 45 and 90° views of the environment. These results suggest that animals can learn about their position in a spatial environment through observation and that an animals ability to locate its position is directly related to the extent of the surrounding environment it can see and the length of time it is allowed to look. The implications of these findings for list and map hypotheses of spatial memory representation are discussed.

The principle of aggregation in psychobiological correlational research: An example from the open-field test

The principle of aggregation states that the sum of a set of multiple measurements is a more stable and representative estimator than any single measurement. This greater representation occurs because there is inevitably some error associated with measurement. By combining numerous exemplars, such errors of measurement are averaged out, leaving a clearer view of underlying relationships. The present study explored the effect of score aggregation over various time periods on correlations among a number of reliable measures frequently used in open-field testing. Twenty-six male rats were given four open-field tests (4 min in duration) at 48-h intervals. Ambulation, rearing, and defecation responses were measured on a minute-by-minute basis in the open-field tests. Correlation matrices were calculated among the three measures for unaggregated scores (1-min totals) and for scores aggregated over daily tests, and mean correlation coefficients were computed for all three pairwise comparisons of the three response variables. These mean correlations were then compared to those obtained when the open-field measures were aggregated over all 4 test days. The results showed that aggregation produced substantial increases in correlation-coefficient magnitude. The correlation between ambulation and rearing increased from a mean of .39 to a value of .81. Similar increases were observed when defecation scores were correlated with ambulation (−.17 to −.59) and rearing (−.16 to −.49). Thus aggregation is an important factor to be considered in the design of psychobiological correlational studies.

Facial symmetry detection ability changes across the menstrual cycle.

The effects of menstrual cycle phase and hormones on womens visual ability to detect symmetry and visual preference for symmetry were examined. Participants completed tests of symmetry detection and preference for male facial symmetry at two of three menstrual cycle phases (menses, periovulatory, and luteal). Women were better at detecting facial symmetry during the menses than luteal phase of their cycle. A trend indicated the opposite pattern for dot symmetry detection. Similarly, change in salivary progesterone levels across the cycle was negatively related to change in facial symmetry detection scores. However, there was no clear evidence of a greater preference for facial symmetry at any cycle phase, despite an overall preference for facial symmetry across phases. These findings suggest a menses phase advantage and a low progesterone advantage in womens ability to detect facial symmetry. The results are discussed in the context of hormonal, evolutionary mate selection, and functional neurocognitive theories.

A Systematic Review of the Association Between Psychiatric Disturbances and Endometriosis

We read with great interest the article by Pope et al., an interesting review that examined the existing empirical findings about the association between endometriosis and psychiatric conditions. We agree that our knowledge of this association is limited because of methodological differences and the limited number of controlled studies in the published literature. Although we appreciated the reported methodology, we take the opportunity to point out several elements which would let us further realize the results of this study. First of all, we observed that only four of the identified studies used clinical diagnostic criteria to assess for psychiatric diagnosis. Nevertheless, the diagnosis of any psychiatric condition requires the use of a specific validated test, as we recently did. Second, the characteristics of the cohort varied between studies: some included women with a diagnosis of endometriosis whereas others used a sample of women with chronic pelvic pain secondary to endometriosis. We believe that future research studies should include only patients with a diagnosis of endometriosis obtained through the visualization of lesions at the time of laparoscopy and histological analysis, according to the most updated international guidelines. Additionally, it might be helpful to divide the patients by disease stage, according to the American Fertility Society classification, in order to obtain more information regarding a possible correlation between endometriosis severity and psychiatric comorbidity. Third, of the reported three studies using a comparator group, one used a healthy control group, and the others consisted of women with chronic pelvic pain due to another medical condition. Moreover, several studies showed a close correlation between psychiatric disorders, such as anxiety and depression, and medical conditions. Considering this last point, it would not be possible to accurately state whether the psychiatric disorder could be clearly related to endometriosis or to other comorbidities, impairing the validity of results. Based on this element, we strongly suggest that future studies should exclude patients with other underlying conditions both in endometriosis and control groups. Fourth, none of the studies reported about other pharmacological, surgical, or psychosocial treatment, although it is widely accepted that some of the medications for endometriosis are associated with adverse side effects, including psychiatric symptoms. For example, oral contraceptives have been associated with decreased psychosexual arousal or negative changes in mood. Furthermore, gonadotropin-releasing hormone agonists have been found to be associated with emotional lability and depression. As the use of different hormonal therapies in some patients with endometriosis may influence the onset and progress of psychiatric disorders, prophylactic treatment with an antidepressant may reduce the risk for the experience of treatment-induced depressive symptoms. Finally, we believe that future studies should consider separately the patients with “endometriosis and chronic pelvic pain” and “endometriosis and infertility.” These two complaints adversely affect quality of life and mental health of patients, causing emotional distress, social isolation, relationship difficulties, and worse job performance; these last points could also modulate the relationship between endometriosis and psychiatric disorders. Moreover, chronic pelvic pain and infertility require specific and individualized pharmacological and psychosocial treatments. In conclusion, considering the impact of endometriosis on psychological health and the paucity of papers on this topic, we take the opportunity to solicit further studies in order to find clearer evidence and to provide the best evidence-based treatment for the patients.

Mindfulness-based cognitive therapy reduces symptoms of depression in people with a traumatic brain injury: results from a randomized controlled trial.

Objective:We sought to determine if we could reduce symptoms of depression in individuals with a traumatic brain injury using mindfulness-based cognitive therapy. Setting:The study was conducted in a community setting. Participants:We enrolled adults with symptoms of depression after a traumatic brain injury. Design:We conducted a randomized controlled trial; participants were randomized to the 10-week mindfulness-based cognitive therapy intervention arm or to the wait-list control arm. Main Measures:The primary outcome measure was symptoms of depression using the Beck Depression Inventory-II. Results:The parallel group analysis revealed a greater reduction in Beck Depression Inventory-II scores for the intervention group (6.63, n = 38,) than the control group (2.13, n = 38, P = .029). A medium effect size was observed (Cohen d = 0.56). The improvement in Beck Depression Inventory-II scores was maintained at the 3-month follow-up. Conclusion:These results are consistent with those of other researchers that use mindfulness-based cognitive therapy to reduce symptoms of depression and suggest that further work to replicate these findings and improve upon the efficacy of the intervention is warranted.

Effects of the menstrual cycle on bipolar disorder

Several lines of research suggest that reproductive events may affect the course of bipolar disorder (BD) in some women. With respect to the menstrual cycle, the focus has been on dysphoric symptoms [e.g., premenstrual dysphoric disorder (PMDD)], and the exacerbation of depression, in the premenstrual phase. This article reviews the literature on the potential effects of the menstrual cycle on BD.