Justine E. Owens

The "soap opera" effect in story recall

When people learn a series of actions of a character, their memory is strongly influenced, we suggest, by beliefs about that character’s motives. Motives serve as schema for deciding the meaning of the actions, their importance, and their interconnections. In two experiments, subjects read and later remembered some dull activities of a character. Experimental subjects knew what this character was worrying about (e.g., an unwanted pregnancy); control subjects did not. Recall and recognition showed that motive subjects distorted many of the colorless events to be motive relevant. Although the motive schema helped connect the disparate actions, it interfered with accurate recording and recall of the details.

BRIEF REPORT: A Pilot Study Evaluating Mindfulness‐Based Stress Reduction and Massage for the Management of Chronic Pain

BACKGROUND: Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain.OBJECTIVE: To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood.DESIGN: Randomized trial comparing MBSR or massage with standard care.PARTICIPANTS: Thirty patients with chronic musculoskeletal pain.MEASUREMENTS: Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12.RESULTS: The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with — 1.7 in the standard care group (P<.04).CONCLUSIONS: It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain.

The Short-Term Effect of Interdisciplinary Medication Review on Function and Cost in Ambulatory Elderly People

Objectives: To determine whether a medication review by a specialized team would promote regimen changes in elders taking multiple medications and to measure the effect of regimen changes on monthly cost and functioning.

Binaural Auditory Beats Affect Vigilance Performance and Mood

When two tones of slightly different frequency are presented separately to the left and right ears the listener perceives a single tone that varies in amplitude at a frequency equal to the frequency difference between the two tones, a perceptual phenomenon known as the binaural auditory beat. Anecdotal reports suggest that binaural auditory beats within the electroencephalograph frequency range can entrain EEG activity and may affect states of consciousness, although few scientific studies have been published. This study compared the effects of binaural auditory beats in the EEG beta and EEG theta/delta frequency ranges on mood and on performance of a vigilance task to investigate their effects on subjective and objective measures of arousal. Participants (n = 29) performed a 30-min visual vigilance task on three different days while listening to pink noise containing simple tones or binaural beats either in the beta range (16 and 24 Hz) or the theta/delta range (1.5 and 4 Hz). However, participants were kept blind to the presence of binaural beats to control expectation effects. Presentation of beta-frequency binaural beats yielded more correct target detections and fewer false alarms than presentation of theta/delta frequency binaural beats. In addition, the beta-frequency beats were associated with less negative mood. Results suggest that the presentation of binaural auditory beats can affect psychomotor performance and mood. This technology may have applications for the control of attention and arousal and the enhancement of human performance.

Wisdom in Medicine: What Helps Physicians After a Medical Error?

Purpose Confronting medical error openly is critical to organizational learning, but less is known about what helps individual clinicians learn and adapt positively after making a harmful mistake. Understanding what factors help doctors gain wisdom can inform educational and peer support programs, and may facilitate the development of specific tools to assist doctors after harmful errors occur. Method Using “posttraumatic growth” as a model, the authors conducted semistructured interviews (2009–2011) with 61 physicians who had made a serious medical error. Interviews were recorded, professionally transcribed, and coded by two study team members (kappa 0.8) using principles of grounded theory and NVivo software. Coders also scored interviewees as wisdom exemplars or nonexemplars based on Ardelt’s three-dimensional wisdom model. Results Of the 61 physicians interviewed, 33 (54%) were male, and on average, eight years had elapsed since the error. Wisdom exemplars were more likely to report disclosing the error to the patient/family (69%) than nonexemplars (38%); P < .03. Fewer than 10% of all participants reported receiving disclosure training. Investigators identified eight themes reflecting what helped physician wisdom exemplars cope positively: talking about it, disclosure and apology, forgiveness, a moral context, dealing with imperfection, learning/becoming an expert, preventing recurrences/improving teamwork, and helping others/teaching. Conclusions The path forged by doctors who coped well with medical error highlights specific ways to help clinicians move through this difficult experience so that they avoid devastating professional outcomes and have the best chance of not just recovery but positive growth.

The Quantification of Placebo Effects Within a General Model of Health Care Outcomes

OBJECTIVES The objective of this study was to test a model of placebo effects in the context of a general model of health care outcomes. DESIGN The design of this study was a multisite, double-blind, placebo-controlled crossover trial. SETTINGS The study was conducted at The University of Washington Hospital, Seattle, Washington, Cooper Hospital/University Medical Center, Camden, New Jersey, and at the Neurology Center of Fairfax, Fairfax, Virginia. SUBJECTS One hundred and seventeen (117) patients diagnosed with Multiple Sclerosis were enrolled in the study. INTERVENTION Subjects had daily exposure to a pulsing electromagnetic generator. OUTCOME MEASURES The outcome measures were the average score of three quality-of-life indices: the Modified Fatigue Impact Scale, the Medical Outcomes Study Pain Effects Scale, and the Spasticity Effects Scale. RESULTS Placebo responders scored higher in the personality trait of Absorption compared with nonresponders (p<0.01). Placebo responders were more confident that the sham device was active compared to placebo nonresponders (p<0.009). The two factors of confidence in the treatment and Absorption accurately identified 80% of placebo responders in a discriminant analysis (p<0.0004). CONCLUSIONS Placebo effects are best understood when integrated in a general model of health care outcomes.

Stories of Growth and Wisdom: A Mixed-Methods Study of People Living Well With Pain.

Chronic pain remains a daunting clinical challenge, affecting 30% of people in the United States and 20% of the global population. People meeting this challenge by achieving wellbeing while living with pain are a virtually untapped source of wisdom about this persistent problem. Employing a concurrent mixed-methods design, we studied 80 people living with chronic pain with “positive stories to tell” using semi-structured interviews and standardized questionnaires. In-depth interviews focused on what helped, what hindered, how they changed, and advice for others in similar circumstances. Major qualitative themes included acceptance, openness, self-efficacy, hope, perseverance, self-regulation, kinesthetic awareness, holistic approaches and integrative therapies, self-care, spirituality, social support, and therapeutic lifestyle behaviors such as music, writing, art, gardening, and spending time in nature. Themes of growth and wisdom included enhanced relationships, perspective, clarity, strength, gratitude, compassion, new directions, and spiritual change. Based on narrative analysis of the interviews and Ardelts Three-Dimensional Wisdom Model, participants were divided into 2 groups: 59 wisdom exemplars and 21 nonexemplars. Non-exemplar themes were largely negative and in direct contrast to the exemplar themes. Quantitatively, wisdom exemplars scored significantly higher in Openness and Agreeableness and lower in Neuroticism compared to non-exemplars. Wisdom exemplars also scored higher in Wisdom, Gratitude, Forgiveness, and Posttraumatic Growth than non-exemplars, and more exemplars used integrative therapies compared to the non-exemplars. As a whole, the exemplar narratives illustrate a Positive Approach Model (PAM) for living well with pain, which allows for a more expansive pain narrative, provides positive role models for patients and clinicians, and contributes to a broader theoretical perspective on persistent pain.

A randomized controlled trial evaluating Mindfulness-Based Stress Reduction (MBSR) for the treatment of palpitations: A pilot study.

Article history: Received 26 July 2016 Accepted 8 August 2016 Available online 9 August 2016 heart palpitations is associated with improved autonomic balance during 24 h Holter recordings. We conducted a randomized trial of an 8 week MBSR class compared to a wait-list control group in patients with palpitations, in a protocol approved by the UVA IRB. Twenty participations reporting heart palpitations of at least two months duration were recruited in the UVA Primary Care and Cardiology