Tosca D. Braun

Self-compassion, body image, and disordered eating: A review of the literature.

Self-compassion, treating oneself as a loved friend might, demonstrates beneficial associations with body image and eating behaviors. In this systematic review, 28 studies supporting the role of self-compassion as a protective factor against poor body image and eating pathology are reviewed. Findings across various study designs consistently linked self-compassion to lower levels of eating pathology, and self-compassion was implicated as a protective factor against poor body image and eating pathology, with a few exceptions. These findings offer preliminary support that self-compassion may protect against eating pathology by: (a) decreasing eating disorder-related outcomes directly; (b) preventing initial occurrence of a risk factor of a maladaptive outcome; (c) interacting with risk factors to interrupt their deleterious effects; and (d) disrupting the mediational chain through which risk factors operate. We conclude with suggestions for future research that may inform intervention development, including the utilization of research designs that better afford causal inference.

Who practices yoga? A systematic review of demographic, health-related, and psychosocial factors associated with yoga practice.

Yoga has become increasingly popular in the US and around the world, yet because most yoga research is conducted as clinical trials or experiments, little is known about the characteristics and correlates of people who independently choose to practice yoga. We conducted a systematic review of this issue, identifying 55 studies and categorizing correlates of yoga practice into sociodemographics, psychosocial characteristics, and mental and physical well-being. Yoga use is greatest among women and those with higher socioeconomic status and appears favorably related to psychosocial factors such as coping and mindfulness. Yoga practice often relates to better subjective health and health behaviors but also with more distress and physical impairment. However, evidence is sparse and methodological limitations preclude drawing causal inferences. Nationally representative studies have minimally assessed yoga while studies with strong assessment of yoga practice (e.g., type, dose) are generally conducted with convenience samples. Almost all studies reviewed are cross-sectional and few control for potential confounding variables. We provide recommendations for future research to better understand the correlates of yoga practice.

Moving Beyond Health to Flourishing: The Effects of Yoga Teacher Training

Research in the medical and psychological fields has primarily followed a “disease-focused” approach to health. Although there is growing research on the components and outcomes of well-being, very few studies have focused on traditional practices that can be used as interventions to encourage human flourishing. The current study was developed to address this research gap. We suggest one effective method of increasing psychological well-being, the practice of yoga, an age-old practice that has been said to produce physical and psychological health. In this observational study, we examined associations with participation in a 4-week yoga teacher training resident program. Measurement instruments were chosen to capture changes in psychosocial health and human flourishing. Measurements were taken before the start of the program, immediately after the program, and 3 months postprogram. As expected, in this healthy population, the human flourishing scales showed more change than the psychosocial health scales. For example, in this healthy sample, there were no significant changes in perceived social support, quality of life, or self-efficacy from baseline to the 3-month follow-up. However, optimism, a positive psychology research measure, improved from baseline to follow-up. The mindfulness subscales of observation, awareness, and nonreactivity all improved following the training, suggesting that one benefit of yoga practice is a more refined ability to attend to ones inner experience. This study adds to the growing literature focusing on interventions that move beyond relieving pathology to those that produce optimal functioning and human thriving.

The Essential Properties of Yoga Questionnaire: Development and Methods.

Yoga interventions have considerable heterogeneity, are multi-dimensional, and may impact health in different ways. However, most research reports regarding the effects of yoga on health and wellbeing do not adequately describe the components of the yoga interventions being used. Thus, drawing comparisons across studies or understanding the relative effects of specific aspects of a yoga intervention are rarely possible. To address this problem, we created the Essential Properties of Yoga Questionnaire (EPYQ) Project, an NCCAM-funded set of studies to develop a translational tool for yoga researchers. Here we describe the methods and developmental processes used in the EPYQ Project in detail. The project consists of four main phases. Phase I was designed to gain a comprehensive understanding of the relevant aspects of yoga by conducting a comprehensive systematic literature review and conducting focus groups with stakeholders including a wide variety of yoga teachers and students. In Phase II, a pool of potential questionnaire items was developed for the prototypic questionnaire using information from Phase I. Cognitive interviews were conducted with the preliminary EPYQ items to assess the perceived clarity, meaning, and importance of each item. In Phase III, the prototypic questionnaire was administered to two large samples of yoga students and instructors. Military personnel and veterans who practiced or taught yoga (n = 329) were recruited to participate. Factor analysis and item response theory were used to identify factors and select the final questionnaire items. Phase IV is ongoing and will collect reliability and validity data on the final instrument. Results are expected to be available in 2016. The EPYQ will provide an objective tool for describing the amount of various components of yoga interventions, eventually allowing researchers to link specific yoga components to health benefits, and facilitating the design of yoga interventions for specific health conditions.

Improving physical and mental health in frontline mental health care providers: Yoga-based stress management versus cognitive behavioral stress management

ABSTRACT The need for brief, low-cost, easily disseminable, and effective interventions to promote healthy lifestyles is high. This is especially true for mental health providers. The authors developed two studies to compare the impacts of Cognitive Behavioral Stress Management (CBSM) and Yoga-Based Stress Management (YBSM) interventions for health care professionals. Study 1 offered an 8-week YBSM intervention to 37 mental health care participants and collected health data pre- and post. Study 2 offered YBSM and CBSM classes to 40 randomly assigned mental health care providers and collected mental and physical health data at four time points. In Study 1, using t tests, the YBSM intervention affected a number of mental and physical well-being indices pre to post. In Study 2, using linear mixed modeling, YBSM and CBSM groups both improved significantly (p < .05) in fruit and vegetable intake, heart rate, alcohol consumption, relaxation and awareness, professional quality of life, compassion satisfaction, burnout, depression, and stress levels. There was a group by time effect for coping confidence (CBSM increased more, p < .05, F = 4.34), physical activity (YBSM increased more, p < .05, F = 3.47), overall mental health (YBSM increased more, p < .10, F = 5.32), and secondary traumatic stress (YBSM decreased more, p < .10, F = 4.89). YBSM and CBSM appear to be useful for health care professionals’ mental and physical health. YBSM demonstrates some benefit above and beyond the extremely well studied and empirically supported CBSM, including increased physical activity, overall mental health, and decreased secondary traumatic stress benefits.

Assessing Disruptions in Meaning: Development of the Global Meaning Violation Scale

Models of meaning making following stressful events are based on the notion that individuals’ appraisals of events (i.e., their situational meaning) can violate their goals and beliefs (i.e., global meaning), and that resulting discrepancies between situational meaning and global meaning negatively affect their psychological adjustment. To date, research has relied primarily on indirect measures of meaning violation. We describe the development of a new instrument, the Global Meaning Violation Scale (GMVS), for directly assessing belief and goal violations. We establish the psychometric integrity of the GMVS across three studies. In Study 1, we identify and replicate a factor structure consisting of three subscales: belief violation, intrinsic goal violation, and extrinsic goal violation. In Study 2, we provide evidence for the reliability and validity of the GMVS. In Study 3, we test the predictive validity of the GMVS in a sample of undergraduates reporting on the most stressful experiences of their lives. Our findings indicate that the GMVS is a reliable and valid tool for directly examining global meaning violation. We anticipate that the GMVS will advance research on stress, trauma, and coping by giving researchers a tool to directly explore the role of violations in meaning making processes.

P04.76. Characteristics of yoga practice in an undergraduate student sample

Purpose Young adults are increasingly practicing yoga (Barnes et al., 2008) and yoga interventions have been shown to decrease stress and anxiety. However, little is known about the characteristics of young adults who engage in yoga or the correlates of yoga practice outside of clinical contexts. Our objective was to characterize students who practice yoga and to examine correlates of recent yoga practice.

P04.59. National surveys show lower well-being among yogis yet efficacy trials show favorable results: does dose-response resolve the contradiction?

Methods Yoga practitioners across the US (82 men, 456 women, mean age 44 years) completed standardized questionnaires on the Internet, including full time teachers (N=44) and part time teachers (N=118). Demographics were similar to those of nationally representative samples of yoga practitioners. Dose was calculated as minutes/week of studio, home, and studio + home practice along with studio + home minutes/week x years of practice.

The Essential Properties of Yoga Questionnaire (EPYQ): Psychometric Properties

Yoga interventions are heterogeneous and vary along multiple dimensions. These dimensions may affect mental and physical health outcomes in different ways or through different mechanisms. However, most studies of the effects of yoga on health do not adequately describe or quantify the components of the interventions being implemented. This lack of detail prevents researchers from making comparisons across studies and limits our understanding of the relative effects of different aspects of yoga interventions. To address this problem, we developed the Essential Properties of Yoga Questionnaire (EPYQ), which allows researchers to objectively characterize their interventions. We present here the reliability and validity data from the final phases of this measure-development project. Analyses identified fourteen key dimensions of yoga interventions measured by the EPYQ: acceptance/compassion, bandhas, body awareness, breathwork, instructor mention of health benefits, individual attention, meditation and mindfulness, mental and emotional awareness, physicality, active postures, restorative postures, social aspects, spirituality, and yoga philosophy. The EPYQ demonstrated good reliability, as assessed by internal consistency and test-retest reliability analysis, and evidence suggests that the EPYQ is a valid measure of multiple dimensions of yoga. The measure is ready for use by clinicians and researchers. Results indicate that, currently, trained objective raters should score interventions to avoid reference frame errors and potential rating bias, but alternative approaches may be developed. The EPYQ will allow researchers to link specific yoga dimensions to identifiable health outcomes and optimize the design of yoga interventions for specific conditions.

P05.16. Subjects’ experiences of a bi-weekly yoga and Ayurveda-based weight loss protocol in overweight and obese women

Purpose Yoga is one of the most common forms of complementary and alternative therapies utilized for weight loss. This mixed methods study included quantitative surveys and interviews of participants of a 10-week, bi-weekly yoga and Ayurveda-based weight loss program designed for overweight and obese women. The program involved training in yoga poses, breathing, and philosophy as well as eating mindfully, cultivating relaxation, and compassion.