Mindfulness-based interventions for weight loss: a systematic review and meta-analysis.

BACKGROUND: An increasing number of studies are investigating the efficacy of mindfulness-based interventions (MBIs) for weight loss and obesity-related eating behaviours. However, the results of past reviews are inconsistent. OBJECTIVE: To clarify these inconsistencies, we conducted a comprehensive effect-size analysis to evaluate the efficacy of MBIs on weight loss and eating behaviours. DATA SOURCE: Data sources were identified through a systematic review of studies published in journals or as dissertations in PsychINFO, PubMed, CINAHL, Web of Science, Medline and Scopus, ProQuest or OATD from the first available date to March 10, 2017. REVIEW METHODS: A total of 18 publications (19 studies, n = 1,160) were included. RESULTS: Mean weight loss for MBIs at post-treatment was 6.8 and 7.5 lb at follow-up. In pre-post comparisons, effect-size estimates suggest that MBIs are moderately effective for weight loss (n = 16; Hedge's g = .42; 95% CI [.26, .59], p < .000001) and largely effective in reducing obesity-related eating behaviours (n = 10; Hedge's g = .70; CI 95% [.36, 1.04], p < .00005). Larger effects on weight loss were found in studies that used a combination of informal and formal meditation practice (n = 6; Hedge's g = .55; CI 95% [.32, .77], p < .00001) compared with formal meditation practice alone (n = 4; Hedge's g = .46; CI [.10, .83], p < .05). CONCLUSION: Results suggest that MBIs are effective in reducing weight and improving obesity-related eating behaviours among individuals with overweight and obesity. Further research is needed to examine their efficacy for weight loss maintenance.

Limitations of diagnostic criteria and assessment instruments for mental disorders. Implications for research and policy.

During the past 2 decades, psychiatric epidemiological studies have contributed a rapidly growing body of scientific knowledge on the scope and risk factors associated with mental disorders in communities. Technological advances in diagnostic criteria specificity and community case-identification interview methods, which made such progress feasible, now face new challenges. Standardized methods are needed to reduce apparent discrepancies in prevalence rates between similar population surveys and to differentiate clinically important disorders in need of treatment from less severe syndromes. Reports of some significant differences in mental disorder rates from 2 large community surveys conducted in the United States--the Epidemiologic Catchment Area study and the National Comorbidity Survey--provide the basis for examining the stability of methods in this field. We discuss the health policy implications of discrepant and/or high prevalence rates for determining treatment need in the context of managed care definitions of "medical necessity."

Shared determinants of native and denatured bovine serum albumin are recognized by both B- and T-cells.

The antigenic relationship between native and denatured bovine serum albumin (BSA) was investigated by examining specificity of antibodies directed against both proteins. Polyclonal antibodies produced to native and denatured BSA in hyperimmunized mice were specific for the homologous molecule. In contrast, polyclonal antibodies formed early in the response to native BSA reacted both the denatured and the native molecule. Monoclonal antibodies to native BSA were specific for the homologous antigen, while one of three clones prepared by immunization with denatured BSA produced an antibody cross-reactive with native BSA. Our results suggest that shared determinants of native and denatured BSA molecules can be recognized by both B- and T-cells.

Diagnosing major depression in the elderly: evidence for response bias in standardized diagnostic interviews?

Recent epidemiological and family genetic studies in different countries using standardized diagnostic interviews for mental disorders have rather consistently demonstrated considerably lower current (e.g. ECA Study: 0.9%) and lifetime (1.4%) prevalence estimates of Major Depression in the elderly (older than 65 years of age) as compared to younger age groups (e.g. 30-44 years: 1 year, 3.9%; lifetime, 7.5%). Some investigators have questioned the validity of these data and suggested alternative interpretations. One possibility is that the complex standardized symptoms and clinical probe questions, and the required judgmental process inherent in diagnostic interviews exceed the cognitive capacity of older adults. This may result in systematic response bias. This paper examines the degree to which the lower prevalence estimates of depression in the elderly are biased due to specific characteristics of the assessment strategy. Analyses of epidemiologic data from the Munich Follow-up Study (MFS), based on the Diagnostic Interview Schedule, demonstrate that (1) older respondents report lifetime depressive symptoms with the same frequency as younger respondents. The additional probe questions designed to identify the degree to which symptoms were caused by factors other than psychological revealed that (2) the elderly more often attribute such symptoms to physical illnesses or conditions. This results in (3) the exclusion of the reported symptoms as a basis for diagnosing depression. A laboratory study demonstrated that "working memory capacity" was a good predictor of this response behavior, indicating that the complexity of the formalized questions exceeds the cognitive capacity of the elderly. Attributing symptoms to a physical illness or condition might be a heuristic strategy to simplify complex recall and judgment processes; the resulting answer is plausible but incorrect. We recommend that the symptom and probe questions of standardized diagnostic interviews be simplified, especially for use with the elderly.

Looking back at anger: reference periods change the interpretation of emotion frequency questions.

When asked to report on behaviors and experiences, participants draw on the specified reference period to infer the question meaning: Short reference periods suggest that the question pertains to frequent experiences; long reference periods suggest that it pertains to rare ones. Because frequent experiences are typically less intense than rare ones, this meaning shift results in reports of different experiences. Three experiments support this analysis in the domain of emotion reports. Participants asked how frequently they get angry (a) assumed that the question refers to less intense and more frequent episodes when presented with a short (1-week) rather than a long (1-year) reference period, (b) reported more extreme episodes in the latter case, and (c) provided differential frequency reports. These differences reflect conversational inference processes and cannot be fully accounted for by memory search biases.

Lifetime risk of depression.

Over the past decade, major epidemiological studies have been conducted to determine the prevalence of depressive syndromes, primarily major depression or dysthymia. The highest prevalences occur in younger cohorts (18-29 years); considerably lower prevalences are found in older individuals (45 years and above), with the lowest in those aged 65 and older. Several studies have confirmed an increase in the cumulative lifetime estimates of major depression in successively younger birth cohorts during this century. At the same time, questions have been raised about the low prevalence of depression in the elderly, including the role of confounding factors (e.g. differential morbidity and response-biased memory). Standardised diagnostic assessment procedures may be insufficiently adapted for use in the elderly. It has also been recognised that a substantial number of elderly individuals suffer from clinically relevant symptoms of depression but do not meet the criteria for major depression. Future research will be required to elucidate fully the apparently changing rates of depression.

Moderators of psychological recovery from benign cancer screening results.

OBJECTIVE: The sudden confrontation of a potential health threat such as cancer, even after the diagnosis turns out to be benign, can have enduring adverse psychological consequences, including persistent anxiety, cancer fears, and other manifestations of psychological distress. The present study examines factors that potentially moderate psychological recovery among women who face a breast cancer threat. DESIGN: Participants were adult women had just received a benign outcome from a breast cancer diagnostic procedure that had been conducted because of suspicion of breast cancer (a non-conclusive mammography or ultrasonography result, a referral from their doctor because of pain or family history, detection of a lump, a 6-month follow-up appointment after a breast abnormality from a previous screening or diagnostic procedure, or a fluid leak from one or both breasts). We measured several psychological traits at Time 1 (right after receipt of the "no cancer" feedback) and then each month for the next 3 months. Analyses examined the factors that hindered or facilitated psychological recovery from the cancer threat. RESULTS: Results showed that trait anxiety and family history of cancer hindered recovery and that older age and optimism facilitated recovery and lessened adverse psychological consequences. Self-regulatory strategies such as planful problem-solving, positive reappraisal, and mastery facilitated recovery. CONCLUSIONS: Our findings shed light on the factors that are implicated in psychological recovery from a benign breast cancer outcome after a diagnostic procedure (ultrasonography, repeat or initial mammography, stereotactic biopsy, fine-needle aspiration, or ultrasound-guided biopsy). Those factors could be used to identify women who may experience prolonged psychological distress, so as to assist them when they face stressful diagnostic concerns.

Collective memories of Germans and Japanese about the past half-century.

We investigate the collective memories of two samples drawn in 1991, one from the former West Germany and one from Yokohama, Japan. In the early 1990s such samples included many members of World War II cohorts and also cohorts born long after that war had ended. We consider the relation of age, conceptualised as birth cohort, to the salience of memories of national and world events that were mentioned as important in response to a quite general open-ended question about the past half-century. The relations are similar across the two countries in so far as external events like World War II might have had similar impacts on each population, while each country is distinctive with regard to events that especially impinged upon it. Hypotheses about the importance of adolescence and early adulthood to the imprinting of memories are generally confirmed, but several types of evidence suggest the need to extend the delimiting ages to earlier than the mid-teens and later than the mid-twenties. Other evidence indicates the desirability of distinguishing between recent events that are the focus of media attention and earlier events that depend more fully on autobiographical memory.