An assessment of an automated EEG biofeedback system for attention deficits in a substance use disorders residential treatment setting.

Attention deficits are prevalent among individuals with substance use disorders and may interfere with recovery. The present study evaluated the effectiveness of an automated electroencephalogram (EEG) biofeedback system in recovering illicit substance users who had attention deficits upon admission to a comprehensive residential treatment facility. All participants (n = 95) received group, family, and individual counseling. Participants were randomly assigned to 1 of 3 groups that either received 15 sessions of automated EEG biofeedback (AEB), 15 sessions of clinician guided EEG biofeedback (CEB), or 15 additional therapy sessions (AT). For the AEB and CEB groups, operant contingencies reinforced EEG frequencies in the 15-18 Hz (ß) and 12-15 Hz (sensorimotor rhythm, "SMR") ranges and reduce low frequencies in the 1-12 Hz (Δ, θ, and α) and 22-30 Hz (high ß) ranges. The Test of Variables of Attention (TOVA), a "Go-NoGo" task, was the outcome measure. Attention scores did not change on any TOVA measure in the AT group. Reaction time variability, omission errors, commission errors, and d' improved significantly (all p values < .01) in the AEB and CEB groups. AEB and CEB did not differ significantly from each other on any measure. The results demonstrate that automated neurofeedback can effectively improve attention in recovering illicit substance users in the context of a comprehensive residential substance abuse treatment facility.

New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder.

Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR's potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use.

Classical mindfulness: an introduction to its theory and practice for clinical application.

Among the modern versions of mindfulness, mindfulness based stress reduction (MBSR) has played the key role in introducing mindfulness practice to the field of psychology and medicine. In fact, the efforts to integrate mindfulness into psychology have resulted in further adaptation of MBSR into more secular and psychological forms as well as the creation of a number of mindfulness measures such as the Mindful Attention Awareness Scale, the Freiburg Mindfulness Inventory, the Kentucky Inventory of Mindfulness Skills, and the Cognitive and Affective Mindfulness Scale. At the same time there is increasing scrutiny of mindfulness that goes beyond the initial positive efficacy studies resulting in several important questions being raised. These range from the absence of an operational definition of mindfulness as well as little evidence for the mechanisms of mindfulness that account for outcome changes for various psychopathology and medical conditions. Questions about the defining characteristics of mindfulness are also being raised such as the lack of differentiation between the features called attention and awareness and the interchangeable use of the two terms in modern descriptions of mindfulness. Such questions resonate with traditional practitioners of Buddhist contemplative psychology for whom attention signifies an every-changing factor of consciousness, while awareness refers to a stable and specific state of consciousness.

Tibetan medicine: a complementary science of optimal health.

Traditional medical systems are challenging because their theories and practices strike many conventionally trained physicians and researchers as incomprehensible. Should modern medicine dismiss them as unscientific, view them as sources of alternatives hidden in a matrix of superstition, or regard them as complementary sciences of medicine? We make the latter argument using the example of Tibetan medicine. Tibetan medicine is based on analytic models and methods that are rationally defined, internally coherent, and make testable predictions, meeting current definitions of "science." A ninth century synthesis of Indian, Chinese, Himalayan, and Greco-Persian traditions, Tibetan medicine is the most comprehensive form of Eurasian healthcare and the world's first integrative medicine. Incorporating rigorous systems of meditative self-healing and ascetic self-care from India, it includes a world-class paradigm of mind/body and preventive medicine. Adapting the therapeutic philosophy and contemplative science of Indian Buddhism to the quality of secular life and death, it features the world's most effective systems of positive and palliative healthcare. Based on qualitative theories and intersubjective methods, it involves predictions and therapies shown to be more accurate and effective than those of modern medicine in fields from physiology and pharmacology to neuroscience, mind/body medicine, and positive health. The possibility of complementary sciences follows from the latest view of science as a set of tools--instruments of social activity based on learned agreement in aims and methods--rather than as a monolith of absolute truth. Implications of this pluralistic outlook for medical research and practice are discussed.

Mind/Body psychological treatments for irritable bowel syndrome.

Currently, the goal of treatment for those with irritable bowel syndrome (IBS) is to improve the quality of life through a reduction in symptoms. While the majority of treatment approaches involve the use of traditional medicine, more and more patients seek out a non-drug approach to managing their symptoms. Current forms of non-drug psychologic or mind/body treatment for IBS include hypnotherapy, cognitive behavioral therapy and brief psychodynamic psychotherapy, all of which have been proven efficacious in clinical trials. We propose that incorporating the constructs of mindfulness and acceptance into a mind/body psychologic treatment of IBS may be of added benefit due to the focus on changing awareness and acceptance of one's own state which is a strong component of traditional and Eastern healing philosophies.