Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament

SUMMARY OBJECTIVE: Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. METHODS: The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. RESULTS: Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. CONCLUSION: This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

Acupuncture for Attenuating Frontal Lobe α Band Asymmetry Induced by Anger: a pilot study.

Objectives: Previous studies have shown that anger can lead to frontal lobe α (8-13 Hz) band asymmetry (FAA) in electroencephalogram (EEG), in accordance with motivational direction. This pilot study aimed to investigate the impact of acupuncture on FAA elicited by anger. Methods: Thirty-four right-handed participants scoring above 75 points on the Novaco Anger Scale were included. Baseline EEG signals were recorded for eight minutes using a 32-channel cap under comfortable conditions. Anger was induced through a nine-minute sequence of Articulated Thoughts in Simulated Situations (ATSS) task. Following that, participants received acupuncture at GB20 and GB21 for 10 minutes. Fast Fourier transform was employed for frequency analysis, and repeated measure ANOVA was conducted for statistical analysis. Results: The results revealed that participants exhibited significantly higher FAA (p = 0.026), particularly in the left hemisphere, after the ATSS task sequence compared to the baseline. During acupuncture treatment, the greater left-sided FAA was significantly reduced (p = 0.027) and reversed. Upon the cessation of acupuncture, FAA returned to a value between the baseline and the anger-evoked stage (p = 0.046). Conclusion: The EEG results of this study revealed that anger stimulation induced an increase in left-sided FAA, which was effectively alleviated by acupuncture. This led to an immediate restoration of FAA asymmetry induced by anger. These findings suggest the potential of acupuncture as a treatment option for reducing FAA associated with anger.

Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies.

BACKGROUND: Overgeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and have previously been associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal cortices. Another study showed that remitted MDD patients were able to modulate this neural signature using functional magnetic resonance imaging (fMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown. METHOD: This single-blind pre-registered randomised controlled pilot trial probed a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (BA25) fMRI neurofeedback, targeting self-blaming emotions in people with insufficiently recovered MDD and early treatment-resistance (n = 43, n = 35 completers). Participants completed three weekly self-guided sessions to rebalance self-blaming biases. RESULTS: As predicted, neurofeedback led to a training-induced reduction in rSATL-BA25 connectivity for self-blame v. other-blame. Both interventions were safe and resulted in a 46% reduction on the Beck Depression Inventory-II, our primary outcome, with no group differences. Secondary analyses, however, revealed that patients without DSM-5-defined anxious distress showed a superior response to neurofeedback compared with the psychological intervention, and the opposite pattern in anxious MDD. As predicted, symptom remission was associated with increases in self-esteem and this correlated with the frequency with which participants employed the psychological strategies in daily life. CONCLUSIONS: These findings suggest that self-blame-rebalance neurofeedback may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. Simple self-guided strategies tackling self-blame were beneficial, but need to be compared against treatment-as-usual in further trials. https://doi.org/10.1186/ISRCTN10526888.

Relations of perceived injustice to psycho-spiritual outcomes in advanced lung and prostate cancer: Examining the role of acceptance and meaning making.

OBJECTIVE: Many advanced cancer patients struggle with anxiety, depressive symptoms, and anger toward God and illness-related stressors. Patients may perceive their illness as an injustice (i.e., appraise their illness as unfair, severe, and irreparable or blame others for their illness), which may be a risk factor for poor psychological and spiritual outcomes. This study examined relations between cancer-related perceived injustice and psycho-spiritual outcomes as well as potential mediators of these relationships. METHODS: Advanced lung (n = 102) and prostate (n = 99) cancer patients completed a one-time survey. Using path analyses, we examined a parallel mediation model including the direct effects of perceived injustice on psycho-spiritual outcomes (i.e., anxiety, depressive symptoms, anger about cancer, anger towards God) and the indirect effects of perceived injustice on psycho-spiritual outcomes through two parallel mediators: meaning making and acceptance of cancer. We then explored whether these relations differed by cancer type. RESULTS: Path analyses indicated that perceived injustice was directly and indirectly-through acceptance of cancer but not meaning making-associated with psycho-spiritual outcomes. Results did not differ between lung and prostate cancer patients. CONCLUSIONS: Advanced cancer patients with greater perceived injustice are at higher risk for poor psycho-spiritual outcomes. Acceptance of cancer, but not meaning making, explained relationships between cancer-related perceived injustice and psycho-spiritual outcomes. Findings support testing acceptance-based interventions to address perceived injustice in advanced cancer patients.

Effect of Practicing Meditation, Pranayama, and Yoga on the Mental Health of Female Undergraduate Medical Students: An Interventional Study.

Background Medical education is a rigorous formal education with a vast syllabus. Burnout and stresses are common among medical students and more prominent in females. Female medical students suffer from a higher level of stress than male medical students. For the improvement of physical and mental health, meditation, pranayama, and yoga are some of the ancient techniques. Meditation is a technique of focusing the mind on a target like an object, activity, or any thought. Pranayama is an ancient yogic practice focusing on the breath. Yoga is a combination of physical, mental, and spiritual dimensions that has the potential to improve mental and physical health. Objective This study aimed to find the effect of meditation, pranayama, and yoga on the improvement of mental health among female undergraduate medical students. Materials and methods This was an interventional study. A total of 105 females with a median age of 19 years (first quartile - third quartile: 18-20) first-year undergraduate medical students were recruited for this study. They were randomly allocated to control, meditation, pranayama, and yoga groups. The control group did not practice any form of meditation, pranayama, or yoga. The rest of the group practiced a designated program for their group, six days a week for 12 weeks. The anxiety, depression, anger, and sense of well-being were assessed by a validated self-administered questionnaire developed by the Defence Institute of Physiology and Allied Sciences, New Delhi before starting the study, at six weeks, and at 12 weeks after the intervention. Inter-group levels of anxiety, depression, anger, and well-being were compared by the Kruskal-Wallis test with Dunn's posthoc test. Intra-group parameters at baseline, at six weeks, and at 12 weeks after the intervention was tested by Friedman's test. Result The age (years) (p = 0.07), height (cm) (p = 0.98), and weight (kg) (p = 0.26) of participants among groups were similar. Anxiety, depression, and anger significantly decreased after six weeks in all three intervention groups. A further decrement was seen after 12 weeks of meditation, pranayama, and yoga. The maximum effect was seen in the yoga group. A sense of well-being was improved after practicing all types of interventions. However, meditation was found to increase a sense of well-being to the highest level compared to pranayama and yoga. Conclusion Introduction and sustainment of meditation, pranayama, and yoga programs for first-year female undergraduate medical students may help reduce anxiety, depression, and anger and promote a sense of well-being. Although a six-week program helps to improve mental health, a 12-week program helps in further improvement. A yoga program is more effective for improving the mental health of the students in comparison with pranayama and meditation.

Religious and Spiritual Implications in Functional Anger.

The topic of spirituality has been of interest for many years in the helping professions ( Matise et al., 2018; Pargament, 2011). Another level of interest is how spirituality may be connected to anger that is culturally informed ( Subarimaniam et al., 2020). This writing approaches the topic of functional anger as impacted by the religious and spiritual beliefs with case vignettes pertinent to students, pastoral counselors, nurses, social workers, psychologists, psychotherapists, and other helping professionals.

The Relationship Between Cannabis Use and Self-Reported Trait Anger in Treatment-Seeking Young People.

Objective: Trait anger has been shown to be predictive of emotion-focused coping and alcohol use. Yet, the connection between cannabis use and trait anger remains poorly characterized. The present study sought to investigate the relationship between cannabis use and self-reported trait anger in youth seeking substance use treatment. Methods: A retrospective chart review was conducted on youth (n=168) aged 14-26 presenting for an initial evaluation at an outpatient substance use treatment program. Patients self-reported trait anger score (TAS) and lifetime, recent, and Diagnostic and Statistics Manual-5th Edition diagnostic status of cannabis use were assessed. Clinician-coded psychiatric and substance use patterns were collected, along with urine carboxy delta-9-tetrahydrocannabinol (THC) concentration levels. Additional measures of anxiety, depression, and demographic variables were assessed. Results: Higher self-reported TAS were associated with cannabis use, cannabis use disorder (CUD), and more recent and frequent cannabis use. The presence of a CUD was independently associated with TAS after controlling for the presence of other substance use disorders and co-occurring depression and anxiety disorders. Higher urine THC concentration levels were associated with higher TAS. Conclusions: Findings support an association between heavy, chronic cannabis use and elevated self-reported trait anger at intake. There may be important neurological consequences of heavy, chronic cannabis use that impact anger regulation. It is also plausible that trait anger maybe a predisposing factor for elevated cannabis use. Better controlled prospective research is needed to help determine directionality. Treatment programs should target both cannabis use and anger regulation in youth.

Higher frequency of mantram repetition practice is associated with enhanced clinical benefits among United States Veterans with posttraumatic stress disorder.

Background: There is increasing support for the use of meditation-based treatments for US military Veterans with posttraumatic stress disorder (PTSD). The Mantram Repetition Program (MRP), which is a portable meditative practice that features mindful repetition of a sacred phrase, is associated with significant reductions in PTSD symptom severity. Although regular practice is emphasized in meditation-based interventions, associations between frequency of practice and clinical outcomes are often not reported. Objectives: This study will examine whether the frequency of mantram repetition is associated with greater improvements in clinical outcomes. Methods: Veterans with PTSD participating in MRP (N = 160; combined experimental groups from two randomized controlled trials). Participants completed pre- and post-treatment self-report measures of anger and well-being and a clinician-administered interview of PTSD severity (CAPS-IV-TR). Veterans also reported average daily mantram repetition practice at post-treatment. We conducted a series of hierarchal multiple regression analyses. Results: When controlling for race/ethnicity and pre-treatment severity, higher frequency of mantram repetition practice was associated with significantly greater improvements (small effect sizes) in PTSD symptom severity (F(3,128) = 6.60, p < .001, ß = .21, p = .007), trait anger (F(3,128) = 31.23, p < .001, ß = .25, p < .001), state anger (F(3,110) = 17.62, p < .001, ß = .16, p = .04), mental health well-being (F(3,128) = 28.38, p < .001, ß = .14, p = .04), and spiritual well-being (F(3,127) = 13.15, p < .001, ß = .23, p = .003), but not physical health well-being. Conclusions: Higher frequency of mantram repetition practice appears to have beneficial effects on clinical outcomes for Veterans with PTSD. Strategies that promote skills practice may be an important target for improving clinical outcomes for meditation-based interventions. HIGHLIGHTS: Higher frequency of meditation practice during Mantram Repetition Program was associated with greater reductions in PTSD symptoms and anger as well as improvements in well-being.Strategies to promote at-home meditation practice may optimize the benefits of MRP.

The Applicability of Virtual Reality-Based Training for Controlling Anger in Aggressive Individuals.

Because a failure of anger control leads to emotional and social problems, appropriate anger management may be important for social well-being. Virtual reality (VR) may potentially be effectively utilized in anger management, and this study aimed to verify the applicability of the VR-based anger control training program. The data obtained by having 60 young male participants divided into 2 groups, the high aggression group and the low aggression group, based on their Aggression Questionnaire scores to execute this program were analyzed. The program consisted of "Anger Exposure Training" for provoking anger and facilitating anger control and "Mindfulness Training" for providing the meditation experience for controlling anger. The anger scores and comfort scores obtained from these tasks, respectively, were analyzed for differences between the groups and between the experimental conditions. The anger regulation and comfort enhancement rates were analyzed for correlations with psychological variables. In Anger Exposure Training, the anger scores in angry expression were reduced in managed expression of anger in both groups. In Mindfulness Training, meditation increased comfort score as well in both groups, and the comfort enhancement rates were negatively correlated with the levels of self-differentiation and open communication with mother only in the high aggression group. These results indicate that the VR environments can provide an effective means of trainings for managing anger. Therefore, further research on the effectiveness of the VR-based anger control training program is worthy conducting in individuals who express excessive aggression.

A Comparison Between the Relaxation/Meditation/Mindfulness Tracker t Inventory and the Freiburg Mindfulness Inventory for Predicting General Health, Anxiety, and Anger in Adult General Population.

Introduction: An individual's level of mindfulness can predict his/her level of general health, anxiety, and anger. If we have a valuable tool for measuring mindfulness, we can predict such factors more concisely. Therefore, the aim of this study was to compare a narrowband and a broadband mindfulness scale in predicting the level of general health, anxiety, and anger in a general population. Materials and Methods: This was a cross-sectional study on an Iranian general population (all citizens living in Kerman) from September 22, 2020 to April 14, 2021. The convenience sampling method was used. Data were collated via electronic and paper forms of the Relaxation/Meditation/Mindfulness Tracker t-Persian version (RMMt-P), the Freiburg Mindfulness Inventory- Short-Form-Persian version (FMI-P), the General Health Questionnaire, the trait anxiety section of the State-Trait Anxiety Inventory, and the trait anger section of the State-Trait Anger Expression Inventory-2. Results: The FMI-P predicted 0.05% of GHQ variance while the first and third levels of RMMt-P predicted 0.145%. The FMI-P predicted 0.19% of anxiety variance, while the first and third levels of RMMt-P predicted 0.195%. The FMI-P predicted 0.0% of anger variance, while the first, second, and third levels of RMMt-P predicted 0.08%. RMMt-P Level 1 was a better predictor of general health, anger, and anxiety. Conclusion: The current study found that the RMMt-P was a better predictor of general health and anger than the FMI-P. These findings suggest that the type of questionnaire used in the study of mindfulness is important, but more research is needed to determine the extent of these relationships.

Interpersonal mindfulness and forgiveness: Examining the mediating roles of anger rumination and state anger.

Measuring mindfulness without accounting for specific contexts may lead to controversial results. This study attempted to examine whether the newly proposed construct of interpersonal mindfulness, mindfulness as it happens within the interpersonal context, was connected to forgiveness and the mechanisms behind this connection. Data were collected from 312 participants using measures of interpersonal mindfulness, trait mindfulness, anger rumination, state anger, self-reported forgiveness, and forgiving behavior. Results showed that interpersonal mindfulness was significantly associated with both self-reported forgiveness and forgiving behavior even while accounting for trait mindfulness. Mediation analysis revealed that anger rumination and state anger could mediate this link separately and sequentially, but only when trait mindfulness was uncontrolled. When controlling for trait mindfulness, the mediating role of state anger remained significant, but neither anger rumination nor the serial combination did. An alternative model was also supported, showing that after controlling for interpersonal mindfulness, trait mindfulness was indirectly associated with forgiveness through anger rumination and the serial mediating effect of anger rumination and state anger, but not state anger. These findings suggest that interpersonal mindfulness is more suitable for predicting interpersonal forgiveness than trait mindfulness. State anger may operate as a proximal mechanism in explaining how mindfulness relates to interpersonal forgiveness, whereas anger rumination may operate at a more distal level.

The Effects of Heart Rate Variability (HRV) Biofeedback on HRV Reactivity and Recovery During and After Anger Recall Task for Patients with Coronary Artery Disease.

Patients with coronary artery disease (CAD) often experience anger events before cardiovascular events. Anger is a psychological risk factor and causes underlying psychophysiological mechanisms to lose balance of the autonomic nervous system (ANS). The heart rate variability (HRV) was the common index for ANS regulation. It has been confirmed that heart rate variability biofeedback (HRV-BF) restored ANS balance in patients with CAD during the resting state. However, the effects of HRV-BF during and after the anger event remain unknown. This study aimed to examine the effects of HRV-BF on ANS reactivity and recovery during the anger recall task in patients with CAD. This study was a randomized control trial with a wait-list control group design, with forty patients in the HRV-BF group (for six sessions) and 44 patients in the control group. All patients received five stages of an anger recall task, including baseline, neutral recall task, neutral recovery, anger recall task, and anger recovery. HRV reactivity in the HRV-BF group at the post-test was lower than that in the control group. HRV recovery at the post-test in the HRV-BF group was higher than that in the control group. The HRV-BF reduced ANS reactivity during anger events and increased ANS recovery after anger events for CAD patients. The possible mechanisms of HRV-BF may increase total HRV, ANS regulation, and baroreflex activation at anger events for patients with CAD, and may be a suitable program for cardiac rehabilitation.

Does mindfulness reduce trolling? The relationship between trait mindfulness and online trolling: The mediating role of anger rumination and the moderating role of online disinhibition.

BACKGROUND: Online trolling is a highly prevalent online antisocial behaviour that has recently received increasing attention because of its potentially destructive consequences. The current study aimed to examine whether trait mindfulness was negatively related to online trolling and whether anger rumination mediated this relationship. We further examined whether online disinhibition moderated the direct and indirect relation between trait mindfulness and online trolling. METHODS: A total of 1303 Chinese college students completed the measurements of trait mindfulness, anger rumination, online disinhibition, and online trolling. Moderated mediation analysis was performed to examine the relationships between these variables. RESULTS: After controlling for sex, the results showed that trait mindfulness was negatively related to online trolling and that this relationship was partially mediated by anger rumination. Moreover, the effect of anger rumination on online trolling was strengthened when online disinhibition was high. LIMITATIONS: This study is a cross-sectional study, and causal inferences cannot be drawn. CONCLUSIONS: Individuals with trait mindfulness are less likely to ruminate anger and further express less online trolling. Online disinhibition serves as a risk factor for online trolling. Interventions targeting trait mindfulness, anger rumination, and online disinhibition might aid prevention strategies.

Anti-anger Effects of Herbal Medicine: A Mini-Review of Rat Studies.

OBJECTIVE: To analyze the available data on the anti-anger effects of herbal medicines (HMs) as well as their underlying mechanisms in rat models. METHODS: From 6 electronic databases [PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Oriental Medicine Advanced Searching Integrated System (OASIS), and Research Information Sharing Service (RISS)], relevant animal experiments were searched by using "anger," "rats," and "animal" as search keywords. The last search was conducted on November 22, 2019, and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered. RESULTS: A total of 24 studies with 16 kinds of HMs were included. Most studies have used the "tail irritating method" and "social isolation and resident intruder" method to establish anger models. According to the included studies, the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology (Bupleuri Radix, Paeoniae Radix Alba, and Glycyrrhizae Radix), regulation of sex hormones (Bupleuri Radix, Cyperi Rhizoma, and Paeoniae Radix Alba), regulation of neurotransmitters (Cyperi Rhizoma), regulation of anger-related genes (Bupleuri Radix, Glycyrrhizae Radix, and Paeoniae Radix Alba), and other effects. Overall, Liver (Gan) qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used. CONCLUSIONS: This review found the frequent methods to establish an anger model, and major mechanisms of anti-anger effects of HMs. Interestingly, some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM. These findings provide insight into the role and relevance of HMs in the field of anger management.

Anti-anger Effects of Herbal Medicine: A Mini-Review of Rat Studies / 中国结合医学杂志

OBJECTIVE@#To analyze the available data on the anti-anger effects of herbal medicines (HMs) as well as their underlying mechanisms in rat models.@*METHODS@#From 6 electronic databases [PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Oriental Medicine Advanced Searching Integrated System (OASIS), and Research Information Sharing Service (RISS)], relevant animal experiments were searched by using "anger," "rats," and "animal" as search keywords. The last search was conducted on November 22, 2019, and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered.@*RESULTS@#A total of 24 studies with 16 kinds of HMs were included. Most studies have used the "tail irritating method" and "social isolation and resident intruder" method to establish anger models. According to the included studies, the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology (Bupleuri Radix, Paeoniae Radix Alba, and Glycyrrhizae Radix), regulation of sex hormones (Bupleuri Radix, Cyperi Rhizoma, and Paeoniae Radix Alba), regulation of neurotransmitters (Cyperi Rhizoma), regulation of anger-related genes (Bupleuri Radix, Glycyrrhizae Radix, and Paeoniae Radix Alba), and other effects. Overall, Liver (Gan) qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used.@*CONCLUSIONS@#This review found the frequent methods to establish an anger model, and major mechanisms of anti-anger effects of HMs. Interestingly, some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM. These findings provide insight into the role and relevance of HMs in the field of anger management.

Anxiety, anger, and mindfulness as predictors of general health in the general population during COVID-19 outbreak: A survey in southeast Iran.

Communities have been exposed to the complications and problems caused by COVID-19 disease, which has had various and complex effects on general health. The aim of this study was to investigate the relationship between anxiety, anger, mindfulness, and general health in the general population during the COVID-19 outbreak in Iran. This cross-sectional study was performed on 456 participants from September 2020 to April 2021. For data collection, Demographic Characteristics Form, General Health Questionnaire, Freiburg Mindfulness Inventory-Short Form, The trait anxiety section of the State-Trait Anxiety Inventory, The State-Trait Anger Expression Inventory-2 were used. General health was positively correlated with anxiety and anger and negatively correlated with mindfulness. Anxiety was positively correlated with anger and negatively correlated with mindfulness. No significant correlation was found between anger and mindfulness. Based on the multiple regression model, anxiety, anger and a family member infected with COVID-19 were the predictors of general health (p < 0.001). Given that anxiety, anger, and family members infected with COVID-19 are all predictors of public health, it is suggested that psychological programs and interventions be designed to reduce anxiety and anger, as well as to support family members infected with COVID-19, to promote general health.

Acupuncture for Psychosomatic Symptoms of Hwa-byung, an Anger Syndrome: A Feasibility Randomized Controlled Trial.

Objectives: Emerging studies found the potential effects of acupuncture for treating chronic pain and mental disorders, namely, depressive and anxiety disorders. Acupuncture is widely used for treating culture-related anger syndrome, Hwa-byung. This pilot trial aimed to investigate the feasibility of a clinical trial testing acupuncture for the psychosomatic symptoms of Hwa-byung. Methods: A total of 26 patients with Hwa-byung planned to be randomly assigned to the acupuncture or sham acupuncture groups. About 10 treatment sessions were applied over 4 weeks. The 100-mm visual analog scale was used to measure the six major Hwa-byung symptoms: stuffiness in the chest, heat sensations, pushing-up in the chest, feeling a mass in the throat, feelings of unfairness, and hard feelings. The criteria for assessing the success of this pilot trial were defined as improvement in three or more of the six Hwa-byung symptoms after treatment, with an effect size >0.2. Results: A total of 15 patients were finally included and randomly assigned to the acupuncture group (n = 7) or the sham acupuncture group (n = 8). After 10 treatment sessions, the Cohen's d effect sizes for acupuncture compared to sham acupuncture were >0.2 for each one of the six major Hwa-byung symptoms, which met our a priori criteria for success. Also, the effect size for the somatic symptoms of "stuffiness in the chest" was 0.81 (95% CI -0.40, 2.20), referring to a large effect size. Conclusions: Our results suggest that acupuncture treatment would be regarded as an acceptable intervention for a full-scale study of psychosomatic symptoms in patients with Hwa-byung. Trial Registration: cris.nih.go.kr, identifier: KCT0001732.

Short-Term Effects of Forest Therapy on Mood States: A Pilot Study.

Immersion in forest environments was shown to produce beneficial effects to human health, in particular psychophysical relaxation, leading to its growing recognition as a form of integrative medicine. However, limited evidence exists about the statistical significance of the effects and their association with external and environmental variables and personal characteristics. This experimental study aimed to substantiate the very concept of forest therapy by means of the analysis of the significance of its effects on the mood states of anxiety, depression, anger and confusion. Seven forest therapy sessions were performed in remote areas and a control one in an urban park, with participants allowed to attend only one session, resulting in 162 psychological self-assessment questionnaires administered before and after each session. Meteorological comfort, the concentration of volatile organic compounds in the forest atmosphere and environmental coherence were identified as likely important external and environmental variables. Under certain conditions, forest therapy sessions performed in remote sites were shown to outperform the control session, at least for anxiety, anger and confusion. A quantitative analysis of the association of the outcomes with personal sociodemographic characteristics revealed that only sporting habits and age were significantly associated with the outcomes for certain psychological domains.

Development and validation of Yoga Module for Anger Management in adolescents.

BACKGROUND: Development of anger management programs and in particular, yoga module for anger management has not been well researched. Being a complex emotion, anger poses serious challenges in developing a comprehensive anger management program. While various theories of anger are dealt in modern psychology, several anger management techniques are set forth in Indian traditional texts. Yoga, which is considered as a holistic and integrated approach is explored in this study to develop and validate a school-based yoga program for anger management in adolescence. MATERIALS AND METHODS: Integrated Approach to Yoga Therapy (IAYT) principles and literary review formed the basis for deriving the concepts of anger management. The methodology includes construction of the yoga module, validation of the module by 22 experts followed by a pilot non-randomised control study (n-50) to assess feasibility and initial effectiveness. Content Validity Ratio (CVR) and paired t-test were employed to analyse the experts' rating and pilot-study data respectively. RESULTS: Emergence of IAYT based yoga program for anger management. Based on CVR ratio, 16 out of 18 yogic techniques qualified for the final module. The pilot study revealed viability of the module and its recognition as an anger management program. Significant reduction of anger scores in yoga group substantiates initial effectiveness of the module. CONCLUSION: The developed and validated yoga module for anger management is recognised as a well-accepted and effective yoga program for anger management in adolescents.

Regulating emotion following severe traumatic brain injury: a randomized controlled trial of heart-rate variability biofeedback training.

BACKGROUND: While difficulties regulating emotions are almost ubiquitous after traumatic brain injury (TBI), remediation techniques are limited. Heart-rate variability (HRV) is a physiological measure of emotion regulation and can be modified using biofeedback training. The aim of the current study was to evaluate the efficacy of repeated biofeedback training for improving emotion regulation difficulties following TBI. DESIGN: Fifty adults with severe TBI were allocated to either biofeedback or waitlist conditions. Treatment consisted of six biofeedback sessions whereby participants were taught to breathe at their resonant frequency. Outcomes included changes in physiological and subjective reactivity to anger-induction, emotional well-being, and physiology at rest, together with symptoms of psychological distress and sleep disturbances (ACTRN12618002031246). RESULTS: While biofeedback led to reduced skin conductance, it did not affect any other objective or subjective response to the mood induction procedure. Biofeedback led to fewer sleep disturbances, and reduced negative mood valence and depression during follow-up. CONCLUSIONS: HRV biofeedback training is a feasible technique following TBI that transfers to improved symptoms of general emotional well-being, psychological distress, and sleep. Biofeedback does not transfer to a laboratory-based emotional provocation task. HRV biofeedback training may represent a novel adjunct for generalized emotional difficulties following injury.