Mediation of effects of the level of response to alcohol and impulsivity 15 years later in 36-year-old men: Implications for prevention efforts.

BACKGROUND: Although the prevalence of alcohol use disorders (AUDs) has increased in older individuals in the recent decade, there are few programs to mitigate that increase. The current analyses evaluate the feasibility of applying to older drinkers elements of an approach to prevent heavier drinking in young adults by focusing on mediators of effects of two risk factors for alcohol problems, low levels of response to alcohol (low LRs) and higher impulsivity. METHODS: Data were extracted from the San Diego Prospective Study (SDPS). Structural Equation Models evaluated relationships among age 36 low LRs and higher impulsivity; age 46 perceived peer drinking, alcohol expectancies, and drinking to cope; and age 51 alcohol problems, even after controlling for age 36 alcohol problems. RESULTS: Relationships of age 36 low LRs to later alcohol problems was both direct and linked to age 46 heavy drinking peers. LR also operated indirectly through peer drinking to alcohol expectancies and drinking to cope. Age 36 impulsivity had no direct path to later alcohol problems and operated primarily through mediation by alcohol expectancies and via expectancies to drinking to cope. After controlling for age 36 alcohol problems, the low LR and impulsivity results remained robust. CONCLUSIONS: Programs for mitigating increases in alcohol problems in middle-age drinkers should consider identifying individuals with low LRs and/or higher impulsivity and implementing prevention approaches similar to a program used in young adults. The approach should emphasize some different mediators for older drinkers with low LRs and those with higher impulsivity.

Self-monitoring of a stress reduction technique using wrist-worn counters.

In a study of 59 veterans and healthcare workers, the reliability of a self-monitoring method used to track the frequency of a spiritually oriented stress reduction technique was assessed. During a 5-week program of silently repeating a mantram (a spiritual word or phrase) to lower stress and anger and improve spiritual well-being, portable wrist-worn counters were used to track daily mantram practice sessions. All outcomes significantly improved in the hypothesized direction. Mantram practice tracked by the counters was highly correlated (r = .84) with retrospective self-reports, indicating that such counters may be a reliable self-monitoring tool and could be used to measure a variety of other behavioral health quality indicators.

Relationship of frequent mantram repetition to emotional and spiritual well-being in healthcare workers.

BACKGROUND: Healthcare workers report high levels of stress in the workplace. To determine how to reduce stress, the authors examined the effectiveness of frequently repeating a mantram (a word with spiritual meaning) on emotional and spiritual well-being. METHODS: A pretest-posttest design was used to measure stress, state/trait anxiety and anger, quality of life, and spiritual well-being in a convenience sample (N=42) of hospital workers completing a mantram intervention program. RESULTS: Significant improvements were found in stress (p < .001), trait-anxiety (p = .002), trait-anger (p = .02), quality of life (p = .001), and spiritual well-being (p = .003). When examining the effects of mantram practice, trait-anxiety and religious and spiritual well-being were significant (p < .05). CONCLUSION: Improvements in emotional and spiritual well-being may be mediated by frequent mantram repetition.

Effects of spiritual mantram repetition on HIV outcomes: a randomized controlled trial.

We examined the efficacy of a psycho-spiritual intervention of mantram repetition--a word or phrase with spiritual associations repeated silently throughout the day--on psychological distress (intrusive thoughts, stress, anxiety, anger, depression), quality of life enjoyment and satisfaction, and existential spiritual well-being in HIV-infected adults. Using a 2-group by 4-time repeated measures design, 93 participants were randomly assigned to mantram (n = 46) or attention control group (n = 47). Over time, the mantram group improved significantly more than the control group in reducing trait-anger and increasing spiritual faith and spiritual connectedness. Actual mantram practice measured by wrist counters was inversely associated with non-HIV related intrusive thoughts and positively associated with quality of life, total existential spiritual well-being, meaning/peace, and spiritual faith. Intent-to-treat findings suggest that a mantram group intervention and actual mantram practice each make unique contributions for managing psychological distress and enhancing existential spiritual well-being in adults living with HIV/AIDS.

Efficacy of frequent mantram repetition on stress, quality of life, and spiritual well-being in veterans: a pilot study.

PURPOSE: Silent, frequent repetition of a mantram-a word or phrase with spiritual significance, sometimes called a Holy Name-is an ancient form of prayer that may reduce stress and related symptoms. The authors tested the feasibility and efficacy of a 5-week (90-min per week) intervention on mantram repetition in a sample of ambulatory veterans. METHOD: Aconvenience sample (N= 62) of outpatient veterans participated in the study by completing pre-and posttest self-report questionnaires on stress, anxiety, anger, quality of life, and spiritual well-being. Wrist-worn counters were provided to track mantram practice. FINDINGS: Mantram repetition significantly reduced symptoms of stress and anxiety and improved quality of life and spiritual well-being. CONCLUSION: Additional research using a larger sample size and control group is needed to further substantiate the benefits of this intervention. IMPLICATIONS: Frequent, silent mantram repetition is easily taught and could be used by nurses and patients for managing stress and increasing well-being.