Effects of a online brief modified mindfulness-based stress reduction therapy for anxiety among Chinese adults: A randomized clinical trial.

The COVID-19 pandemic has exacerbated anxiety and related symptoms among the general population. In order to cope with the mental health burden, we developed an online brief modified mindfulness-based stress reduction (mMBSR) therapy. We performed a parallel-group randomized controlled trial to evaluate the efficacy of the mMBSR for adult anxiety with cognitive-behavioral therapy (CBT) as an active control. Participants were randomized to mMBSR, CBT or waitlist group. Those in the intervention arms performed each therapy for 6 sections in 3 weeks. Measurements were conducted at baseline, post-treatment and 6 months post-treatment by Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Patient Health Questionnaire-15, reverse scored Cohen Perceived Stress scale, Insomnia Severity Index, and Snaith-Hamilton Pleasure Scale. 150 participants with anxiety symptoms were randomized to mMBSR, CBT or waitlist group. Post intervention assessments showed that mMBSR improved the scores of all the six mental problem dimensions (anxiety, depression, somatization, stress, insomnia, and the experience of pleasure) significantly compared to the waitlist group. During 6-month post treatment assessment, the scores of all six mental problem dimensions in the mMBSR group still showed improvement compared to baseline and showed no significant difference with the CBT group. Our results provide positive evidence for the efficacy and feasibility of an online brief modified MBSR program to alleviate anxiety and related symptoms of individuals from the general population, and the therapeutic benefits of mMBSR persisted for up to six months. This low resource-consuming intervention could facilitate the challenges of supplying psychological health therapy to large scale of population.

The Psychological Effect of Internet-Based Mindfulness-Based Stress Reduction on the Survivors of Breast Cancer During the COVID-19.

Objective: To examine the efficacy and the role of engagement of an internet-based Mindfulness-based Stress Reduction (iMBSR) for survivors of breast cancer (BC) during the COVID-19 period from January to March in 2020 in China. Methods: 48 survivors of BC were divided into the absentees group and the iMBSR groups according to their attending to the standardized, group-based, 8-week iMBSR. Based on practice time, survivors of BC in the iMBSR were categorized into three subgroups: group 1 (<30 min/day), group 2 (30-60 min/day), and group 3 (>60 min/day). In addition, participants were classified as partial attendees (<4 sessions) and completers (more than 4 sessions) of the iMBSR groups. All participants were evaluated for symptoms of depression, anxiety and insomnia at baseline, mid-intervention, and post-intervention. Results: After an 8-week iMBSR practice, at mid-intervention and post-intervention, participants in iMBSR group had significant improvement in scores and reduction rates of depression, anxiety, and insomnia compared to absentees. Scores of depression and insomnia, reduction rates of depression at post-intervention, scores of anxiety, reduction rates of anxiety and insomnia at mid-intervention and post-intervention, had significant differences among subgroups of practice time. Daily practice time was positively related to reduction rates of depression, anxiety and insomnia at post-intervention in the iMBSR group. Conclusion: Internet-based MBSR showed efficacy in reducing psychological symptoms among survivors of BC. For survivors of BC, iMBSR practice has a potential dose-response efficacy, with a threshold of >30 min daily practice for most optimal symptoms reduction. Trial Registration: Registration number is [ChiCTR2100044309].

Patterns of posttraumatic stress disorder and posttraumatic growth among women after an earthquake: A latent profile analysis.

It is well known that women are more vulnerable than men to mental health problems following disasters. However, the patterns of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among women are unclear. This study was conducted to investigate the profiles of PTSD and PTG among women after an earthquake and determine the predictors of profile membership. A total of 1487 women (Mage = 40.66 years, SD = 10.39) completed questionnaires assessing PTSD, PTG, trauma exposure during an earthquake, trauma history, and demographic information. A three-step latent profile analysis was used. Five profiles were identified: mild PTSD/mild PTG (12.4% of the sample), moderate PTSD/moderate PTG (39.4%), high PTSD/moderate PTG (9.6%), mild PTSD/high PTG (17.5%) and high PTSD/high PTG (21.1%). Women who were older, had been injured, or felt horrible and those whose houses were severely damaged in the earthquake were more likely to be in profiles characterized by higher levels of PTSD and PTG, whereas women with lower education levels were more likely to be in profiles characterized by higher levels of PTSD but lower levels of PTG. The results of this study provide a foundation for providing psychological assistance for particular groups of women.

A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression.

BACKGROUND: This study aims to evaluate the effects of Group Cognitive Behavioral Therapy (GCBT) in treating major depression in Chinese women with breast cancer. METHODS: Sixty-two breast cancer patients diagnosed with major depression were randomly assigned to GCBT group (N = 31) or a waiting list control group provided with an educational booklet (N = 31). The primary outcome measure was the 17-Item Hamilton Depression Rating Scale (17-HAMD). The second outcome measures were Self-Rating Anxiety Scale, Functional Assessment of Cancer Therapy - Breast and Self-Esteem Scale (SES). Assessments were carried out at completion of the study and six-month afterwards. RESULTS: Patients in the GCBT group had a significant reduction in the 17-HAMD mean score by 9 points (p < 0.001), more than any reduction among patients in the control group from baseline to the end of therapy and a significant 7 points (p < 0.001) more reduction from baseline to six-month follow-up. GCBT also yielded significantly greater improvement than the control group with regard to quality of life (QoL; p < 0.01) and self-esteem (p < 0.05). No significant differences were found between groups on improving anxiety (p > 0.05). CONCLUSION: The results of this trial suggest that GCBT is effective for treating major depression, as well as for improving QoL and self-esteem in breast cancer patients. TRIAL REGISTRATION: Chictr.org ChiCTR-TRC-11001689.

Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers.

Although police officers are frequently exposed to potentially traumatic incidents, only a minority will develop chronic posttraumatic stress disorder (PTSD). Identifying and understanding protective factors could inform the development of preventive interventions; however, few studies have examined this. In the present prospective study, 233 police officers were assessed during academy training and again following 2 years of police service. Caucasian race, less previous trauma exposure, and less critical incident exposure during police service as well as greater sense of self-worth, beliefs of greater benevolence of the world, greater social support and better social adjustment, all assessed during academy training, were associated with lower PTSD symptoms after 2 years of service. Positive personality attributes assessed during training with the NEO Five-Factor Personality Inventory were not associated with lower PTSD symptoms. In a hierarchical linear regression model, only Caucasian race, lower critical incident exposure during police service, greater assumptions of benevolence of the world and better social adjustment during training remained predictive of lower PTSD symptoms after 2 years of police service. These results suggest that positive world assumptions and better social functioning during training may protect police officers from critical incident related PTSD.

A prospective study of predictors of depression symptoms in police.

Police work is one of the most stressful occupations. Previous research has indicated that work stress and trauma exposure may place individuals at heightened risk for the development of depression symptomatology. This prospective longitudinal study was designed to examine predictors of depression symptoms in police service. Participants comprised 119 healthy police recruits from an ongoing prospective study. They completed baseline measures of depression symptoms, childhood trauma exposure, neuroticism, and self-worth during academy training. Follow-up measures of depression symptoms, PTSD symptoms, critical incident exposure, negative life events, and routine work environment stress were assessed after 12 months of police service. Hierarchical linear regression analysis was conducted to examine predictors of current levels of depression symptoms, controlling for baseline depression symptoms and current PTSD symptoms. Greater childhood trauma exposure, lower self-worth during training, and greater perceived work stress in the first year of police service predicted greater depression symptoms at 12 months. Depression symptoms at 1 year of police service were partly independent from PTSD symptoms at 12 months. Greater childhood trauma exposure and lower self-worth during training may be important variables to screen as risk factors for duty-related depression. Strategies to reduce routine work environment stress have the potential to decrease duty-related depression in law enforcement.

Low expression of catecholamine-O-methyl-transferase gene in obsessive-compulsive disorder.

This study examined peripheral catecholamine-O-methyl-transferase (COMT) gene expression in obsessive-compulsive disorder (OCD) patients and healthy controls. Participants included 35 first episode OCD patients and 31 age- and sex-matched healthy controls. Relative COMT gene expression levels were examined by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) in peripheral blood of all the subjects. COMT gene expression levels, normalized by glyceraldehyde-3-phosphate dehydrogenase (GAPDH), were significantly decreased in the OCD group compared with healthy controls (F=6.244, p=0.015). OCD patients showed a 32% down-regulation. We also found lower COMT gene expression levels in female in comparison to male participants (F=5.366, p=0.024) in the sample as a whole. COMT gene expression down-regulation of male OCD patients relative to male controls is 38%, and that of female OCD patients relative to female controls is 27%. These results suggest that COMT gene expression down-regulation might play an important role in the development of OCD and that there may be gender differences in this alteration.

Ethnic differences in beliefs regarding Alzheimer disease among dementia family caregivers.

OBJECTIVE: The purpose of this study was to examine ethnic differences in female dementia family caregivers' knowledge, attitudes, and beliefs about Alzheimer disease (AD). METHODS: Baseline data were collected from 215 female caregivers before their participation in various psychoeducational intervention programs. Caregivers were questioned about the epidemiology, etiology, and treatment of AD. Logistic regressions and one-way analysis of variance were conducted to assess ethnic differences. RESULTS: Hispanic and Chinese caregivers were more likely to believe that AD is a normal part of aging and that AD can be diagnosed by a blood test than the white group. These beliefs about AD may delay help-seeking activities for these patients and their family caregivers. CONCLUSION: Increased public education about AD is needed in these communities. Results are discussed in terms of barriers to accessing information about AD and ways to improve public informational outreach activities, so that the intended audiences are reached more effectively.

Impact of in-home behavioral management versus telephone support to reduce depressive symptoms and perceived stress in Chinese caregivers: results of a pilot study.

OBJECTIVE: Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs). METHODS: Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms. RESULTS: CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments. CONCLUSION: This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.

Recruiting Chinese Americans for dementia caregiver intervention research: suggestions for success.

OBJECTIVE: The purpose of this study was to compare the relative effectiveness of three recruitment modalities for enrolling Chinese-American and white family caregivers into research studies to evaluate intervention strategies. METHODS: A total of 116 Chinese Americans and 134 whites were screened for eligibility to participate in one of two clinical intervention trials. Participants were recruited using: 1) media sources; 2) nonprofessional referral sources; or 3) professional referrals. Each participant was asked an open-ended question about how they became aware of the programs offered. RESULTS: A smaller proportion of Chinese Americans (39%) than whites (50%) who responded to recruiting strategies actually enrolled as subjects. There was a significant interaction between ethnicity and recruitment strategy. Chinese-American caregivers who were recruited by nonprofessional sources were less likely to enroll in the intervention studies than those who were recruited through media sources or professional referrals. Whites, on the other hand, were more likely to be recruited through nonprofessional sources than the other two. CONCLUSIONS: A consumer-oriented approach, which included direct face-to-face contact with key community leaders, generated the highest number of Chinese-American participants. Culture-specific factors such as trust-building with social service agencies, demonstrating genuine commitment to the well-being of the target community, and linguistic and ethnic matching between research staff and potential participants appear helpful to successful research recruitment in this rapidly increasing segment of dementia caregivers.