Bridging the brain-mind divide in psychiatric education: The neuro-bio-psycho-social formulation.

Psychiatrists of the future need to have a strong working knowledge of the organ they work with-the brain. Neuropsychiatry is now more than a paradigm. Systems-level behavioral neuroscience, while still evolving, is mature enough to provide circuit-based foundation. Cellular and molecular neuroscience is starting to yield further mechanistic understanding. It is important to integrate such approaches into an evidence-based, bio-psycho-social formulation, with increasing implications for disease taxonomy, diagnosis and treatment.

Effect of a metacognitive training program of mentalist skills / Efecto de un programa de entrenamiento metacognitivo en habilidades mentalistas

Background: Recent researches in Theory of Mind (ToM) relate its development to the development of the metacognitive skills 'planning' 'regulation' and acquisition of 'predictive and causal reasoning.' These studies reveal the importance of metacognitive training in the development of mentalist skills. Method: In the present work, the effects of training were compared in 20 children, aged between 4 and 5 years. Results: Significant within-group differences in the skills of belief attribution and memory attribution were found and a tendency towards significance in the skills of behavior prediction. Significant between-group differences were found in belief attribution, prediction, and memory. Conclusions: Mentalist skills training improve attribution, prediction and memory skills in ToM tasks (AU)

Antecedentes: recientes investigaciones en Teoría de la Mente (ToM) relacionan su desarrollo con el desarrollo de habilidades metacognitivas de 'planificación', de 'regulación', así como con la adquisición del 'razonamiento predictivo y causal'. Dichos estudios señalan la importancia que tiene el entrenamiento metacognitivo en el desarrollo de habilidades mentalistas. Método: en el presente trabajo participaron 20 niños de 4 y 5 años con objeto de comparar los efectos del entrenamiento. Resultados: se han encontrado diferencias significativas «intragrupo» en habilidades de atribución de creencia, de memoria y tendencia a la significación en habilidades de predicción del comportamiento. Asimismo se han hallado diferencias significativas «intergrupo» en atribución de creencia, predicción y memoria. Conclusiones: el entrenamiento en habilidades mentalistas parece incrementar las habilidades de atribución, predicción y memoria en tareas de Teoría de la Mente (AU)

Medical and psychology students' knowledge of and attitudes towards mindfulness as a clinical intervention.

BACKGROUND: Mindfulness is a technique for training people to pay full attention and to fully accept the reality of what they are paying attention to. The clinical efficacy of mindfulness has been increasingly demonstrated during the last two decades. Very little research, however, has been undertaken on health professionals' and students of health professions' knowledge of and attitudes towards mindfulness. These may affect the current and future level of use of a technique that offers important clinical advantages. OBJECTIVES: We aimed to compare knowledge of and attitudes towards mindfulness of medical students without exposure to it in their training with psychology students without exposure and with medical students with exposure to mindfulness in their training. METHODS: A total of 91 medical students from Monash University, 49 medical students from Deakin University, and 31 psychology students from Deakin University were given a questionnaire that elicited quantitative and qualitative responses about level of knowledge of mindfulness and willingness to administer or recommend it to their future patients. RESULTS: Psychology students without exposure to mindfulness in their training have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure to it in their training. Medical students with exposure to mindfulness in their course have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure. Knowledge of mindfulness is positively correlated with students' willingness to use or recommend it. CONCLUSIONS: Possible implications of the findings of this study are that if future doctors are routinely instructed in mindfulness as a clinical intervention they may be more likely to form a more positive attitude towards it, that is more consistent with that of nonmedical health professions such as psychologists, and that they therefore may be more likely to administer it or refer its use. The inclusion of mindfulness exposure in medical courses, and possibly also in psychology courses, may help mindfulness fulfill its clinical potential, and increasingly benefit patients who are suffering from a range of clinical conditions.

Some useful insights for graduate students beginning their research in physiological psychology: anecdotes and attitudes.

This paper is based on my experiences in 40 years of research in behavioral neuroscience. It is aimed at giving help to beginning graduate students with advice for how to do their research.

Preparación psicofísica para el parto: seguridad y satisfacción a las gestantes / Psychophysical preparation for labor: safety and satisfaction for pregnant women

Fundamento: el trabajo de parto es un reto fisiológico y psicológico para las mujeres. El momento en que el parto se hace inminente puede ser de emociones conflictivas, el miedo y la aprehensión pueden coincidir con la excitación y la felicidad. Objetivo: determinar la seguridad y satisfacción de las gestantes al recibir el curso básico sobre la preparación psicofísica para el parto. Métodos: estudio descriptivo, longitudinal y prospectivo realizado en el Hogar Materno Área II, con el universo de 113 embarazadas ingresadas en el período de febrero 2008 a mayo 2009, las cuales recibieron el curso básico sobre preparación psicofísica para el parto. Se analizaron las variables: edad gestacional, paridad, conocimientos previos sobre psicoprofilaxis y conocimientos alcanzados después de finalizada las sesiones, grado de seguridad y satisfacción de las embarazadas durante la labor del parto. Resultados: predominó la edad gestacional de 29-35 semanas (48,6 por ciento), el nivel de escolaridad de pre-universitario (47,8 por ciento). Al iniciar el curso no tenía conocimientos el 68,5 por ciento; al finalizar el curso refirió haberse capacitado el 87,7 por ciento; después del parto, 96,4 por ciento se sienten seguras y satisfechas de haber recibido clases. Conclusiones: el curso de preparación psicofísica para el parto brindó seguridad y satisfacción a la gestante durante el embarazo y el parto(AU)

Background: labor is a physiological and psychological challenge for women. When delivery is imminent, conflicting emotions may appear: fear and apprehension can coincide with the excitement and happiness. Objective: to determine the safety and satisfaction levels of pregnant women after they receive the basic course on psycho-physical preparation for childbirth. Methods: a descriptive, longitudinal and prospective study was conducted in the Area II Maternity Home. It included the universe of 113 patients admitted from February 2008 to May 2009, which received the basic course on psycho-physical preparation for childbirth. The fallowing variables were analyzed: gestational age, parity, knowledge and expertise on psychoprofilaxis before and after the sessions and safety and satisfaction levels of pregnant women during labor and delivery. Results: Gestational age from 29 to 35 weeks (48, 6 percent) and high school academic degree (47,8 percent) predominated. Before the course was delivered, 68.5 percent of women had no previous knowledge on the topic. After the course 87, 7 percent of them referred to have been trained. After delivery, 96, 4 percent felt safe and satisfied to have received it. Conclusions: Psychophysical preparation for childbirth provided safety and satisfaction to the mother during pregnancy and childbirth(AU)

Histórias infantis: um recurso para a compreensão dos estados mentais / Children's storybooks: a resource to the understanding of mental states

Este estudo examinou uma amostra de 100 livros de histórias infantis nacionais para crianças pré-escolares de quatro a seis anos de idade quanto à ocorrência de termos/expressões referentes a estados mentais a partir de três eixos de análise: via palavras e expressões no texto; via figuras; e via presença de ironia e crença falsa na narrativa. A análise dos termos mentais foi realizada por um grupo de três avaliadores. Foi encontrado que 92 por cento dos livros analisados apresentavam termos denotando estados mentais, 12 por cento apresentavam ironia situacional, 11 por cento continham crença falsa e que as figuras representavam o estado mental expresso no texto. Os resultados sugerem que os livros infantis nacionais podem ser utilizados como recurso para promover o desenvolvimento sociocognitivo das crianças.(AU)

This study examined a sample of 100 national children's storybooks directed to pre-school children aged four to six years to identify words/utterances that denote mental states according to three views of analysis: via words and expressions in the text; via the pictures; and via presence of irony or false beliefs in the narrative. The analysis of mental words was realized by a group of tree people. It was found that 92 percent of the analyzed books contained internal state language, 12 percent contained situational irony, 11 percent contained false belief and the pictures represented the mental state concepts expressed in the text. The results point out that the national children's storybooks can be used as a resource to promote socio-cognitive development of clildren.(AU)

Histórias infantis: um recurso para a compreensão dos estados mentais / Children's storybooks: a resource to the understanding of mental states

Este estudo examinou uma amostra de 100 livros de histórias infantis nacionais para crianças pré-escolares de quatro a seis anos de idade quanto à ocorrência de termos/expressões referentes a estados mentais a partir de três eixos de análise: via palavras e expressões no texto; via figuras; e via presença de ironia e crença falsa na narrativa. A análise dos termos mentais foi realizada por um grupo de três avaliadores. Foi encontrado que 92 por cento dos livros analisados apresentavam termos denotando estados mentais, 12 por cento apresentavam ironia situacional, 11 por cento continham crença falsa e que as figuras representavam o estado mental expresso no texto. Os resultados sugerem que os livros infantis nacionais podem ser utilizados como recurso para promover o desenvolvimento sociocognitivo das crianças.

This study examined a sample of 100 national children's storybooks directed to pre-school children aged four to six years to identify words/utterances that denote mental states according to three views of analysis: via words and expressions in the text; via the pictures; and via presence of irony or false beliefs in the narrative. The analysis of mental words was realized by a group of tree people. It was found that 92 percent of the analyzed books contained internal state language, 12 percent contained situational irony, 11 percent contained false belief and the pictures represented the mental state concepts expressed in the text. The results point out that the national children's storybooks can be used as a resource to promote socio-cognitive development of clildren.

Integration of the biopsychosocial model: perspectives of medical students and residents.

PURPOSE: To examine residents' and medical students' attitudes toward the incorporation of psychosocial factors in diagnosis and treatment and to identify barriers to the integration of evidence-based, mind-body methods. METHOD: A random sample of third- and fourth-year medical students and residents was drawn from the Masterfiles of the American Medical Association. A total of 661 medical students and 550 residents completed a survey, assessing attitudes toward the role of psychosocial factors and the clinical application of behavioral/mind-body methods. RESULTS: The response rate was 40%. Whereas a majority of students and residents seem to recognize the need to address psychosocial factors, 30%-40% believe that addressing such factors leads to minimal or no improvements in outcomes. The majority of students and residents reports that their training in these areas was ineffective, yet relatively few indicate interest in receiving further training. Females are more likely to believe in the need to address psychosocial factors. Additional factors associated with greater openness to addressing psychosocial factors include (1) the perception that training in these areas was helpful, and (2) personal use of behavioral/mind-body methods to care for one's own health. CONCLUSIONS: There is a need for more comprehensive training during medical school and residency regarding both the role of psychosocial factors in health and the application of evidence-based, behavioral/mind-body methods. The current health care structure-particularly insufficient time and inadequate reimbursement for addressing psychosocial factors-may be undermining efforts to improve patient care through inconsistent or nonexistent application of the biopsychosocial model.

Effectiveness of CancerGuides a study of an integrative cancer care training program for health professionals.

PURPOSE: To determine how CancerGuidesâ, an integrative cancer care training program, would affect participants' perception of their professional skills, their mood, use of self care and mind-body modalities, and the acceptance of integrative cancer care at their institutions. STUDY DESIGN: Qualitative and quantitative measures were used during the training program and at 6-month follow-up. A focus group met before and after the training, and individual interviews of focus group participants were done at follow-up. METHODS: The week-long program consisted of lectures that provided information on integrating conventional and complementary therapies into individualized programs of cancer care. Small group sessions used mind-body techniques to allow participants to understand the dilemmas faced by cancer patients. A self-report survey was administered at the training program and at 6-month follow-up. The survey included questions on the personal and professional use of modalities and on participants' sense of how well they met the course objectives. Qualitative questions addressed self-care, changes in clinical practice, and the acceptance of integrative therapies by their institutions. The Profile of Mood States was administered before and after the training. RESULTS: Six months after the training, there was a significant increase in the use and/or recommendation of complementary and alternative medicine modalities in clinical practice and a significant increase in the personal practice of these modalities. Participants' perceived level of skill for all of the course objectives was significantly increased following the training and was maintained at 6-month follow-up. There were significant reductions in the Anger-Hostility and Tension-Anxiety subscale scores of the Profile of Mood States questionnaire. In response to qualitative questions, participants reported positive changes in patient care and in their clinical practices at 6-month follow-up. The subset of participants in the focus group interviews reported similar improvements. Thirty-five percent of those responding at follow-up reported an increase in acceptance of integrative cancer therapies at their institutions, and 77% reported making positive changes in self-care. CONCLUSIONS: Cancer-Guides provided training that allowed participants to enhance personal self-care, to interact more effectively with their patients, and to develop programs of integrative cancer care.

Psychophysiological training of operators in adaptive biofeedback cardiorhythm control.

A new individual computerized technique for psychophysiological training of operators before performing psychomotor activity on a computer model (psychomotor concentration and spatial orientation test) was developed. Qualitative criteria for the prediction of safe operator activity were formulated. Preliminary testing of operators' activity quality showed great dispersion of individual results: The amount of errors ranged from 0 to 56 and the rate of information processing varied from 1.01 up 3.56 bit/s. Subjects with initially identified respiratory sinus arrhythmia or synchronization caused by respiratory movements committed minimal recognition errors in initial stages at a high rate of information processing. The number of errors remained unchanged after the biofeedback cardio-training cycle, with the rate of information processing increasing noticeably. Subjects without inherent harmonics developed harmonics after sessions of cardiorhythm biofeedback control, and their operator activity quality improved significantly, making fewer mistakes and increasing the rate of information processing. Biofeedback control led not only to the restoration of respiratory sinus arrhythmia, a favorable diagnostic sign, as revealed by cardiorhythmograms, but also resulted in improvement of the quality of operator activity.

Psychophysiological training of operators in adaptive biofeedback cardiorhythm control

A new individual computerized technique for psychophysiological training of operators before performing psychomotor activity on a computer model (psychomotor concentration and spatial orientation test) was developed. Qualitative criteria for the prediction of safe operator activity were formulated. Preliminary testing of operators’ activity quality showed great dispersion of individual results: The amount of errors ranged from 0 to 56 and the rate of information processing varied from 1.01 up 3.56 bit/s. Subjects with initially identified respiratory sinus arrhythmia or synchronization caused by respiratory movements committed minimal recognition errors in initial stages at a high rate of information processing. The number of errors remained unchanged after the biofeedback cardio-training cycle, with the rate of information processing increasing noticeably. Subjects without inherent harmonics developed harmonics after sessions of cardiorhythm biofeedback control, and their operator activity quality improved significantly, making fewer mistakes and increasing the rate of information processing. Biofeedback control led not only to the restoration of respiratory sinus arrhythmia, a favorable diagnostic sign, as revealed by cardiorhythmograms, but also resulted in improvement of the quality of operator activity (AU)

Se desarrolló una nueva técnica informática para el entrenamiento psicofísiológico de operadores antes de llevar a cabo una actividad psicomotora en un modelo informático (test de concentración psicomotora y orientación espacial). Se formularon los criterios cualitativos para la predicción dela actividad segura de los operadores. Las pruebas preliminares de la calidad de la actividad de los operadores reveló una gran dispersión de los resultados individuales: la cantidad de errores oscilaba entre 0 y 56 y el porcentaje de información procesado variaba entre 1.01 y 3.56 bits/s. Los sujetos inicialmente identificados con una arritmia respiratoria sinusal o sincronización causada por los movimientos respiratorios cometían mínimos errores de reconocimiento en las fases iniciales, con una alta velocidad de procesamiento de la información. El número de errores no cambió después del ciclo de entrenamiento biofeedback cardíaco y la velocidad de procesamiento de la información aumentó considerablemente. Los sujetos sin armónicos inherentes desarrollaron armónicos después de las sesiones de control biofeedback del ritmo cardíaco, y su calidad de actividad mejoró significativamente, cometiendo menos errores y aumentando su velocidad de procesamiento de la información. El control biofeedback no sólo llevó a la restauración de la arritmia respiratoria sinusal, una señal diagnóstica favorable, como se observa en los cardiorritmogramas, sino que también mejoró la calidad de la actividad de los operadores (AU)

Effectiveness of a mind-body skills training program for healthcare professionals.

CONTEXT: Because of the increased use and benefits of mind-body therapies, it is important that healthcare professionals receive training in these modalities. OBJECTIVE: To determine whether healthcare professionals who attended the Center for Mind-Body Medicine's training program were incorporating mind-body skills into their professional or personal practices and whether they had a greater sense of life satisfaction. DESIGN: Repeated measures analysis. SETTING: Annual training programs were held in hotels and conference centers in the US. PARTICIPANTS: Four hundred fifty-one healthcare professionals attended the programs from 1998 to 2001. Two hundred fifty-nine completed the one-year follow-up survey, and 307 completed the well-being survey. INTERVENTION: The week-long program included didactic and experiential training in biofeedback, meditation, autogenics, imagery, and movement/exercise, as well as self-expression in small groups through drawings, written exercises, and genograms. MAIN OUTCOME MEASURES: Questionnaires on previous training and personal and professional use of mind-body approaches were administered before and one year after the program. The Existential Well-Being (EWB) scale also was administered before and immediately after the training. RESULTS: There was a significant increase in the personal use of mind-body skills and the number of participants who were teaching their clients to use all modalities and a significant decrease in the number of participants who were referring clients to others for training. Participants also had significantly higher life satisfaction scores after the program. CONCLUSION: This professional training program was effective in promoting the personal and professional use of mind-body skills and in enhancing the personal fulfillment of trainees.

A "creative tension": the Royal Army Medical Corps and the interplay of psychological and physiological in the rise of a psychoanalytic synthesis, 1915-22.

Secondary accounts of the impact of the First World War on psychological medicine have traditionally painted a picture of psychoanalysis as the preserve of a small number of pioneering individuals, led by William Rivers and marginalized by a Royal Army Medical Corps (RAMC) obsessed with discipline. This view ignores the climate of theoretical exchange promoted by the RAMC's concern with returning as many soldiers to the front line as possible. The RAMC approach provided new resources and a positive environment for the rise of a psycho-physical psychoanalytic synthesis, to build on the extensive work in this field in which RAMC officers were engaged from a very early stage in the war. William Rivers, despite recent popular acclaim, stood at the rearguard of this movement, in which the varied and important work of William Brown is often overlooked.

The relationship between theoretical memory psychology and art of memory: a historical analysis.

The split between the theoretical branch and the practice--oriented art of memory psychology has existed for centuries. Whereas the theory of memory involved creation of elaborate models to elucidate the structure and processes of memory, in contrast the art of memory embraced techniques to enhance memory performance. One might expect a close relationship between practice and theory. This is, however, not the case. Theorists and memory artists criticized, fought, or ignored each other, as is demonstrated by examples from the 16th to the 19th century.